Inspection on 11/05/06 for Pickering Lodge Care Centre

This inspection was carried out on 11th May 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

Pickering Lodge Care Centre 08/07/09

Pickering Lodge Care Centre 03/07/08

Pickering Lodge Care Centre 05/07/07

Pickering Lodge Care Centre 05/10/05

Pickering Lodge Care Centre 06/07/05

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Pickering Lodge Care Centre Pickering Nook Burnopfield Newcastle Upon Tyne NE16 6AX Lead Inspector Jean Pegg Unannounced Inspection 11th May 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 Pickering Lodge Care Centre DS0000063766.V291850.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. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pickering Lodge Care Centre Address Pickering Nook Burnopfield Newcastle Upon Tyne NE16 6AX 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) 01207 271900 01207 270966 www.europeancare.co.uk European Care (England) Ltd Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (30) of places Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2005 Brief Description of the Service: Pickering Lodge is owned by European Care (England) Limited and is registered to provide residential and nursing care for up to thirty older people. The home is a converted village school on the outskirts of Stanley. The original building has been extended to provide accommodation over two floors. Inside, the home has a range of different size lounge areas and dining spaces. Bedrooms are currently used to provide single room accommodation but some bedrooms are large enough to provide double room accommodation should it be required. One set of first floor bedrooms can be reached via a passenger lift. A stair lift takes you to first floor bedrooms that are on the opposite side of the building. Some of the bedrooms within the home have en-suite facilities. Outside, the home has a small front garden and a medium size back garden and these are reasonably well maintained. The home overlooks the main road that runs through the village and is close to all local amenities and residential housing. At the time of this inspection, it costs between £356 and £412 a week to live in this home. Additional charges are made for personal items and services for example toiletries, hairdressing, newspapers etc. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on Thursday May 11th and Tuesday May 16th and lasted for 13 hours. As part of the inspection 3 service users, 1 relative and 4 members of staff were interviewed. 8 service user surveys and 1 relative survey were also received. The 5 surgeries that provide G.P. services to the home were sent comment cards, 2 of these were returned by the date asked. A variety of documents were looked at and a tour of the building was made to check that it was well looked after. What the service does well: Information is available to help new service users to decide if the home is right for them. Service user health needs are met by making sure that they are able to see a range of other health and care professionals. The way medication is managed in the home is generally satisfactory. On the whole, service users felt that they were treated with respect and that privacy was upheld. “Some staff knock before entering rooms and some don’t. It depends upon the member of staff.” Service users are able to keep in contact with family and friends. Generally, service users are able to make choices and keep control over their lives. Service users are offered quite a good diet. “Someone comes with a menu and gives you choices.” “They generally come round on a morning, you have two options and if you don’t want (it), they say what can I get you?” Complaints are listened to and acted on. Overall, the home is reasonably well maintained including the garden and car park. There are enough toilets and bathrooms within the home. The home is generally clean and reasonably tidy. “My bedroom gets cleaned every day.” “That carpet was washed yesterday.” “I am satisfied with the cleanliness.” There are enough staff on duty to meet service user physical needs like bathing. Over half of the care staff have a nationally recognised qualification in care. The home carries out proper checks on staff before they start to work in the home. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: The information contained in the Service User’s guide needs to be improved as it does not contain everything it is required to do. It should provide sufficient information to service users about services and facilities available in the home. Not all service users have a written contract or statement of terms and conditions, which means that they do not have a written agreement about what they are paying for. Service users are assessed before they are admitted to the home. The quality and detail of that assessment could be a lot better so that all needs are known and understood. Care plans could be improved by making sure that service user social care needs and how they will be met are included. Staff need to know how to report concerns or suspicions of abuse as described in the Local Interagency Adult Protection Procedures. The home is old fashioned in appearance. Furnishings and facilities inside the home are adequate but are in need of updating. The quality of some of the furniture in the bedrooms is not good. Some service users experience problems with lighting and heating. “The building is old, it leaves a lot to be desired with the electrics going off, quite a lot in my opinion.” “Heating was always a problem, in winter it was too low and in summer too high.” New staff should have a proper induction to the job, in line with the National Training Organisation timescales. Pickering Lodge Care Centre DS0000063766.V291850.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. Pickering Lodge Care Centre DS0000063766.V291850.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 Pickering Lodge Care Centre DS0000063766.V291850.