Inspection on 19/07/06 for Orchard Lodge Nursing Home

This inspection was carried out on 19th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Orchard Lodge Nursing Home 05/07/07

Orchard Lodge Nursing Home 29/07/05

Orchard Lodge Nursing Home 14/04/05

Orchard Lodge Nursing Home 26/08/04

Orchard Lodge Nursing Home 13/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Orchard Lodge Nursing Home 601-603 Lytham Road Blackpool Lancashire FY4 1RG Lead Inspector Mr Kevan Royston Unannounced Inspection 19 July 2006 08:30 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 Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 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. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Orchard Lodge Nursing Home Address 601-603 Lytham Road Blackpool Lancashire FY4 1RG 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) 01253 345623 01253 344033 david@dmarrs.wanadoo.co.uk Dharma limited Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (6) of places Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 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 44 service users to include: up to 44 service users in the category OP (older persons over 65) and/or up to 6 service users in the category PD (physical disability). Date of last inspection Brief Description of the Service: Orchard Lodge Nursing Home is registered as a care home that provides nursing and can accommodate 45 service users .The home is situated in the south of Blackpool, in a residential area within close proximity of local amenities. The accommodation 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 accommodated in three lounges and a dining room and a smoking lounge is provided separately. Twenty-three of the bedrooms are single and six shared ten of which have an en-suite facility. The home provides a passenger lift and aids and adaptations to promote independence. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over two days the 19 and 20th July 2006. The Inspector spoke to the homeowner, the matron and registered manager four staff, a district nurse visiting the home and with residents. The inspection visit was undertaken over a period of two days. As part of the inspection process the inspector used case tracking as a means of assessing some of the National Minimum Standards. The process allows the inspector to focus on a small number of people living at the home. All records relating to these persons are examined and the rooms they occupy are looked at. Other residents are invited to pass their opinions to the inspector if they wish. The response from surveys sent to relative’s residents and GP surgeries was poor only two completed questionnaires received from relatives. However comments in relation to care practices were generally positive. Records of three staff members were also examined. A tour of the premises was undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection process. What the service does well: The home has a designated social activities person who is responsible for arranging daily activities and outings to suit each individual’s interests ensuring the residents are motivated and stimulated. A member of staff spoken to said “ We have quite a lot of trips out in summer the residents like that”. A resident spoken to said “We are going out tonight for tea I like to get out as much as possible”. Staff training is a priority for the management and staff are encouraged to attend courses to improve their competencies and develop their careers. Staff members commented, “Lots of courses are provided for us”. Other comments included “I have never attended so much training”. And, “training opportunities is very good”. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 6 There are over 50 of care staff who have to completed a recognised qualification in care required by legislation ensuring care staff have the competencies and skills required to work in a care home. What has improved since the last inspection? What they could do better: Monthly reports provided by a representative of the Company are required by regulations. These must be completed and sent to The Commission for Social Care Inspection (CSCI) to ensure that there is an overview of the management of the home which can show any developments that are taking place and make sure the residents needs are being met. Further work is required in the redecoration and refurbishment of parts of the home in particular bedrooms and communal areas ensuring residents live in comfortable homely surroundings. A member of staff said “We know we need to redecorate some areas and provide new carpets which will be done”. Although there are sufficient numbers of staff employed there are at times shortages especially domestic staff. To ensure the home is maintained to a good standard and residents care and support is not affected extra staff should be provided at certain times of the day. The management said “We have been short of staff lately but are currently looking to employ more personnel”. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 7 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 DS0000006068.V287103.R01.S.doc Version 5.1 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 Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents records examined confirmed they had been assessed and a plan of care developed with written terms and conditions ensuring they had full information about the home and care to be provided. EVIDENCE: Completed terms and conditions of residence had been provided for residents. One resident spoken to said, “ The staff were good when I came here and sorted everything out on paper”. Residents records examined had completed assessments prior to moving into the home provided by Social workers if funded and the matron if privately funded with all the information required by legislation ensuring the health and welfare needs of residents are accurately recorded. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 10 Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously. Resident’s welfare is closely monitored and health needs are identified and met. Medication procedures have improved and are good and provide safety and protection for residents. EVIDENCE: Records of three residents were examined and accurately reflected the individual’s health and social care needs. Care plans were up to date and regular reviews taking place with relatives invited to meetings and outlining any changing health needs required. One Staff member said “ We invite relatives to reviews so they know what care we are giving them”. Records examined confirmed risk assessments are constantly reviewed and updated reflecting any changes that have occurred individually and the environment ensuring the resident’s needs are being met. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 12 Medication practices observed at breakfast time were safe and good records had been kept ensuring residents health is maintained. A senior member of staff said, “Only senior trained staff administers medication”. Records inspected confirmed which trained staff administers medicines. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Contact with families and friends is encouraged and supported by staff to maintain relationships. Activities are centred on resident’s interests. Meals are varied and wholesome with choice provided ensuring residents dietary needs are met. EVIDENCE: Residents spoken to confirmed visitors are allowed at any time to see them. Residents spoken to said, “My son comes when he can because he works a lot”.” Observations of residents rooms showed personal belongings are allowed into the home so to provide a homely atmosphere for each individual. Residents spoken to say the routines of the home are flexible and they have a choice of how to spend their daily life. One said, “Its nice on trips out”. Another said, “You spend your time how you choose”. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 14 Breakfast and Lunchtime meals served were seen to be wholesome, home baked with fresh vegetables providing a nutritious meal. Menus examined are balanced and interesting. Meal times are set although flexible enough to accommodate preferences. One resident spoken to said, “The food is good”. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 15 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. The homeowner and staff have good knowledge and understanding of adult protection issues, which protect residents from abuse. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents and relatives on admission and is included in the homes brochure ensuring the residents feel protected. Staff spoken to are aware of the complaint and abuse procedures. One member of staff said “We do abuse and complaints training and policies during our induction training”. Another staff member said, “My NVQ training looks at abuse issues during the training”. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe and clean maintained to a good standard providing comfortable surroundings for the residents. Some parts of the home require redecoration to ensure the home is pleasant to live in. EVIDENCE: A tour of the building found the home to be clean and tidy. The home has a separate laundry with policies and procedures in place to control the risk of infection. Domestic staff are employed to ensure the home is kept clean however a shortage of staff is putting a strain on existing employees. One staff member spoken to said, “We need more cleaning help” The manager spoken to said “We are currently recruiting for more staff “. Surveys received from relatives confirmed the home is always clean and tidy with no evidence of unpleasant odours. The home has new furniture in parts of Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 17 the lounge area. However some bedrooms and communal areas require redecoration and new furnishings to maintain the good standard of the home. A staff member spoken to said, “We are aware of the need for new carpets in one or two rooms”. There is an ongoing maintenance and repairs programme with records kept. The maintenance person is employed daily to ensure the home remains safe and protect the residents attends to any repairs reported. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 18 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): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment of staff are robust ensuring the safety and protection of the residents. Training for staff is very good ensuring they have the skills and competencies for there roles. EVIDENCE: Observation of staff rotas and discussion with staff confirmed staffing levels could be increased at certain times of the day to ensure the residents receive the support and attention needed. Staff members spoken to said, “Lately we have been pushed and low on staff”. Another commented, “We need more domestic staff”. A resident spoken said, “The girls are wonderful but we don’t get out much when there are not enough staff on duty”. The management confirmed recruitment of new staff is ongoing and said, “We have put and advert for more staff in the local paper”. Examination of staff files confirmed the recording procedures of the home are good. And staff records include, application forms, individual photographs, CRB (Criminal records Bureau), POVA (Protection of Vulnerable Adults) checks and references were in place to ensure the residents are protected. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 19 Records show training is ongoing and the home has over 70 of care staff that has completed NVQ (National Vocational Qualification) level 2 in care to meet the 50 required by legislation. Training is ongoing and accessible for staff development and they are encouraged to attend courses to ensure they are competent and have the skills to provide the care and support for the residents. Records are kept of staff training. Comments from staff included “ They always encourage us to go on courses”. Another said “You cannot fault the training here its very good”. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 20 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): 31,33,35,37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes management has improved and good systems are now in place for the protection of staff and residents. EVIDENCE: There is now a manager who is registered with CSCI in place. Comments from staff members confirm support and communication between management and staff has got better despite some staff shortages. Staff members spoken to said, “Things have improved between the manager and staff we get on and communicate better”. Others commented, “Morale is a lot better than it was”. and, “things have changed and we feel more supported by management”. A resident spoken to said “The matron is always there if we want her”. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 21 Examination of records confirmed regular tests to emergency lighting, fire procedures and extinguishers had been carried out ensuring the safety of residents and staff is maintained. Records show the management has good systems to gather staff, residents and relative’s views to enable ongoing improvements to the home. Staff and resident meetings are held regularly and recorded ensuring there views discussed and implemented if needed and improves the running of the home. Relative surveys are sent out every six months has a quality assurance system to gather the views of friends and relatives to ensure they feel the home is run smoothly and any suggestions to improve the home are put in writing. Regulations require a visit monthly from an appointed person of the Company and a report sent to CSCI to explain any developments and monitor the care provided to ensure the home is managed properly and continues to develop to provide the care and support for the residents and staff. This must take place monthly. Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 22 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 X 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 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 3 X 3 X 3 X 3 3 Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 23 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. Standard Regulation Requirement Timescale for action 30/09/06 1 OP37 17,26 Records required by regulation must be in place, under Regulation 26, visits to the home must be undertaken by a responsible individual monthly and a report provided to CSCI. (Timescale of 31-09-05 not met) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 24 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 © 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 Orchard Lodge Nursing Home DS0000006068.V287103.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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