CARE HOMES FOR OLDER PEOPLE
Pickering Lodge Care Centre Pickering Nook Burnopfield Newcastle Upon Tyne NE16 6AX Lead Inspector
Sue Lowther Key Unannounced Inspection 3rd July 2008 11:30 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 Pickering Lodge Care Centre DS0000063766.V367837.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. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 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 Pleuropeancare@aol.com www.europeancare.co.uk European Care (England) Ltd Mr Paul Roper 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.V367837.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th July 2007 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. The fees charged at the time of this inspection were between £394 and £533:50p 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.V367837.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes.
This unannounced inspection of Pickering Lodge took place on the 3rd July 2008. Records were examined and a tour of the building took place. Time was spent talking to people living at the home, staff and visitors. The manager supplied some information prior to the inspection on a form called an AQAA. This is an annual quality assurance assessment for home’s to provide information about their service. The inspection focussed on key standard outcomes for people living at the home. We also checked whether requirements from the previous report had been met. What the service does well: What has improved since the last inspection?
Care plans are now evaluated on a monthly basis and have the relevant plans in place where a risk is identified to make sure that people have plans in place Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 6 to cover all of their needs. These were requirements in the last inspection report. The last report recommended one to one staffing for people who require assistance. This has been implemented and staff were seen to support those who needed help during mealtimes in a sensitive manner. The last inspection report contained some requirements and recommendations with regard to the environment. As a result a new bedpan disinfector has been fitted to reduce the risk of cross infection. Several of the extractor fans that were noisy have been replaced and the dirty ones have been cleaned. The manager said that the conservatory temperature is monitored on a daily basis. The overall programme of refurbishment is ongoing. Several bedrooms have been decorated and some have new furniture. 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. The summary of this inspection report can be made available in other formats on request. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 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 Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use the service experience good quality outcomes in this area. Assessment procedures are in place to ensure that the home can meet the needs of the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is usually the manager. This is to make sure that the home can meet the care needs of the people who go to live there. The family of one person who had recently gone to live in the home confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. Most of the people who responded to the survey said that they had received enough information about the home before they went to live there.
Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 9 The home does not admit people for intermediate care therefore assessment of standard 6 is not required. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. People who use the service experience good quality outcomes in this area. People’s health care needs are well managed by the home. Systems to administer medication are safe and people living at the home say that they are treated well and that the standard of care is good. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Three were examined during the inspection. These were comprehensive and contained individual plans of care. They are now evaluated on a monthly basis and have the relevant plans in place where a risk is identified. These were requirements in the last inspection report. However it is recommended that evaluation sheets include the name of the person and the care plan to which it corresponds to avoid any confusion. Some did not include written evidence to confirm that where possible the person who lives in the home had been involved and agreed to the plan of care.
Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 11 People spoken to during the inspection said that they are happy with the care received and the level of information given. One relative said, “The home did their best to settle in my relative. When she was upset they always rang me and I went to see her or spoke to her on the phone. She is now quite content”. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Two health care professionals returned surveys. Both indicated that they are happy with the standard of care at Pickering Lodge Medication is administered by qualified nurses . The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. People spoken to said that staff always treat them with dignity and respect. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. People who use the service experience good quality outcomes in this area. The activities are varied and provide recreation for some of the people who live in the home. Family and friends can visit at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and people are given a choice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Some of the surveys returned indicated that activities are not always suitable. Comments included “Perhaps more social activities” and “Would like more trips out”. However a new activities organiser had been appointed and at the time of inspection, she had only been working in the home a few days. She told the inspector that she had been talking to the people about what they would like to do and trips out were going to be a priority. She also intends to do activities requested by the people and that this would sometimes be at weekends. During the afternoon of the inspection a group of people were involved in card making. The atmosphere was relaxed and everyone seemed to enjoy it. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 13 People were asked about visiting arrangements, which are flexible. One of the comments from a visitor included, “We are made welcome to the home, its lovely”. Visitors can see people in their own rooms or in any of the communal areas available throughout the home. Comments about the food were good. The looked appetising and people said that it was tasty. Specialist diets are catered for and include menus for diabetics and soft menus. The last report recommended one to one staffing for people who require assistance. This has been implemented and staff were seen to support those who needed help during mealtimes in a sensitive manner. One person said, “The food is good, no complaints”. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. People who use the service experience good quality outcomes in this area. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and sufficient safeguards are in place to protect them from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. There have been no complaints recorded since the last inspection. One person said, “If I had a problem I would tell the staff”. One relative said, “I have never had any reason to complain. If I am unhappy about anything I approach any member of staff immediately and it is sorted as soon as possible”. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. One member of staff said, “I would have no hesitation in reporting any concern. I
Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 15 am here for the residents”. Another said, “I would always report anything straight away”. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26. People who use the service experience good quality outcomes in this area. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: During a tour of the building the inspector saw that many of the rooms are decorated to the person’s own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. There was a range of equipment seen around the home to support people with bathing and mobility. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 17 The last inspection report contained some requirements and recommendations with regard to the environment. As a result a new bedpan disinfector has been fitted to reduce the risk of cross infection. Several of the extractor fans that were noisy have been replaced and the dirty ones have been cleaned. The manager said that the conservatory temperature is monitored on a daily basis. The overall programme of refurbishment is ongoing. Several bedrooms have been decorated and some have new furniture. The inspector found the building to be clean, tidy and free from offensive odours. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. People who use the service experience good quality outcomes in this area. The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the people who currently live in the home. Training is provided for all staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. People said that staff were usually around and answered the call bells quickly. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with many of the staff having an NVQ at level 2 or above. Training is provided for staff. As well as mandatory training, recent training has also taken place in adult protection and health and safety. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments included “There is always lots of training, sometimes too much”.
Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 19 Another said, “The manager is always encouraging staff to attend different courses.” Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38. People who use the service experience good quality outcomes in this area. The home’s registered manager provides clear leadership, support and guidance to those living and working at the home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager is a qualified nurse and has completed an appropriate management course. There was an open and friendly culture between the management team and staff working at the home. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. Staff confirmed that supervision takes place on a regular basis and that they are
Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 21 well supported. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to him if they had any concerns. Regular meetings are held and the company have a number of systems in place to consult with people living at the home. The manager confirmed that monthly Regulation 26 audits by the owner take place. Customer satisfaction surveys have also taken place and the manager said that comments are acted on and improvements made wherever possible. Personal finances are kept in the home for people who request this. Two signatures are obtained and receipts are kept to ensure peoples’ financial interests are safeguarded. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. However the electrical wiring certificate was not available. The manager said that this work was due to be done the week after the inspection. He has since confirmed that this has been done. A copy of the certificate must be submitted to the CSCI as soon as it is available. Health and Safety checks are carried out regularly to safeguard people living and working at the home. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP38 Regulation 23(2) Requirement A copy of the electrical wiring certificate must be submitted to the CSCI as soon as it is available. Timescale for action 31/08/08 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 OP7 OP7 OP19 Good Practice Recommendations It is recommended that care plan evaluation sheets include the name of the person and the care plan to which it corresponds to avoid any confusion. Wherever possible care plans should contain written evidence that people have involved in their care plans and have agreed to the content. The programme of refurbishment should continue to provide a homely environment throughout the home. Pickering Lodge Care Centre DS0000063766.V367837.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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