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): 1, 2, & 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information is available for prospective service users to make an informed choice about where to live, however, the information contained in the Service User’s guide is limited and should be expanded to provide more relevant information. Not all service users have a written contract or statement of terms and conditions that details what services they are entitled to receive for the fees paid. Service users are assessed prior to being admitted to the home but the quality of that assessment could be improved by making sure that all sections are completed about the individual being assessed. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 10 EVIDENCE: All 8 service users who completed the surveys said that they had received sufficient information about the home before moving into it. The home has recently updated its Statement of Purpose and Service User’s Guide. Both of these documents have been checked. The Statement of Purpose contains all of the information required by regulation. The Service User’s Guide needs to include more information about the terms and conditions of residency including the amount and method of payment of fees, a copy of the standard form of contract for the provision of services, a summary of the home’s complaints procedure and details as to where a copy of the latest Inspection Report can be found. From the survey results, 5 service users said that they had not received a contract, 1 said that they had and 2 said that they did not know. Not all service user contracts were available for viewing, of those that were seen, there was no evidence of the contracts having been signed by either the service user or their representative. 2 service user assessments were looked at in detail. Generally the standard and level of detail contained within the pre admission assessments varies according to when the assessment was completed. Of the documents seen, the new pre admission assessment form covers all of the areas identified within the national minimum standards, however, not all sections had been completed fully and signatures and dates were missing. Pickering Lodge Care Centre DS0000063766.V291850.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 &10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user health and personal needs are set out in care plans but there is no evidence that they have been written with the agreement of the service user. The inclusion of social care needs would improve the standard of these plans. Service user health needs are met by providing access to a range of other health and care professionals. The management of medication within the home is satisfactory. Generally, service users felt that they were treated with respect and that their privacy was upheld. EVIDENCE: The manager confirmed that almost all of the service users had care plans completed in the new format. 2 care plans were looked at in detail. Both could be more detailed in their content but they do give a good idea about what type Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 12 of support should be offered to each service user. The care plans focussed mostly on the personal and health care needs of service users and each service user had a financial care plan in place, which is to be commended. Care plans would be improved if plans relating to social needs were devised based on service user preferences. There was no evidence of service users and, or, their representatives signing agreement to the content of the care plans. Of the 3 service users spoken to only 1 said that they knew what was in their care plan and that they “more or less agreed with what was in it.” Of the 3 staff spoken to all said that they had seen service user care plans but mainly for residential service users. The level of knowledge about what was contained in the care plans differed from person to person. Of the care plans seen there was no evidence to show that they were being evaluated on a regular basis. Internal monthly regulation 26 reports indicate that the quality of care plans is being monitored and that only some are being updated regularly. The manager is aware of the problem and is in the process of introducing a systematic process for auditing 6 care plans each week. The daily records show that health checks are being maintained. Service users who talked about visits to the hospital and dentist etc confirmed this. G.P.s were seen visiting service users. The 2 G.P.s that had returned the comment cards sent to them indicated that they were generally satisfied with the overall care provided by the home. No negative comments were made or indicated. Dietary forms are completed and given to the cook so that he is aware of individual service user preferences. The cook commented that the information “was very helpful”. The drugs administration system used within the home was audited and was generally found to be satisfactory. There were some areas where improvements could be made and these were discussed with the manager. Service users spoken to confirmed that they were given their tablets regularly and staff confirmed that only those qualified to do so gave out tablets. The way tablets are given out in the home was observed and was seen to be generally satisfactory. The deputy manager audits the medication regularly although the audit tool used could be more detailed. The service users spoken to indicated that staff were generally respectful. Comments included “they try to be as fair as they can.” “Some staff knock before entering rooms and some don’t. It depends upon the member of staff.” Service users commented that they were given time to soak in the bath if they wanted. One service user gave an example of how staff were respectful “ when I have a bath, they take all my clothes down that I want so they are there to put them on. I get a cup of tea when I am finished.” Different members of staff spoken to were able to give examples of how they think they showed respect towards service users. Pickering Lodge Care Centre DS0000063766.V291850.