Inspection on 08/06/06 for Palmtree Lodge

This inspection was carried out on 8th June 2006.

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

Palmtree Lodge 14/08/07

Palmtree Lodge 12/01/06

Palmtree Lodge 26/07/05

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 Palmtree Lodge 20/28 Nutter Road Cleveleys Blackpool Lancashire FY5 1BG Lead Inspector Ms Jenny Hughes Unannounced Inspection 8th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Palmtree Lodge DS0000063455.V291089.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. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Palmtree Lodge Address 20/28 Nutter Road Cleveleys Blackpool Lancashire FY5 1BG 01253 852092 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) Mr Naveed Yousaf Muhammad Fayyaz Chauhdry Ms Linda Josephine Pratt Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (2) of places Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 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 22 service users to include up to 20 service users in the category OP (older persons 65 and over ) and 2 service users in the category PD (physical disability) who must be 60 or over.. The registered manager must achieve the Registered Managers Award by April 2006 12th January 2006 3. Date of last inspection Brief Description of the Service: Palmtree Lodge care home is situated within Cleveleys town centre, only a short walk from shops and close to the sea front. The home provides residential care for twenty-two persons on ground and first floor levels. All bedrooms have ensuite facilities and comply with minimum space requirements. There are two lounges and a dining/lounge area. The home has been fitted to suit the needs of older people, with, for example, a passenger lift, grab rails and ramps. There is a small front patio area with benches for residents to enjoy watching the daily comings and goings in the town. There is very limited car parking to the rear of the home, although cars can be parked in nearby roads. Information about the service the home provides is available in the form of written guides, which try to cover everything a resident needs to know about life in the home. Copies of these can be found in the entrance hall of the home, or are available on request from the manager. The latest report from the Commission for Social Care Inspection is also available in the entrance hall. As at 5th May 2006, the fee scale for older people ranged from £324 to £366 a week, and for people with a physical disability from £360 to £412 a week. There are additional charges for chiropodist and hairdresser visits, and any extra newspapers and toiletries requested. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 5 Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit to the home, in that the owners were not aware that it was to take place. The length of the visit was for 6 hours. Before the visit took place, the manager was asked to complete a preinspection questionnaire, and surveys were received from residents and their relatives, and visiting professionals. During the inspection visit, staff records and resident care records were viewed, alongside the policies and procedures of the home. The manager, residents and care staff were spoken to, along with a relative who called during the visit. Their responses are reflected in the body of this report. A tour of the home was made, viewing lounges, dining room, bedrooms and bathrooms. Everyone was friendly and cooperative during the visit. What the service does well: The home has some long-term experienced staff who lead by example with good practices and attitudes. The management of the home is open, with easy communication between residents, relatives and staff. All of the residents said that the staff were friendly and kind. Care plans for residents are clear for staff to understand how to best look after each individual, and personal routines are respected. Meals are home-cooked, varied, with well-balanced choices. They are well presented, with meal times being pleasant and unrushed. The environment is warm, homely and safe. The small outside area at the front of the home is a nice place to sit, and chat to passers-by. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Palmtree Lodge DS0000063455.V291089.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 Palmtree Lodge DS0000063455.V291089.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information the home gives to people about the services available, and the way it gathers information about people who want to live there, means that proper choices can be made about the suitability of the home. EVIDENCE: Individual records are kept for each of the residents, and there is a set procedure for admitting someone to the home, with a pre-admission assessment form being seen on three selected files. These are used by management to check that staff can give suitable care to each person, before the manager agrees that the home is the right place for them to live. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 10 The needs of someone who was transferred to the home in an emergency were properly discussed and assessed, and the staff at the home were able to then make good arrangements to care for the person. GP’s responses to a survey said that the home always communicates clearly and works in partnership with them, and staff have a clear understanding of the care needs of residents. Staff spoken to were aware of the needs of the residents they were looking after. “The assessment is very clear”, said one staff member “We know to make sure we have all the details so that we can look after people the way they need looking after”. Palmtree Lodge DS0000063455.V291089.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 The quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a clear and consistent care planning system in place meaning that the health and personal care needs of the residents are well met by well informed staff. EVIDENCE: Individual care plans are available, identifying the areas of need for each person, and with clear instructions for staff for what they must do to meet that need. The detailed plans covers the health needs, personal needs, and social needs each person may have. A resident profile gives plenty of background information about the person, so that staff can try to understand each individual better. The assistant manager regularly reviews these needs, clearly indicating where there are any changes, so that staff can continue to provide the best care. There are formal handovers of information from the management when shifts change, to confirm these updates to all of the staff. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 12 The care plans were signed and dated by the resident or their representative, to show that they were involved in deciding what the care needs were. “I like this assessment and care plan system we use, it’s easy to follow and makes sure you cover all the needs of each person”, said a staff member. “You only have to ask and the girls try to help”, commented a resident. A visitor called in and added “They try to do the best for everyone”. Staff are able to care for people with diverse needs, for example there are residents from different cultural backgrounds. Records hold good information about the needs of the different cultures, and in speaking to staff they were very knowledgeable about how they should care for the individuals. Residents can choose to go where they wish in the home, and may see visitors in the lounges or dining room, or in their own room. Some residents prefer to stay in their own room, where staff were seen to knock and wait for an answer before entering. “I like to stay in my room quietly, but sometimes I sit in the lounge and join in what’s going on there”, commented a resident. “I like to stay downstairs, but I choose this quiet lounge”, said another. Some residents sat in the lounges chatting, some were watching television, sleeping or reading the paper. Another was being helped into a wheelchair by staff, while a relative waited to take them out for a stroll in the good weather. The need to be aware of the privacy, dignity and respect of residents is noted in care plans, for example when helping to bathe, or when family visit or a GP calls. Medication was stored in a lockable trolley. Records were clear and up to date, and information leaflets about the medication were available. Staff assisting with the administration of medication had all been trained. The staff were advised to have two signatures to evidence any medication handwritten onto the record sheet. Residents are able to self medicate if they wish, following a risk assessment, and sign a waiver if they do so. This is also included in the care plan. The local pharmacist visited the home to help update the medication system, and the management are able to contact the pharmacist with any queries or problems, as they did during this visit. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meals were nutritious, and mealtimes relaxed, which encourages residents to enjoy food and mealtimes. Residents daily lives and social activities are generally catered for, and all people benefit from living in a home that aims to continue to develop to ensure that people are provided with opportunities to live lives that are fulfilled. EVIDENCE: The individual care plans include information on each person’s life history, their religious needs, and which hobbies and activities they prefer. An activities book records what activity has taken place, with who has enjoyed it and who has not. This helps towards finding activities for all of the residents. Those taking place include T’ai Chi with an instructor coming to the home and taking the residents through some easy armchair exercises, hair and manicure sessions for the ladies, and music and sing-a-longs. The provider commented that he is looking to develop the limited activities in the home, and has a bus trip out planned, with ice-cream for all. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 14 The decoration of the outside of the home, and the tidying up of the seating area, has encouraged the planning of outside activities to include the local community, such as a table top auction. A poster displayed on the notice-board advertised a forthcoming clothes party to be held at the home, and a coffee morning for all is advertised. “I don’t join in because it’s too difficult for me. I like listening to music though, and any sing-a-longs. My visitors call every day, and the staff always make sure I’m OK”, said a resident. The sample meal taken was meat and potato pie, followed by strawberries and ice-cream. Fruit juice or tea or coffee was readily offered to residents. “I like most of the meals, they’re good”, commented a resident. Most of the residents said they enjoyed the meals made by the cook, who spoke to the residents to make sure there were no problems. “I’m aware of all the likes and dislikes, and if anyone’s on a special diet. I have that noted in the kitchen”, said the cook. He commented that sometimes the residents made suggestions for meals, and he would try them if they did. He stated that residents were very clear if they did not like something, “They make sure I know that!” he said. He worked to a four week menu plan, which was varied and nutritious. The dining room is compact, but tidy, and residents can get to tables easily enough. The lunch-time was relaxed and unhurried, with staff quietly and tactfully helping residents when needed. Different needs are addressed individually, to make sure everyone feels part of the home. One resident preferred meals in their room, and staff made sure this was prepared and taken to them while it was piping hot. Food for residents from a different culture are purchased to make sure religious needs are met. Picture books, or a translator, are examples of what has been used by the home for people who need help with communication. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon. Staff have an understanding of Adult Protection issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. Since the present owners have had the home, there has been one complaint; the outcome of which was that the home was partially responsible. Action has been taken by the home to make sure a similar incident does not happen again. The report regarding this is available with this report. Residents spoken to said they would “tell any of the staff” if they were not happy with something. Staff spoken to knew about the Adult Protection procedure, and what to do if they had any concerns. They said they would always act if they thought a resident was at risk. Also if it was a member of staff causing concern they would inform the management. All staff attend abuse awareness training. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 16 Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recent and ongoing investment has considerably improved the appearance of this home, creating a comfortable and safe environment for those living there. EVIDENCE: The providers have continued with their refurbishment plan since the last inspection. The small front garden area has been tidied and made into a more attractive place to sit, and a lot of the front of the building has also been painted and repaired where necessary. The provider said that a lot of visitors and local people had commented to him on how much better the home looked. All of the interior of the home has been refreshed with new paint on walls and ceilings, and new curtains, making the whole environment a brighter and fresher place to live. A visiting social worker commented that there had been a great improvement in the décor. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 18 Minor maintenance needs are recorded by staff in a Problems Register, and noted when they are dealt with. The manager said that he is aware that there is still some work to do on the re-decoration, and replacement of some of the furniture which, over time, has become marked or stained; for example some of the lounge chairs. This is still an ongoing process. “It’s very nice isn’t it?” commented a resident about the redecoration. Bedrooms were full of personal possessions, such as ornaments, pictures and photographs, or small pieces of furniture. The rooms and the neat ensuites were all fresh and clean. Grab rails, assisted bath, raised toilet seats and a lift all go towards helping the mobility of people around the home. Environmental Health had visited the home in June 2005, and a fire officer in September 2005, giving guidance to make sure the home operates safely. Staff records show that they all have fire awareness training. The laundry area is away from the kitchen and dining area, and was clean and tidy. Staff spoken to were aware of the correct way to work to prevent and control infection. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 19 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 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are supported by well trained staff, who are generally in sufficient numbers. EVIDENCE: Staff files showed that the necessary recruitment checks had been carried out to ensure the protection of residents. References and Criminal Records Bureau checks were available. The staff group are mainly made up of long term staff, both male and female. “I’m really happy here”, commented one staff member “The management are so approachable”. “We all try to work as a team and work any problems out together”, said the provider. All new staff have induction training, which gives guidance and information on their terms and conditions, and working practices in the home. Further training records were seen as attended by staff, including food hygiene, health and safety, dementia care, infection control, moving and handling, and caring for confusion. “Training is planned, and we all have to attend the courses”, said a carer. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 20 NVQ Levels 2 and 3 are attended, and 55 of the staff have achieved NVQ qualifications. Staff rotas were available, and it was recommended that the numbers of care staff, domestic staff and kitchen staff on duty should be addressed, as the numbers of residents and their needs increase, so that the carers can provide the most suitable care. The amount of hours provided for management duties should be separate from this. Staff were being supported by hands-on work from the provider. Some care plans indicated that staff should try to spend specific ‘quality’ time with residents. Due to the work load this was only occasionally possible. “The staff are brilliant. It’s a really happy atmosphere”, stated a resident in a survey. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 21 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 and 38 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The owners and senior staff work to improve services and to protect the health and safety of residents. However, there is no registered manager to lead and support the staff as a role model, and to develop high quality services. EVIDENCE: The Registered Manager has recently left her role, and the owners are in the process of recruiting another manager. The home at present is being managed by one of the owners, who has a management qualification, with the support of experienced senior care staff who hold NVQ qualifications. One is a qualified nurse. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 22 The owners also own other care homes, so can use their experiences from these to help develop Palmtree Lodge. A visiting relative said they are always able to speak to the management about the care provided, and that it was a very friendly place to be. A survey is used to get feedback from residents and their relatives, and the ones seen were all positive about the home. “Very friendly and helpful”, “happy with the home and standard of care” and “Staff polite and knowledgeable”, are examples of comments. Resident meetings are also held, with family welcome if they wish, and minutes are taken of the discussions and any suggestions made. Visiting GP’s confirmed that staff demonstrate a clear understanding of the care needs of service users, and they were satisfied with the care provided to residents. One of the owners implemented the systems in the home, and is always open to suggestions on ways to improve them. The manager is not responsible for handling any residents’ finances, and they either manage them themselves, or family help in this area. Clear records are kept of any personal allowances. Staff supervision takes place regularly, with each staff member meeting with management to go through a review of their work, personal targets, and any training needs they may have. Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 23 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 4 8 4 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 2 X 3 X 3 X X 3 Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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 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 Refer to Standard OP27 Good Practice Recommendations The owners should make sure the numbers of care staff on duty providing care to residents is suitable for residents needs Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 25 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 Palmtree Lodge DS0000063455.V291089.R01.S.doc Version 5.2 Page 26 - 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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