Inspection on 01/03/07 for Oaklands

This inspection was carried out on 1st March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Oaklands 28/01/08

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Scole Lodge Norwich Road Scole Diss Norfolk IP21 4EE Lead Inspector Hilary Shephard Unannounced Inspection 1st March 2007 09:55 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 Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 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. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Scole Lodge Address Norwich Road Scole Diss Norfolk IP21 4EE 01379 740646 01379 740479 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) Regal Healthcare Properties Ltd Position Vacant Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1 Twenty-eight (28) Older People may be accommodated. Date of last inspection 12th July 2006 Brief Description of the Service: Scole Lodge is a large detached building situated just outside the village of Scole. It is set in eighteen acres of grounds with mature gardens and meadowland. Bedrooms are on the ground and first floors and consist of two double and twenty-four single bedrooms. Nineteen of the single rooms and both the double rooms have en-suite facilities. The home has a variety of communal rooms for the residents use. A shaft lift & a wheelchair lift are provided to aid residents to the first floor, which is on three levels. The home informed CSCI of its charges in November 06 and charges residents from £338 to £500 per week for care provision. Residents are expected to pay extra for hairdressing, chiropody, optician, dentist, newspapers and toiletries. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care services are judged against outcome groups, which assess how well a provider delivers care outcomes for people using the service. The key inspection of this service has been carried out using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgments for each outcome group. A total of 4 requirements and 4 recommendations were made as a result of this inspection. Since the last key inspection carried out January 2006, there has been a change of provider. The home was sold in June 06 and is now owned by Regal Healthcare Properties Limited. A visit was made to the home in July 2006 with the intention of carrying out a full key inspection. As the providers had only just taken over the home, that visit was made into a random inspection and focussed on the requirements made at the previous visit in January 2006 under the previous provider. Following a response from the provider to the draft inspection report, a minor amendment has been made regarding the management outcomes for people who use the service. What the service does well: Residents enjoy good home cooked food made from fresh ingredients. Residents enjoy freedom and independence whilst living in the home supported by care staff as needed. Residents said they felt well cared for and looked well cared for. Medicines are safely managed except for recording medicines carried forward from previous stock. Residents are made aware of who to take their concerns to and residents spoken with said they had no complaints and were happy in the home. The home is clean, pleasant smelling, warm, comfortable and provides a homely atmosphere for residents. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 6 Sufficient numbers of qualified and trained staff are provided and competently meet the residents’ whole range of care needs. Residents say they are well looked after and relatives say the home is good. Staff were observed to treat residents with kindness and respect. The home is managed safely and the manager makes sure all safety checks are regularly completed. One area of the home needs improvement to ensure residents are not at risk from injury. What has improved since the last inspection? What they could do better: Care records need to contain more detailed information about residents whole range of care needs to ensure they have been properly assessed and are being met. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 7 Medication that is carried forward from previous stocks should be recorded as such and care must be taken when booking medication in to ensure the dispensing pharmacy has dispensed all medication correctly. 33 of care staff employed are qualified to NVQ level 2 or 3 and this needs to increase to at least 50 . Access to the stairs (near room 27) from the first floor needs to be made safe as currently the door to the stairs opens out directly onto the stairs creating a potentially dangerous area. The garden needs landscaping and improving and the small courtyard near the dining room needs to be made safer before residents can access it. The bathrooms need to be made warmer and more homely as currently a wall mounted electric fan heater provides the only heat. The small cloakroom style sinks in the ensuite provision need to be replaced so as to encourage independence with washing. 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. The summary of this inspection report can be made available in other formats on request. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 8 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 Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate. The outcome of this group of standards could be improved if the home included assessment of residents’ emotional and social needs as part of their pre-admission planning and the pre-admission assessment format allowed for more detail about the residents’ health care needs to be recorded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous inspection carried out in July 2006 found the home had very little recorded detail about residents. Assessments for two new residents were seen at the visit but little information was written. The key inspection visit carried out March 07 found the home using a format for assessing residents, which the manager uses when she visits prospective residents. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 10 This pre-admission format omits reference to residents emotional and social needs and only offers enough space for brief information about care needs to be written down. This needs addressing so the home has an idea of the types of hobbies, interests and care needs the resident has in order to start planning how these needs are to be cared for. The manager advised they received information from the residents’ social worker before admission, which they use as part of the care planning process. A recommendation has been made regarding the homes pre-admission format. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate. The outcome of this group of standards could be improved if the home made sure any medication being carried forward was recorded on the medicine administration charts and care plans contained full and up to date information about the residents whole range of health care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection visit carried out July 06 found care plans were lacking in detail and gave a limited picture of the needs of the resident. Although the care plans were reviewed and residents had signed the document to say they had participated in the review meeting the details were not clear and did not give a person centred care approach to the care that should be available, with little or no recognition to the social care support required. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 12 Information received from residents in July 06 shows that the majority are satisfied with care provision and are happy in the home. The inspection visit carried out in March 07 found that care records remained brief and a computerised care planning system had been put in place. The manager advised a new system of care records was going to be introduced but was not aware then this would be. Care plans were good in parts and poor in parts. Detail about some of the residents care needs was very brief and did not show how care staff should be meeting the needs of the residents. One assessment in a care record indicated a resident was registered blind, however, the plan of how to meet the persons care needs omitted any reference to her blindness and any special care needs she might have in relation to that. The same care plan contained a good risk assessment for mobility, including the residents need to go for walks outside but omitted any reference to her needs relating to poor sight. One care record contained good detail and guidance of how staff should be looking after a lady who had recently been bereaved. Generally however, care records did not contain enough information or detail about residents’ whole range of care needs to provide enough guidance to instruct how staff should be meeting these care needs. Care records failed to contain assessments of residents’ nutritional needs and some did not contain assessments relating to residents risk of developing pressure sores. Observations carried out throughout the day showed staff were caring for residents respectfully and maintaining their dignity. The inspection visit carried out in January 06 found that medication administration record (MAR) charts were properly completed. The July 06 inspection observed poor practice regarding medication administration at lunchtime when tablets were left in front of 3 residents and not checked by staff to have been taken. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 13 The March 07 inspection found MAR charts were completed properly and majority of medicines supplied in a monitored dosage system, which makes the process of booking in, administering and disposal much safer. Storage of medicines was safe and staff administering medicines has had training. The lunchtime medicine round was observed to be carried out safely and correctly. One resident has chosen to administer her own medicines, and it is good practice that the home is encouraging this. However, the care file failed to indicate a proper assessment had been completed to show that the home had made sure she was able to safely take her own medication. The assessment looked at safe storage but omitted reference to the resident’s mental capacity, eyesight and dexterity. Medicine administration records (MAR) showed that some tablets were being carried forward from the previous months supply and the number of tablets were not being entered as “carried forward” on the MAR chart making these difficult to check to see if they had been accurately administered. These were controlled drugs and the drug register did however show the medication was being properly administered and managed. Two residents in the home are prescribed controlled drugs for pain relief and this was checked to ensure it was being given correctly. Boxes of the prescribed medicine were stored safely in an appropriate cupboard but the pharmacy had made an error with the dispensary label on one of the boxes. The label was in another residents name. Staff checking in this medication had failed to notice the label had another residents name on and had booked in the tablets under the name of one of the residents prescribed the same dose of medicine. Requirements have been made regarding care planning and medication. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. Residents enjoy an independent lifestyle and are supported by staff as required. Residents enjoy activities tailored to their individual needs and wishes and enjoy good, nutritious healthy food provided in pleasant surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous key inspection carried out in January 06 found that residents’ social interests were not recorded in all residents’ files. One file checked showed the person liked music events, bingo and quizzes but failed to record if these were provided or offered. The inspection in July 06 found limited recording in care plans of stimulation and activities. Care plans omitted reference to residents’ social needs. The home was providing some activities and some residents were managing their own e.g. scrabble, dominoes, crosswords and suduko, during this visit some of the residents were in the garden playing dominoes. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 15 The inspection visit carried out in March 07 found the home has employed a member of staff to work 4 days per week, whose main responsibilities are to organise and facilitate activities for all residents. Care staff also participate and were seen to sit and chat with residents throughout the day. Staff were also taking their tea breaks in the lounge with the residents which is seen as good practice. Lots of activity was seen throughout the day, the activity coordinator spoke of how all residents are included, she visits residents in their rooms and tailors activity to the residents’ individual needs and wishes. One resident spoke of how she would like to go out more often and another resident was observed going for a walk with care staff. The activity coordinator keeps individual records of the activity residents have participated in, however, care records continue to contain only brief information about residents social needs, hobbies and interests which is not enough to provide evidence that these needs have been assessed. Previous inspections have found that residents’ friends and families are welcomed at any time and the March 07 inspection found this continued to be the case. Previous inspections have found that residents have been offered choices about their meals, and the March 07 inspection found residents encouraged and supported by staff to retain as much independence as possible. Residents spoke of how they enjoy the freedom to live their lives how they wish to. One resident said “staff are good like that, they let me be as independent as I like” another said she was free to do what she wanted, “it’s a bit like home”. The random inspection in July 06 found residents took their meals in institutionalised type dining room with tables set in one long line laid with plastic table cloths and harsh paper napkins. Lunch was adequate with the food placed on the plate but appeared to be enjoyed. Poor practice was observed during meals with staff assisting residents in silence. The March 07 inspection found the dining room had been altered and now provided tables arranged throughout the dining area. Residents said they thought this arrangement was much nicer and they preferred it this way. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 16 Dining tables were laid with cloths, napkins and fresh flowers, which gave the room a very homely feel. Residents said the food was good and they enjoyed it and had a choice of 3 different meals at lunchtime. One resident said he thought the food was very nice and staff came and asked him what he wanted for his meals every day. Lunch was taken with the residents and was nicely presented and was good. The cook spoke about how the meals are prepared using fresh ingredients from local suppliers. Food stocks in the kitchen were plentiful and there was a large range of fresh vegetables and fruit. On the day of the inspection the weather was very cold outside and the home was warm throughout, with the exception of the dining room, which felt cooler than the rest of the building at lunchtime. This may be because this room is, in effect a corridor and care needs to be taken to ensure that the temperatures can be maintained to a satisfactory level while the residents arrive for their meal. It also would be helpful if the choices for the day were displayed in this room as none of the residents asked could remember what they had ordered for their meal. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. Residents are protected from abuse by the homes policies, procedures and staffs knowledge of how to recognise abuse. Residents and relatives are aware of how to complain and who to. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Previous inspections have found that home had written guidance regarding response to abuse; residents said then they were very satisfied and had no complaints, with all the staff being very good and caring. The July 06 inspection found it was to evidence provision of staffs training about protecting the residents from abuse as the training records were poor. Information from residents received in July 06 found mixed views about the complaints procedure with 50 (of 10) knowing how to complain and 10 not knowing. Comment from one states “If I had any complaints to make there would be somebody to help”. Information from relatives indicates 77 are aware of the complaints procedure and none have had to make one. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 18 The March 07 inspection visit found that the activity coordinator had spoken with all residents approx 6 weeks previous about the complaints procedure and showed them where it was available, (in the service user guide in their rooms). Residents said they would discuss their concerns either with their families or with the staff. From discussion with one resident and the manager, it was clear she had spoken with the manager who was dealing with her concerns. Staff had an awareness of how to report issues of abuse and said they would report directly to the manager or one of the homes directors. One member of senior staff was unsure of the role of the adult protection team and was unsure of the staff’s role regarding investigating issues of abuse. Staff confirmed that they have either had or are undergoing training in protecting the residents from abuse. The manager advised they have not received any complaints in the period since the previous inspection. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25 and 26. Quality in this outcome area is good and the environment is suitable for the needs of the current residents. The outcome of this group of standards could be improved if the home made bathrooms warmer and more homely and ensured the outdoor space was upgraded to enabling full use to be made of all areas available to residents. The home needs to further improve the way it handles soiled laundry. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection carried out in January 06 found the communal areas were clean but handling of soiled and potentially infected laundry was not done properly, staff were handling it and not placing directly into a machine on a sluice wash. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 20 The March 07 inspection found staff were not using the special red bags to separate the soiled laundry and were separating it into different bins, then placing it into the machines on the relevant wash temperature. Two new washing machines have been bought which have a facility for washing soiled laundry on high temperature to reduce risk of infections. The inspection carried out in July 06 found that the new provider highlighted areas that have to change, such as the old electrics and kitchen. The resident’s rooms had started to be decorated with an empty room already completed and of a good standard. The communal areas were being improved. Temperature mixer valves on hot water taps were found not working properly. Information received from home in November 06 indicates that one bedroom has new furniture, the dining room and visitors room have been redecorated, 7 bedrooms have been redecorated, the nurses station moved into office, new laundry facilities in place and new valves put on all wash facilities as existing ones too hot. Information from residents received July 06 indicates 80 thought the home was always fresh and clean. The inspection carried out on 12 July 2006 took place two weeks after the current providers had taken over the building. At that time much work was being carried out to refurbish and upgrade the existing provision and this inspection showed that the work had continued. All corridors and communal areas have been decorated and carpeted to a high standard and there very homely touches throughout the building in the form of fresh flowers and ornaments giving the home a very warm and welcoming feel. On the day of the inspection the weather was very cold outside and the home was warm throughout, with the exception of the dining room, which did feel cooler than the rest of the building at lunchtime. The individual rooms are also decorated to a high standard and many of the rooms seen had been personalised with the resident’s own belongings. All of the rooms had an individual lock, but none of the residents asked had chosen to hold a key. Each room had a very discreet sign, which could be hung on the door, indicating that personal care was being offered, and those inside the room should not be interrupted. This is excellent practice. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 21 All of the bedrooms visited had ensuite provision, but in some of the ensuites small cloakroom size sinks had been fitted. These need to be changed, as it is impossible for the residents to wash themselves in a sink this size and it encourages dependence on the staff for assistance with personal care. All of the bedrooms visited had hospital style beds with plastic protectors on the mattresses. These beds are good for the staff when needing to give assistance, as they are easily moved up and down, but the home could risk assess whether they are necessary for each person. This would also be the same for the plastic covering of the mattresses. The areas, which urgently need some attention, are the bathrooms. There are two bathrooms and one shower room in the building, but in reality all of the residents are bathed in the downstairs bathroom. This room was cold and uninviting on the day of the inspection and the glass in the window was not obscured so privacy was maintained by a roller blind, which made the room darker than it needed to be. The flooring had also been repaired and the edges of the flooring were lifting making this a trip hazard. The other two bathroom/shower rooms were also cold and had no heating other than fan heaters which were turned on if the room was about to be used. The shower room was being used a store for large items of equipment. All the bathrooms and shower rooms need to be heated to an adequate temperature during the waking day and the rooms also need to be refurbished so that they are inviting and comfortable. All of the hot water taps have been fitted with temperature control valves thus reducing the risk of scalding. The garden and external areas would benefit from some attention. There is part of a path around one side of the building which one of the residents appreciated on the day of the inspection, but this is gravelled and may not be the best surface for the more physically disabled. There was a patio to the rear of the building and evidence that this was well used in the better weather, as there were many tables and chairs. The concrete may need pressure washing before the good weather comes to make sure that it is not slippery. There is also an internal courtyard, which is accessed from the dining room and a corridor. This area has changes of level and access to the cellar and is potentially dangerous. Care needs to be taken to ensure that residents cannot gain access to this area until it has been improved. There is also another patio accessed from a lounge area. This patio is raised and needs to be made safer with a protecting rail. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 22 Access to the first floor is by two lifts, the one at the rear is difficult to identify as a lift for residents who may be unaware of its purpose. However, the lifts are well placed to assist people to the first floor, which is, in fact on three levels. Signage throughout the building needs to be given some thought to help residents and their visitors find their way about. Recommendations have been made regarding the garden and premises. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. Residents are being cared for by suitably qualified and trained staff provided in sufficient numbers to meet their whole range of health care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous key inspection carried out in January 06 found that one person had commenced without a check being made on the protection of vulnerable adult list and there was an unexplained gap in the employment record. There have been no concerns in the past about insufficient staffing levels. Information from home received in November 06 indicates that 3 care staff have left since previous July 06 inspection, 5 of 15 care staff have NVQ qualifications, basic care practice and induction training has taken place since June 2006. Training in dementia care, continence, fire, pressure areas and diabetes is planned. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 24 Information from relatives’ received in July 06 indicates that 100 are satisfied with overall care and 85 thought staffing levels were satisfactory. 