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 &15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Opportunities for service users to experience a lifestyle that matches their expectations and preferences are not yet fully developed. Service users are able to maintain contact with family and friends. Generally, service users are able to maintain choice and control over their lives. Service users are offered a balanced and varied diet in an improving dining environment. EVIDENCE: Since the last inspection, the home now has access to an activities coordinator for 2 days a week. The coordinator had only been working at the home for about 2 weeks before the inspection visit took place. The manager said that the coordinator intends to get to know service users and collect information about their likes and dislikes. It is intended that based on this information, that the coordinator will then organise both internal and external activities including 1:1 activities with individual service users. The coordinator will also Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 14 plan activities to be carried out by care staff when the coordinator is not in the home so that activities are not just restricted to the two days she is available. Records were seen of service user attendance at different activities. When spoken to service users differed in their opinions about the activities within the home. These are some of the comments made. “ There is a lot of card making!” “I like to knit but I’m shaky.” “ I never get asked, not much I can do.” “ I am asked what I like to do, I sometimes go to the shops.” “There aren’t a lot (of activities) because there are so many people who won’t get them selves into anything, like card making. I like things like that, it occupies your mind.” “We have a singer coming on Sunday, I love music. I still read, we haven’t got a library, we used to have, but it was stopped. My daughter brings me books.” Visitors were seen coming and going in the home and service users spoken to confirmed that they had regular visitors. The manager intends to organise resident and relative meetings but as yet no progress has been made on this. The recommendation to provide relatives with written information about the home’s policy on ‘maintaining family involvement’ has not been fully implemented. Financial care plans are now produced for each service user that show how service user finances are managed and who manages them. Service users were able to confirm the arrangements made about how their personal finances are managed. Personal possessions are evident in individual service user rooms including large items of furniture, electrical items and ornaments. The dining room areas have been redecorated and flower arrangements have been made and placed on the tables helping to make them more attractive. It was noticed that table linen could be changed more frequently to ensure that a higher standard of cleanliness is maintained. The majority of service users who completed comment cards indicated that they were happy with the meals provided. The manager has recently introduced the practice of photocopying dietary information from service user care plans and passing it onto the kitchen so that menus can be adjusted accordingly. The Chef confirmed that this had been “helpful in knowing what people liked or if any special diets were needed.” There was evidence of diets being managed to reduce the need for some medication. This is noted as being an example of good practice. The manager provided copies of 4 weeks menus. The menus showed that alternatives are available and these choices were seen. When service users were asked questions about meal times, menus and choices, they said the following. “ Someone comes with a menu and gives choices.” “They generally come around on a morning, you have two options and if you don’t want, they say what can I get you?” “(name) generally comes round. Choice between 2 things, today it is chicken pie.” None of the service users spoken to said that they had been asked about their dietary preferences at the time of their admission into the home. All service users spoken to said that they were able to choose where they dined. The meals seen were nicely presented and service Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 15 users were encouraged to eat independently however, some service users would have benefited from closer supervision to improve their dining experience. Mealtimes are stated as being breakfast 9am, lunch 12.30pm, evening meal 5pm and supper 7.30 – 8.00pm. The staff spoken to were all complimentary about the chefs involvement with service users in that he is proactive in finding out what people like to eat. Staff also confirmed that there was sufficient food and choices on offer. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are listened to and acted on. Better knowledge of and access to local Interagency Procedures for Adult Protection is needed to help ensure that service users are fully protected from abuse. EVIDENCE: Copies of the updated complaints procedure have now been placed on notice boards and in service user bedrooms. Service users spoken to were able to name people they would complain to in the home. They all knew who the manager was and his name. The manager said that no formal complaints had been made and a social care professional, who was visiting the home, said that they had “never received any bad comments from families.” The staff spoken to were able to give examples of daily concerns raised by service users and described how they would be dealt with. European Care corporate policy on the protection of vulnerable adults states that it should be adapted to ‘local procedures’. Copies of the local procedures were not available in the home but discussion with the manager showed that he had a good general knowledge of the procedures to be followed but that specific contact details were not known. When asked, staff were able to describe what actions they would take if they suspected any form of abuse within the home. Their knowledge of reporting systems outside of the home Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 17 were not that good indicating that there needs to be training in and access to copies of the local interagency procedures including contact details and lines of responsibility. Service user cash records were checked and were generally found to be satisfactory. However, the procedure for gaining 2 signatures when withdrawals were made was not always evidenced in records. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 18 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, 20, 21, 24, 25 &26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, the home is reasonably well maintained but dated in appearance. Indoor facilities are adequate but dated and in need of renewal. Outdoor facilities are reasonably well maintained. There are sufficient numbers of lavatories and bathing facilities within the home but some of the facilities are not fully utilised. The quality of furnishings within bedrooms is variable with many items in need of replacement or renewal. The heating and lighting within the home is only adequate, with problems being experienced by service users in temperature control. The home is generally clean and reasonably tidy. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 19 EVIDENCE: The location of and layout of the home remains the same. A walk around the building provided evidence that the home has recently had all of the communal areas painted which does make it look cleaner. A gardener is now employed to look after the home’s gardens. Externally the garden and parking areas looked fine and new signs have been put up showing the correct name and ownership of the home. When asked, the manager was unable to show evidence of a written plan showing the frequency and extent of renewal and refurbishment to take place within the home. The staff room has been painted but still looked shabby because of the dirty carpet. The manager said that a new one was on order. The home has 3 lounge areas, 1 dining room and 2 conservatories. The garden is accessible to wheelchair users and service users were seen going out into the garden. Light fittings are domestic in nature but service users commented on the electricity going off occasionally. One service user commented, “ The building is old. It leaves a lot to be desired with the electrics going off, quite a lot in my opinion.” Some new linen and soft furnishings have been replaced but the majority of the furniture is dated and showing signs of wear and tear. This criticism of the home was as shared by a visiting professional. Only 1 bathroom tends to get used within the home, mainly because it has a ‘Parker bath’ installed which staff and service users tend to prefer. This leaves 1 bathroom that never gets used and 2 that sometimes get used. Bathrooms still need to be made less clinical and more homely in appearance to create a more relaxing environment. Some bedrooms have en-suite facilities. Door locks have now been fitted to all of the bedroom doors. Some bedroom carpets were showing signs of age and some unpleasant smells were evident. Furniture is looking old and some items were stained and chipped in places. There was evidence to show that bedrooms were not being checked thoroughly when being prepared for new residents. An overhead light shade was missing from one bedroom and stains were evident on a bedroom ceiling. Service user bedrooms were individualised and many personal possessions were evident reflecting individual tastes. The manager confirmed that some new beds were on order. Rooms were generally very warm. Windows were open but radiators were on. There was evidence of temperature control problems in that fans and secondary heating were seen in rooms. A service user commented “heating was always a problem, in winter it was too low and in summer too high.” The manager said that heating problems were being investigated to see if improvements could be made. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 20 The majority of areas within the home are clean but some bedroom carpets have an odour. Some surfaces have deteriorated to the point that it is difficult to determine if they are clean or dirty. Cleaning rotas and checklists were available but these were unreliable due to inaccuracies in recordings made on them as to when things had been cleaned. Training in ‘Infection Control’ was taking place during the inspection visit. The tumble drier was not working in the laundry. This breakdown had been reported and was awaiting repair. This is not seen as satisfactory as the use of driers helps to control the spread of infection. Service users confirmed that rooms were cleaned daily. “My bedroom gets cleaned every day”. “That carpet was washed yesterday.” “My room gets cleaned 2 – 3 times a week.” “I am satisfied with the cleanliness.” 4 service users felt that the home was always fresh and clean, 2 felt that it was usually fresh and clean and 2 felt that it was only sometimes fresh and clean. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 21 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are adequate to meet service user physical needs. Over 50 of care staff have a nationally recognised qualification in care. The home maintains satisfactory recruitment records making sure that proper checks are carried out on staff before they start working at the home. Staff are offered training to help them do their jobs. EVIDENCE: Rotas show that for 17 service users, there is always a qualified nurse on duty in addition to the manager, who now has all of their hours devoted to management. Rotas also show that there are 3 care staff on duty until 3pm then 2 care staff until 9pm. From 9pm – 8am there is 1 qualified nurse and 2 care staff on duty. The manager said that he was currently recruiting staff so that staffing levels could be increased as new service users are admitted to the home. Service user comment cards and those spoken to indicate that staff do not spend a lot of time talking to them as they were often “busy”. When staff were asked how much time they spent talking to service they felt that it was “quite a lot”. Comments made would suggest that conversation mainly took place whilst staff were carrying out tasks rather than sitting down and having a conversation with service users. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 22 Rotas showed that 8 of the 13 care staff employed in the home have at least an NVQ (National Vocational Qualification) level 2. This means that over 50 of staff have a recognised qualification in care. Recruitment records of new staff were checked and found to be satisfactory. The manager has completed a training needs analysis for the home and has organised mandatory training for staff so that they can remain up to date. Files have also been prepared for staff that show individual achievement against planned training. Copies of training certificates are kept on files. Not all new staff have evidence of an induction record. 