CARE HOMES FOR OLDER PEOPLE
Orchard Lodge Nursing Home 601-603 Lytham Road South Shore Blackpool FY4 1RG Lead Inspector
Kevan Royston Announced 14 April 2005 10:00am 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 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. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Orchard Lodge Care Home Address 601-603 Lytham Road South Shore Blackpool FY4 1RG 01253 345623 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dharma Limited CRHN Care Home with Nursing 45 Category(ies) of OP Old Age 45 registration, with number of places Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: A suitiably qualified and experienced manager who is registered with the Commission must be employed at all times. 3 (three) named persons under the age of 65 may be accommodated within the category OP. The total number accommodated in the home shall not exceed 45. Date of last inspection 26 August 2004 Brief Description of the Service: Orchard Lodge Nursing Home is registered as a care home that provides nursing and can acccomodate 45 service users .The home is situated in the south of Blackpool,in a residential area within close proximiatyof local amenities. The accomodation is on two floors and a lift facilitates access to all areas There are garden areas to the front and rear that are attractive and accessible to wheelchair users via a ramp. Communal space is accomodated in three lounges and a dining room and a smoking lounge is provided seperately.Twenty three of thebedrooms are single,and six sharedten of them have a en-suite toilet. The home provides a passenger lift and aids and adaptations. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over two days. The information contained in this report has been gathered by discussion with the registered person, interviews and informal discussion with staff, discussion with residents and relatives, information received from questionnaires sent to relatives, social workers, GP surgeries and residents. A tour of the premises took place and examination of documentation and records formed the basis of the visit. Records of three staff and residents who were spoken to were examined and this is referred to as “case tracking” in the report. Since the previous inspection, which took place on 26/08/04, there has been four complaints received and investigated both by the provider and CSCI (Commission Social Care Inspection). What the service does well: What has improved since the last inspection?
There is ongoing building work to extend the premises and update the general décor and furnishings of the home. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 6 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. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 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 standard(s) 1,3 The admission and assessment procedure were clear to ensure the care needs of resident are met. EVIDENCE: The home has good admission procedures to ensure resident’s needs are assessed and planned for. Individual records are kept for each of the residents and inspection of the three most recent admissions had full assessment information and recorded. Residents spoken to were able to provide information about their individual care plans and needs which had been recorded. Staff members spoken to were fully aware of the care needs of the residents and the review procedure of each individual. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 9 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 standard(s) 7,8,9,10 Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are well met. EVIDENCE: The records for three residents clearly described their health needs. Resident’s care was clearly recorded with good risk assessments. One resident spoken to was aware of their care plan and how often it was reviewed. Other residents spoken to were able to discuss in general terms the contents of care plans. Medication practices observed were safe and good records had been maintained. Staff demonstrated a good understanding of these policies and procedures. Questionnaires completed by residents and relatives said that staff and management were always respectful to privacy and know how to treat each resident with care. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,15 Dietary needs of the residents are well catered for with various menus and a choice of meals available to meet individual tastes. Social activities are well managed, creative and provide variation and interest for people living at the home. EVIDENCE: One staff member takes responsibility for arranging activities and has received specialised training, which has resulted in various programmes being introduced at the home including external entertainers. One resident spoken to said, “I enjoy the entertainers who come to the home”. Another resident said, “Trips out are nice”. Questionnaires completed by the residents and relatives commented positively in relation to social activities put on at the home. A number of people were spoken to and the overall comments about the quality and choice of food were excellent. Menus were inspected and food sampled and found to be nutritious, balanced and plenty of choice. One resident spoken to said “you can have your meals in your room if you like there are always snacks and drinks available” Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16,18 The arrangements for complaints are good but the recording and reporting could be improved. EVIDENCE: The home had a detailed complaints procedure and staff were able to explain the process. Records of complaints investigations with outcomes are kept up to date but complaints investigated by the home need to contain as better detail. Eight complaints have been recorded by CSCI since the last inspection one was up held, one partially up held and six not upheld. Residents knew who to complain to, one said, “if I wasn’t satisfied I would contact social services or you people”. A procedure for responding to allegations of abuse is available. Staff spoken to were aware of the abuse policy and confirmed they have received training in all areas of abuse and the protection of vulnerable adults. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 12 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 standard(s) 25 The standard of the premises and living areas of the home is generally good providing residents with a homely, fully furnished environment . EVIDENCE: Since the last inspection the home have addressed the problems of the hot water temperature. An extension to the home is nearing completion. During a tour of the home it was noted to be clean and tidy. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 13 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 The policy and procedures for the recruitment and training of staff are robust and provide safeguards to offer protection to the residents. The number of staff on duty was sufficient to meet the needs of residents. EVIDENCE: Three staff files and records seen all contained the necessary recruitment checks to ensure the protection of residents. Staff spoken to confirm the recruitment procedure was thorough and had received induction training. Staffing levels are satisfactory and there are sufficient staff on duty sufficient to meet the needs of the residents. Residents spoken to say the staff are caring. One resident said, “They are never to busy to help you and are always pleasant.” Records showed that staff training is ongoing but further staff should achieve NVQ training. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 14 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The home is managed and run efficiently. There is leadership guidance and continuity and staff and residents are aware of the management structure to ensure quality of care is of a high standard. EVIDENCE: The recommendation for the registered manager to achieve NVQ level 4 and registered managers award should be completed this year. This was confirmed by discussion with the registered provider. The registered manager is a qualified nurse. Residents spoken to say the manager is approachable and always helpful. Staff spoken to feel well supported in their role and feel the manager is always accessible and supportive.
Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x 3 x STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 x x x x x x x Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 16 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 Regulation Requirement Timescale for action 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. Refer to Standard 28 31 16 Good Practice Recommendations 50 of care staff should be trained to Level 2 NVQ by 2005. The registered manager should have a relevant mangement qualification by December 2005. The inspector advises the registered person to improve the reporting and recording of complains to contain more detail. Orchard Lodge Nursing Home F57 S6068 Orchard Lodge V210795 120405 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection Area Office, Unit 1 Tustin Court Portway Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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