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Inspection on 29/07/05 for Orchard Lodge Nursing Home

Also see our care home review for Orchard Lodge Nursing Home for more information

This inspection was carried out on 29th July 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The management has produced a survey questionnaire for persons who stay at the home for respite, to seek their views on the quality of care provided in order to continue to monitor the care and to improve the service they provide. All the residents spoken to commented positively on the care provided by the staff, one said "The staff are very nice always helpful"

What has improved since the last inspection?

The new extension creating bedrooms and lounge area is now in use providing extra comfort for the residents . One resident said, "The new building is very nice." The requirement regarding complaints highlighted at the last inspection has been addressed. A thorough recording and outcome of investigations is now in place, which will ensure the residents complaints will be dealt with properly.

CARE HOMES FOR OLDER PEOPLE Orchard Lodge 601-603 Lytham Road Blackpool Lancashire FY4 1RG Lead Inspector Kevan Royston Unannounced 29 July 2005 10:00am th 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 F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Orchard Lodge Address 601-603 Lytham Road Blackpool Lancashire 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 Mrs L Marrs Care home with nursing 44 Category(ies) of OP Old age (44) registration, with number PD Physical disability (3) of places Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 2. 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 3 service users in the category PD (physical disabilty). Date of last inspection 14th May 2005 Brief Description of the Service: Orchard lodge Nursing home is registered as a care home that provides nursing and accomodates 44 residents plus 3 persons under 65 with physical disabilities. The home is situated in the south of Blackpool in a residential area within close proximity of local shops and bus routes. There are two floors and a new extension has been added to the premises providing en-suite bedrooms and a new lounge area. There are garden areas to the front and rear of the building and these are accessible to wheelchair users via a ramp. There are three lounges a dining are and a designated smoking room. Aids and adaptations have been fitted where required. The home provides en-suite facilities in a number of rooms and there are sufficient toilet and bathrooms to meet the residents needs. A passenger lift provides access to the first floor. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 09.45 am and took place over 4.00 hours. The Inspector spoke to the acting manager, matron in charge, four staff members and five residents. 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. There has been two additional inspections since the previous announced inspection. The pharmacist inspector visited the home on 27/06/05 to undertake an inspection of medication issues and a report is available. Concerns were raised regarding the administration and safe handling of medicines and these had to be addressed by the management of the home. The second additional inspection on the 27/06/05 was to assess recruitment procedures. There were no concerns following the inspection regarding the recruitment and records kept for staff. What the service does well: What has improved since the last inspection? The new extension creating bedrooms and lounge area is now in use providing extra comfort for the residents . One resident said, “The new building is very nice.” The requirement regarding complaints highlighted at the last inspection has been addressed. A thorough recording and outcome of investigations is now in place, which will ensure the residents complaints will be dealt with properly. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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 F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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 F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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) This section of standards was not assessed EVIDENCE: Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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) 9 Medication procedures in the home were not safe for the residents. EVIDENCE: The pharmacists inspector undertook a full audit of the medication procedures and has produced a separate more detailed report. However the general outcome from this inspection was that medication practices were poor in respect of administering and recording. One resident had not received their prescribed night time medication which could have had a detrimental effect on their health. Another resident had not received and of their morning medication and this had to be pointed out to the nurse in charge. The recording of medication had also not been consistently carried out and the acting manager was not aware of the problems, which is of concern. Following this inspection a Statutory Requirement Notice was issued to the home, requiring certain improvements to be made. This will be monitored again to ensure the safety of the residents in the home. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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) 13 and 14 Contact and visiting with families and friends is encouraged at any time and supported by staff to maintain relationships. EVIDENCE: Residents spoken to confirmed visitors are allowed at any time. One resident said, “My daughter comes every day and we go out sometimes if the weather is nice.” Observations of residents rooms showed personal belongings are allowed to be brought into the home so to provide a homely atmosphere for each individual. Residents spoken to said the routines of the home are flexible and they have a choice of how to spend there daily life. One said, “Its quite here which is how I like it I go into the lounge if I feel like it” Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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 The arrangements for recording and reporting of complaints are now good ensuring people feel listened to. EVIDENCE: The home has developed its complaints policy and now has a detailed complaints procedure and staff were able to explain the process. Records of complaints investigations with outcomes are up to date. One resident spoken to said, “Any problems and I would speak to who was in charge.” Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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) 26 The premises were found to be clean and tidy with systems in place to prevent the risk of infection and ensure the health and safety of residents is protected. 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. One resident said, “My room is always nice the girls do a good job cleaning”. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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, 28, 29 and 30 The policy and procedures for the recruitment and training of staff are generally good. However robust recruitment checks for new staff must be done to provide safeguards and offer protection to the residents. EVIDENCE: Examination of two staff files confirmed recruitment procedures are in place. However staff photos and evidence of qualifications must be placed in each staff members file. The application form for employment must be completed and examined thoroughly to ensure the residents are safeguarded and protected. Staffing levels were satisfactory and there were sufficient staff on duty to meet the needs of the residents. This was confirmed by staff rotas examined. Records show training is ongoing but further staff should achieve NVQ (National Vocational Qualification) training to meet the 50 required by legislation. Two staff spoken to confirmed they had received induction training on commencement of employment which enabled them to have the confidence and basic skills to provide the care the residents need. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 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) 36 and 37 There is limited communication; guidance and direction to staff to ensure residents receive a consistent level of quality care and the smooth running of the home. EVIDENCE: At present the registered person is not in day to day control due to unforeseen circumstances. However the persons in charge should make sure communication between staff and residents is consistent and good to ensure there lines of discussion are available and the home is run to the best interest of the residents. A resident spoken to said “We don’t see the matron very much.” Discussion with staff indicated morale is low due to the changes in the running of the home not being discussed properly. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 15 Visits required by regulation must take place. This means a responsible individual of the home must visit monthly and comment on the care and support provided to staff and residents and send a report to CSCI and the manager. This form of quality assurance may have picked up some of the problems identified by the inspector. Staff commented on the lack of supervision from management. Regular supervision of staff must be undertaken at least six times a year and recorded to make sure staff feel supported and any aspects of practice is discussed. This is particularly important if there is any change in the home. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 16 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 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 x 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 2 2 x Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 17 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 29 Regulation 19 schedule 2 Requirement The registered person must operate a thorough recruitment procedures and provide documentary evidence of qualifications and a recent photograph. Records required by regulation must be in place and regulation 26 visits must be undertaken monthy and a report provided to CSCI The registered person must ensure medication procedures are safe. This includes the recording and administering of medicines. Timescale for action 30/09/05 2. 37 17,26 30/09/05 3. 9 13(2) 26/08/05 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 36 28 Good Practice Recommendations All staff should receive regular formal suopervision. The registered person should ensure 50 of care staff have completed level 2 NVQ in care by 2005. Orchard Lodge F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 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 © 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 F57 F09 S6068 Orchard Lodge Nursing Home V211601 290705 Stage 4.doc Version 1.40 Page 19 - 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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