This inspection was carried out on 6th July 2005.
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.
CARE HOMES FOR OLDER PEOPLE
Pickering Lodge Care Centre Pickering Nook Burnopfield Newcastle Upon Tyne NE16 6AX Lead Inspector
Jean Pegg Unannounced 6 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Pickering Lodge Care Centre Address Pickering Nook, Burnopfield, Newcastle upon Tyne, NE16 6AX 01207 271900 01207 270966 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) European Care (England) Ltd Care Home 30 Category(ies) of Old age, registration, with number Physical disability of places Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 31st January / 15th March 2005 Brief Description of the Service: Pickering Lodge is registered to provide residential and nursing care for up to thirty older people. The building is a converterd village school on the outskirts of Stanley which provides accomodation over two floors. Bedrooms are currently used to provide single room accomodation but some rooms are large enough to provide double accomodation if needed. First floor bedrooms can be reached via a shaft lift or a stair lift. The home has a range of different sized lounge and dining areas. Externally the home has well kept gardens to the front and to the rear of the building. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as planned on Wednesday 6th July and lasted for seven hours. Six staff and two service users were spoken to during the inspection. Not all of the requirements and recommendations made at the last inspection had been carried out. The home was sold in May 2005 to European Care (England) Limited. What the service does well: What has improved since the last inspection?
All but six of the service user bedrooms have been fitted with door locks to enable privacy. It is expected that the six remaining bedrooms will have door locks fitted before the next inspection. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Service users have their needs assessed before being admitted to the home. EVIDENCE: Two service user files were chosen at random and checked to see if assessments had been completed before admission into the home. Both had records showing that all of the recommended areas for assessment had been covered. Assessment took place prior to admission and continued for the first few weeks of living at the home. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 Service user care plans are not reviewed and kept up to date as often as they should be. The procedures for managing service user medication are satisfactory. EVIDENCE: Two service user care plans were checked. The care plans were well written providing a good level of detail but they had not been evaluated as frequently as they should have been. There was no evidence of the service user or any of their relatives or representatives having been involved in agreeing the care plans. The medication records were checked and were found to be satisfactory. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None None of these standards were assessed. EVIDENCE: Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 11 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None None of these standards were assessed. EVIDENCE: Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 12 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21, 24 & 25 The location and layout of the home remains suitable for it’s stated purpose and the building is kept in a reasonable state of repair and decoration. Service users have access to a sufficient number of bathing and toilet facilities but the tidiness of two of the bathrooms should be improved. Private bedrooms are well furnished and all but six of the bedrooms have been fitted with door locks. More frequent routine water temperature checks may help to reduce the risk of scalding when bathing. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 13 EVIDENCE: Pickering Lodge has a homely, lived in atmosphere. General maintenance work is carried out as and when it is required. The home has access to a handyman who also completes monthly maintenance checks. The grounds were tidy and reasonably well kept with seating areas for service users and visitors. The home has four bathrooms; two that provide assisted bathing facilities. There are two showers available and a number of toilets for service users. The two bathrooms used most often were not as tidy as they should have been to enable service users to have a bath in a relaxing environment. Bedrooms are well furnished, clean and comfortable. Many rooms are personalised by service users to make them more homely. The last inspection said that door locks must be fitted so that service users could have privacy if they wanted it. So far all but six locks have been fitted and the handyman agreed to complete the remaining work. It was recommended that the home carry out a routine weekly check of the water temperatures, records show that this has not happened. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28 & 29 The staffing levels within the home do not allow the manager to carry out the management role properly and staff state that they are experiencing problems with the reduction in staffing levels. So that service users are in safe hands, staff training is needed to make sure that at least 50 of carers are qualified to NVQ (National Vocational Qualification) level 2 by the end of 2005. There is no evidence that the information needed to check if potential employees are suitable to work at the home have been carried out properly. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 15 EVIDENCE: There are nine nursing and eleven residential service users currently living at the home. To look after them, the home has recently altered staffing hours to provide three carers and one qualified nurse throughout the day. Rotas showed that there have been some occasions when only two carers have been on duty. During the night there are two carers and one qualified nurse on duty. At the moment the home has some qualified nurse vacancies which means that during the day, the manager has to share her time between the nursing role and the managers role. This is not very good, as the manager needs to be able to concentrate on the management of the home. Regular nurse agency staff are used by the home to try to provide some continuity of care to service users. Staff spoken to said that they felt the reduction in staffing levels was causing a problem as they did not have the time to spend with service users. Staff commented on the fact that there were eight service users that needed help with feeding and at the moment two-service users who were being nursed in bed. Problems are also experienced at teatime when care staff have to spend some time in the kitchen. There is no dedicated administrative support for the manager and some office equipment was not working which was obviously causing the manager some problems. It was recommended at the last inspection that a minimum of 50 staff trained to NVQ (National Vocational Qualification) level 2 by the end of 2005. The manager said that no progress had been made and that European Care (England) Limited had their own training coordinator who would be looking after staff training issues. One staff file showed that there was no evidence of proper pre employment checks being carried out to make sure that they are suitable for the work. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 & 36 Service user finances are managed appropriately and written records of transactions are maintained. Staff supervision must take place on a regular basis so that staff are clear about the way in which they work and have the opportunity to discuss work related problems. EVIDENCE: Records for service user finances were checked and were found to be satisfactory and in accordance with written procedures. Regular staff supervision was identified as something that needed to be done at the last inspection. The manager said that no progress had been in this area. Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x
COMPLAINTS AND PROTECTION 3 x 3 x x 2 3 x STAFFING Standard No Score 27 2 28 2 29 1 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x 3 2 x x Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 18 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 7 Regulation 15 (2) (b) (c) (d) Requirement The registered person must keep the service users plan under review and where appropriate revise the plan and notify the service user of any such revision The six remaining bedroom door locks are fitted. The registered manager must not employ a person to work at the care home unless they have obtained in respect of that person the information and documents specified in paragraphs 1-7 of schedule 2 and in particular evidence of two references and a criminal records bureau check. The registered person ensures that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice. It is strongly recommended that staff receive supervision at least six times a year. This is outstanding from the last inspection. Timescale for action 31st August 2005 2. 3. 24 29 12 (4) (a) 19 (1) (a) (b) 31st August 2005 31st August 2005 4. 36 18 (2) 31st October 2005 Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 19 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 7 Good Practice Recommendations The service users plan is reviewed by care staff on the home at least once a month, updated to reflect changing needs and current objectives for health and personal care and actioned. The service users plan is drawn up with the involvement of the service user, recorded in a style accessible to the service user; agreed and signed by the service user whenever capable and or representative (if any) Bathrooms should be kept tidy at all times so that service users can enjoy a bath in a relaxing environment. The registered person should ensure that routine weekly water temperature checks are undertaken to prevent the risk of scalding. Staffing levels and staffing mix within the home are appropriate to meet the needs of service users. The manager has all of their hours devoted to the role of management. A minimum ratio of 50 trained members of care staff to NVQ (National Vocational Qualifications) level 2 is achieved by 2005. 2. 7 3. 4. 5. 6. 7. 21 25 27 27 28 Pickering Lodge Care Centre B54 S63766 Pickering Lodge V228473 060705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 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
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