CARE HOMES FOR OLDER PEOPLE
Newfield Lodge Rest Home Newfield Lodge 93-99 St Andrews Road South St Annes Lancashire FY8 1PU Lead Inspector
Mrs Lillian McMullen Unannounced Inspection 17th October 2005 11:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Newfield Lodge Rest Home Address Newfield Lodge 93-99 St Andrews Road South St Annes Lancashire FY8 1PU 01253 721322 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Lakeview Rest Homes Ltd Mr Nicholas Jay Wood Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service is registered to accommodate a maximum of 32 service users in the category OP (older persons 65 and over) 17th October 2005 Date of last inspection Brief Description of the Service: Newfield Lodge is a care home providing personal care and accommodation for up to 32 older people who do not require nursing care and enjoys high occupancy levels. The home is jointly owned by the experienced provider of a small group of homes in the local area and her son who provides day-to-day management responsibility. Newfield Lodge is located in close proximity to the centre of St Annes and is within easy reach of community services and resources. Newfield Lodge is arranged over three floors and provides individual, en-suite bedroom accommodation for all service users that is well maintained and furnished to a high standard. In addition, a communal bathroom provides a medic bath and walk-in shower facility for ease of access in respect of service users with mobility difficulties. A passenger lift is also provided to enable ease of access to all areas of the building. Although the home is not provided with a garden area, a large roof garden is provided with garden tables and chairs that can be accessed from a main corridor and small seating areas are available to the front and rear of the building. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted over a period of five hours The Inspector spoke to four staff members, six residents, one relative and the registered manager. Part of the inspection was spent on looking at care documentation and examination of the environmental standards. What the service does well:
This is a care home where residents are well looked after. There is a stable staff group and no staff vacancies have been experienced for a number of months, the staff team work well together and show a good understanding of the needs of the people living at the home. Those residents spoken to all commented favourably about the care they receive. One resident said, “The staff are always cheerful and will do anything for you”. Observation of the staff team revealed that positive relationships have developed between the residents and the staff, residents appeared comfortable and there was lots of friendly chat taking place. The staff was seen responding to the residents needs appropriately and all tasks of a personal nature were carried out in a sensitive and respectful way. Meals are varied with an alternative available if required. All residents spoken to said that the standard of food was good. Special diets are catered for and all special occasions are celebrated. The relative of one resident who has recently celebrated his 100th birthday said, “the cook had excelled herself and provided a excellent buffet”. The registered manager always conducts a pre admission assessment and visits prospective residents and their relatives prior to the residents being admitted into the home. The physical standards are good, with tasteful furnishings and decoration throughout. All bedrooms are spacious and have full bathroom en suite facilities. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 There is a comprehensive assessment procedure in place, which ensures the needs of the residents are met. EVIDENCE: Residents are only admitted to Newfield Lodge following a pre admission assessment of current strengths and needs by the home’s manager. The records of three residents were examined all had good pre admission information and a full assessment. The information was comprehensive and included detail of specialist needs. To supplement the home’s assessment there was also evidence of other professional assessments being carried out in particular hospital discharge information. All prospective residents and their relatives are invited to visit the home prior to admission in order to view the facilities and meet the residents and staff.
Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 9 One resident spoken to confirmed that the manager had visited her in her own home prior to coming to live at Newfield Lodge. She recalled the manager asking her what her needs were and how she spent her day. She said, “that I made my decision to come that day and I have been here now 2 years and have no regrets what so ever, I have my own room and I was able to bring my budgies with me, every one is well looked after”. People are not admitted to Newfield Lodge solely for intermediate care. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, and 10 The care planning process ensures the assessed needs of the residents are met. EVIDENCE: Individual records are kept for each resident, with a plan of care setting out in detail the action that needed to be taken to ensure that all aspects of health, personal and social care needs of the residents are met. Residents spoken to were aware that they had a care plan and confirmed that they were involved in the care planning and review process. One resident said that she had discussed and signed her care plan with the staff the day prior to the inspection. Upon examination of one care plan it was noted that whilst a review had taken place information supplied by the hospital had not been included onto the care plan. The registered manager was asked to ensure that all relevant information is included in the care plan. Care plans are reviewed on a monthly basis and risk assessments accompany the care plan, however the risk assessments had not been reviewed with the care plan and the registered manager was asked to ensure that all risk assessments are reviewed at least on a monthly basis.
Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 11 Daily diary sheets are maintained and significant events had been recorded, these entries provided good evidence in relation to meeting the health care needs of each resident. The inspector advised that entries should also be made in relation to the wellbeing and daily living pattern of the individual resident to ensure that a complete profile of each resident is maintained. Staff spoken to was aware of the needs of the residents and the level of care required. During the inspection the Inspector observed the caring approach of all the staff towards the residents and was able to confirm that the practices in the home ensured that residents were treated with respect and their right to privacy was upheld. The requirements and recommendations made by the Commissions pharmacy inspector during the last inspection have been acted upon which has resulted in improvements to the home’s medication systems. All prescriptions are now viewed prior to being dispensed and all medications supplied, is now recorded. All records examined were seen to be up to date and correctly completed. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Meals are well prepared, nutritious and varied to meet the tastes and preferences of the residents. An activity programme is in place. EVIDENCE: From observation and discussion with the cook evidence was found to confirm that the meals served were nutritionally balanced with a varied menu provided. The cook confirmed that she has no budgetary constraints and that what ever she orders arrives without question from the registered manager, it was evident from this discussion that a consistently good standard is maintained. The inspector noted good food stocks with plenty of fresh produce. There was a visitor in the home, who spoke to the inspector and confirmed “that she can visit at anytime and that she is always made to feel welcome and is always offered refreshments” she also commented” that the cook was excellent and knows exactly what her father likes to eat. A number of residents were spoken to and all confirmed that they are free to come and go as they please, one resident said, “that she goes out on a regular basis with her daughter and that as long as she lets the staff know that she is leaving the building there are no restrictions imposed”.
Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 13 An activity programme is in place, which includes a trips out and entertainers coming into the home. In addition staff spend time in an afternoon engaging residents in games such as skittles, bingo, memory sessions and sing a longs. At the time of the inspection a member of staff was manicuring residents nails, both the staff member and the residents confirmed that this activity is a regular occurrence and usually occurs two or three times a week. A record of residents who participate in social activities is maintained in ‘list’ form. For the purpose of monitoring the resident’s wellbeing and daily living pattern, the inspector advised that information regarding participation in social activities and residents going out including church visits should be recorded on the resident’s daily notes. Residents confirmed that it was their personal choice weather they participated or not. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The planned maintenance and renewal programme for the redecoration and refurbishment of the home ensures that residents live in a comfortable and homely environment. EVIDENCE: Newfield Lodge is decorated and furnished to a good standard, with the decoration and furnishings being tastefully chosen. All, bedrooms are single with full bathroom en suite facilities. All residents stated they were very happy with the accommodation and confirmed that they are able to bring with them items of a personal nature so they can feel at home and create a sense of belonging. The inspector observed a number of bedrooms and found them to be spacious and personalised, one gentleman who was occupying his room at the time of the inspector was happy to show his bedroom off, he stated “I spend a lot of time in my room and I have everything I need around me, Nick (registered manager) has fixed my video and my internet access I don’t want or need anything else”.
Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 16 Maintenance personnel are employed and at the time of the inspection they were busy making minor improvements to the dining room. The home operates an “All eyes open” policy all staff are requested to note any minor works required in the maintenance book, which is then acted upon on a daily basis by the maintenance men. The home is clean and free from offensive odours. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed at this inspection. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 4 X X X X X X 4 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 23 Requirement Care plans must reflect the assessed needs do the individual resident. Timescale for action 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP7 Good Practice Recommendations Daily diary notes should include full details in relation to the wellbeing and daily living pattern of the residents. Risk assessments that form part of the care plan should be reviewed on at least a monthly basis. Newfield Lodge Rest Home DS0000064313.V258050.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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