80 of residents indicated they always received the care and support they need, 50 said staff were always available when needed. Comments from residents indicated they are happy with the care they received and like living in the home. The inspection visit carried out in July 06 found 6 staff had left since the previous key inspection, some of which had NVQ2. This visit also found training records were poor with no continuity of when training updates occurred or if all health and safety training had taken place. Very few training certificates were seen on staff files and those files lacked evidence to support the home was carrying out proper checks on staff before they started work. The March 07 visit found sufficient numbers of staff on duty to care for the residents’ current range of care needs and duty rosters indicate sufficient numbers of staff are always available. The files of two new staff were checked and contained evidence that they were thoroughly vetted before they started. Induction training has been introduced and staff spoke of how this has helped review her care practice. One member of staff confirmed her supervision sessions with the manager. Training opportunities for staff have improved and staff spoke of the training they have done recently which includes medication, dementia and POVA. Staff spoke of how the majority of care shifts provide at least one person who is NVQ qualified and that this includes weekend and night shifts. Staff whose first language is not English are being provided with English lessons. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38 Quality in this outcome area is adequate. The outcome of this group of standards could be improved if the home was entirely safe and the manager gained more managerial experience and qualifications. The monitoring of quality is good and the provider demonstrates issues raised are dealt with quickly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Regal Healthcare Properties bought and took over the home in June 2006 and a new manager has been in post since July 06 and was registered by the Commission in March 07. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 26 The March 07 inspection found the manager was running the home competently and undertaking NVQ 4 in management. Although the manager has some previous experience of working in a management capacity she lacks experience of managing a residential care setting. The manager needs to focus on the care records as although residents look well cared for, their records do not provide evidence that their health care needs have been assessed and are being met. Formal staff supervision was not satisfactory at previous key inspection in January 06 but the March 07 visit found this is now in progress. A quality audit tool had been developed but not implemented at January 06 inspection but the March 07 visit found a good quality audit tool was being used and results from a recent survey were being collated. The provider has been completing regular monthly quality monitoring visits. Safety of the premises was checked and one area was found to be of some concern. One set of stairs to the first floor is located near to a resident’s bedroom. The door on the first floor opens immediately onto the stairs in an area that is poorly lit. This creates a potential hazard, as residents may be unaware of the stirs behind the door and fall down them, as they may be unable to see them clearly. A small warning sign has been put on the door but this is not sufficient to prevent a serious accident. This was discussed with the provider during the inspection who advised this area would be made safe. Records for fire safety were well maintained and the manager regularly checks accident records. The manager also completes a weekly and monthly quality check of the premises and the homes maintenance company address any areas as required. A requirement has been made regarding safety. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 27 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 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 2 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X X X X 2 Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? ONE 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 15 Requirement The Registered Person must ensure care records contain full and comprehensive assessments of care needs and a written care plan setting out each person’s needs in respect of their health, personal and social care needs. Repeated requirement, deadline of 1/9/06 not met. 2 OP8 15 (1) 17 Schedule 3 (m) The registered person must ensure that care plans contain details and assessments of how residents’ health and welfare needs are to be met, in particular needs relating to nutrition and pressure areas. The registered person must ensure that medication is recorded and booked in correctly, paying particular attention to those medicines regularly carried forward from existing stocks. The registered person must ensure that all parts of the home to which residents have access are kept free from any hazards, DS0000067738.V332219.R01.S.doc Timescale for action 30/06/07 30/06/07 3 OP9 13 (2) 31/03/07 4 OP38 13 (4 a) 30/04/07 Scole Lodge Version 5.2 Page 29 particularly regarding access to the stairs on the first floor near room 27 and the small courtyard area by the lounge. 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 3 4 Refer to Standard OP3 OP20 OP21 OP26 Good Practice Recommendations The registered person should consider expanding the information in the pre admission format to include reference to residents social and emotional care needs. The registered person should consider how to landscape the garden area to make accessible and safe outdoor space for residents to use. The registered person should consider how they could improve the comfort and warmth in the bathrooms. The registered person should ensure safe handling of soiled laundry is carried out by utilising special red bags for containing, carrying and washing of soiled laundry. Scole Lodge DS0000067738.V332219.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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