CARE HOMES FOR OLDER PEOPLE
Patchett Lodge Stukeley Road Holbeach Lincs PE12 7LJ Lead Inspector
Julie Western Unannounced Inspection 8th November 2005 09:30 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 Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Patchett Lodge Address Stukeley Road Holbeach Lincs PE12 7LJ 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) 01406 422012 The Orders Of St John Care Trust Mrs Susan Gardner Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 25th May 2005 Brief Description of the Service: Patchett Lodge is one of sixteen care homes owned and operated by the Orders of St John Care Trust, a registered charity. It is a purpose built two-storey building, formerly a local authority home, and is registered to provide care for up to thirty-eight older people. On the day of the inspection 26 were being accommodated. The home is situated in its own grounds in a quiet residential area for older people in the market town of Holbeach, which has a variety of services and facilities. The home provides its own transport for residents in the form of a mini-bus. Accommodation is provided on two floors, which are accessible via a lift or stairs. In addition the home provides a day care service on the first floor for up to ten persons from Monday to Friday. The day service is not regulated by the Commission for Social Care Inspection and therefore did not form part of this inspection. Residents can use the day care facilities during evenings and at weekends. People who attend for day care also use the same dining facilities as residents. The home’s stated aims are to provide its residents with a secure, relaxed and homely environment in which their care, wellbeing and comfort are of prime importance. Reference is also made to the basic care values of privacy, dignity, rights, choice, fulfilment and independence. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 2 ½ hours. A partial tour of the building took place and care records were inspected. The main method of inspection used was called ‘case-tracking’; this involved selecting three residents and tracking the care they received through the checking of their records, discussions with residents and care staff and observation of practices. Some policies and procedures were examined and records concerning the safety of the home were also seen. Nine of the 30 residents, four of the 47 care and ancillary staff and two visitors were spoken with. The Manager was not present but the Team Leader on duty and the Administrator were present throughout the inspection. What the service does well: What has improved since the last inspection?
The rolling maintenance programme is still in progress with bedrooms being decorated on vacation and several beds have been replaced. The lounge has recently been completely redecorated including new carpets and curtaining and a permanent gazebo has been erected on the patio area. Care plans have been simplified, with some of the duplication having been reduced, saving time for carers. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 the following standard(s): 1,2,4,5 The home clearly sets out what it intends to do for its residents and this information is freely available to residents. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose was examined and was very comprehensive but needed updating to included the name of the new responsible individual. The Manager said a copy of the statement of purpose was in the brochure pack, which was sent or given to all prospective residents or their families. The pack included a copy of the residents’ handbook, a copy of the Quarterly Trust magazine and a summary of the most recent inspection report. The day care gave prospective residents a chance to experience life in a residential care home as they ate meals with the residents and shared some of the activities. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 the following standard(s): 7,9,11 The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. Staff members are knowledgeable about the dying process and death. EVIDENCE: The home uses a Standex card system for recording information and this had been simplified since the last inspection to avoid repetition. The three care plans looked at in depth contained clear and comprehensive assessments, were reviewed regularly and were signed where possible by the service user or relatives/advocates. There was a clear medication policy and the pharmacist visited regularly, the last visit being 13/9/05. Residents said they felt safe and well looked after; one said ‘They’re very kind’ and another said ‘they are such nice people’. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. The Team Leader explained that all staff received training on bereavement, death and dying as part of the induction course and some had visited a local funeral director as part of their training. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 the following standard(s): 12-15 Social activities are extensive and well promoted, creating a variety of events and activities which residents are informed about. The residents exercise choice about which activities, if any, they wish to participate in and what meals they want to eat. EVIDENCE: The home employs an activities organiser for 18 hours weekly; she is responsible for seeking the views of residents about what they wish to take part in. Each resident had an activities profile. The home has a minibus and recent events included a Halloween party and a tea dance with the W.I. Residents said that they frequently had coffee mornings and went out for rural rides when the weather was good; they said those who wanted to had been to Hunstanton and Skegness in the summer. For those who stayed at the home there were books, jigsaws and board games and the residents had their own computer for playing games or writing letters on. Future events, which were advertised around the home, included a market trip, a visit to the local designer shopping outlet and a visit from entertainers. The midday meal was balanced, nutritious and easy for older people to eat, with vegetables served separately. There was a menu board displaying the day’s meals including the alternative choice. Residents all said they enjoyed the meals and were frequently asked for their choices of future meals.
Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 the following standard(s): 16-18 The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: Residents and visitors to the home all said they did not wish to complain but knew how to make a complaint. The home had received one complaint in the last twelve months; this had been responded to appropriately and within the given time. A suggestions box was located in the front entrance hall. There was a clear adult protection procedure, which was linked to the Local Authority procedures. All staff members spoken with had received training on adult abuse and were knowledgeable about complaints. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 the following standard(s): 19-21, 23-26 The residents live in a comfortable and pleasant environment with both private and communal space being generally suitable for their needs. EVIDENCE: The home has a rolling maintenance rota and risk assessments are carried out on the premises to ensure that residents are safe from any potential hazards. The latest redecorations have included several bedrooms, Room 22 in particular having new furniture. The lounge has also recently been completely redecorated including new carpets and curtaining and a permanent gazebo has been erected on the patio area. A resident spoken with said ‘My room is very nice – I’ve brought my own things and it’s just like my old living room used to be, only with a bed!’ The home was clean and smelled fresh throughout, with the exception of the entrance area, where residents smoked; this gave a poor impression to the entrance of the home for visitors. Overall the standard of decorations internally and in the gardens was high and afforded residents a great degree of comfort.
Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 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): These standards were not inspected. EVIDENCE: These standards were not inspected fully but the staff rota showed that staffing was adequate according to the staffing matrix. Staff members and residents said they thought there were enough staff to carry out their tasks within the given time. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 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 The home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of residents are listened to and they are involved in decisions affecting them. EVIDENCE: The registered Manager is an RGN and SCN and is currently working towards the NVQ Manager’s award at Level 4. She has had 27 years’ experience in caring, 8 of these in the management of care homes. The quality assurance manual demonstrated a positive approach to seeking the views of residents and residents spoken with said they were constantly asked for their views on matters concerning the running of the home. There was a record of meals with satisfaction, complaints and concerns logged. The home has the ISO 9000 award and the Investors in People award. Letters from residents’ relatives showed that they felt very much a part of the home and questionnaires supported the evidence that their views were sought.
Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 X 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 3 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 3 18 3 3 2 3 X 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 4 X 3 X X 3 Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? None 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 OP1 Regulation 4 Requirement The registered person must ensure that the statement of purpose is updated. Timescale for action 03/01/06 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 OP20 Good Practice Recommendations It is a recommendation that an alternative to the entrance area is found for those residents wishing to smoke. Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Patchett Lodge DS0000002402.V264594.R01.S.doc Version 5.0 Page 18 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!