1 service user felt that “staff could do with a bit more training to keep up to date” and another felt that “yes” staff were trained to do their job. Staff indicated that they were “quite happy” with the training offered. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 23 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 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a newly appointed manager who is well liked but who needs further training and more experience before this standard can be met. Service users are not fully involved in decisions made about running the home. Records of service user finances are maintained and facilities are in place for the safekeeping of valuables. The management of health and safety within the home is satisfactory. EVIDENCE: The new manager started to work at the home in March 2006. This is his first appointment as a care home manager. The manager is a Registered General Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 24 Nurse with experience in elderly care. He is waiting to start his Registered Managers Award. Staff and service users were clear about who the manager of the home was. A service user made the following comment, “I think he is grand! He comes every morning to speak to you.” When service users were asked if they were ever asked their opinion about how the home is run, only one said that they had been asked if they “liked the colour chosen” for the home when the home was last painted rather than being asked what colour they would have liked. The service user spoken to felt it was a “fait accompli!” Other service users spoken to could not think of any examples when they had been asked their opinion about the running of the home. Service user survey results show that they do not always think that their views are listened to or acted upon. The home has a business plan that covers short, medium and long-term objectives for developing the home and it’s business. The home also has a quality assurance programme that is due to be implemented as from May 2006 and the manager said that service user questionnaires were ready to be sent out. The home has produced financial care plans for each service user that identify who is responsible for managing service user finances. Where money is held on behalf of the service user, written records are maintained. These records were checked and were generally found to be satisfactory. The home has a safe for the keeping of valuables. Health and safety training has been organised for staff. Kitchen staff are labelling and dating stored food and records of cleaning routines are kept up to date. Staff were seen using gloves and aprons at appropriate times. Weekly safety audits of cot sides were seen. The manager provided information indicating that health and safety compliance checks were undertaken and were mainly up to date. Random checks of certificates were made. The manager showed evidence that authorisation had been given to him to arrange Portable Appliance Testing of electrical equipment. This work should have been completed in September 2005. General work risk assessments were available and accident books were seen. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 25 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 2 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 2 2 X X 2 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 3 Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 26 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 OP1 Regulation 5 (1) (a–f) Requirement The Service User’s Guide must include all of the information specified by regulation in particular the terms and conditions of accommodation, a copy of the standard contract and a summary of the complaints procedure. Each service user must have a standard form of contract and, or, where nursing is provided a statement specifying the fees payable and method of payment. The registered person must make arrangements for staff to have access to and training in Local Interagency Adult Protection Procedures, to prevent service users from being harmed or suffering abuse or being placed at risk of harm and abuse. The registered person must ensure that ventilation, heating and lighting suitable for use by, service users is provided in all parts of the care home, which are used by service users. Timescale for action 31/08/06 2 OP2 5 (1) 31/08/06 3 OP18 13 (6) 31/08/06 4. OP25 23 (2) (p) 31/08/06 Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 27 5. OP33 24(1)(a) (b)(2)(3) The registered person must 31/08/06 ensure that effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and the statement of purpose of the home. (Previous requirement - timescale for action January 31 2006) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP7 OP12 Good Practice Recommendations The preadmission assessment should be completed in as much detail as possible and be signed and dated when completed. Care plans should include how social needs will be met and should be drawn up with the involvement of the service user. The registered person must make sure that service users have opportunities for stimulation through leisure and recreational activities in and outside the home which suit their needs and abilities. (Previous recommendation October 2005) The registered person should make sure that relatives, friends and representatives are given written information about the home’s policy on maintaining relatives and friends involvement with service users at the time of moving into the home. (Previous recommendation October 2005) A programme of routine maintenance and renewal of the fabric and decoration of the premises should be available within the home. Furnishings within the home should be updated and renewed regularly to prevent the home from appearing dated. 4. OP13 5. 6. OP19 OP20 Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 28 7. 8. 9. OP21 OP24 OP30 Bathrooms should be made less clinical and more homely in appearance so that service users can enjoy a bath in a relaxing environment. Bedroom furnishings should be updated and renewed when needed. All new staff should receive induction training to National Training Organisation timescales. Pickering Lodge Care Centre DS0000063766.V291850.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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