Inspection on 15/05/05 for Portland Lodge

This inspection was carried out on 15th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Portland Lodge 08/08/07

Portland Lodge 10/11/06

Portland Lodge 13/04/06

Portland Lodge 10/11/05

Portland Lodge 17/11/04

Portland Lodge 18/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Portland Lodge 21 Landguard Manor Road Shanklin Isle of Wight PO37 7HZ Lead Inspector Mark Sims Unannounced 15th May 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. Portland Lodge Version 1.10 Page 3 SERVICE INFORMATION Name of service Portland Lodge Address 21 Landguard Manor Road, Shanklin, Isle of Wight, PO37 7HZ 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) 01983 862148 Isle of Wight Care Ltd Mrs Tina Sara Hughes-Thomas Care Home 19 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number disorder, excluding learning disability or of places dementia (3), Old age, not falling within any other category (19) Portland Lodge Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: One service user may be accommodated under the age of 65 years in the category MD in addition to the three detailed above. Date of last inspection 17/11/2004 Brief Description of the Service: Portland Lodge is registered to accommodate 19 service users, four of which are younger adults (under the age of 65), within 3 categories - DE(E), MD & OP. The property is a large period town house, which is situated along Landguard Manor Road, Shanklin. The amenities of the town are within walking distance for the younger clients and more able bodied, although are potentially too far away for older, less mobile service users to access directly. As the service does not include access to an in-house car or minibus, public transport becomes the most obvious route into town with regular bus services passing the home daily. The premises provides accommodation for service users across two floors, although the first floor is only accessible to fully ambulent individuals, as no passenge lift or stairlift is provided. The accommodation at the home is used mainly on a single room basis and communal facilities are open planned, with the dining room and lounge areas opening up onto one another in an L shaped configuration. Portland Lodge Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a weekend and lasted for five hours, during which time the inspector spent time observing activities within the lounge and dining areas, undertook a tour of the premises, met with service users and staff and reviewed several key documents. This inspection was unannounced and will form part of the 2005-2006 inspection cycle. What the service does well: What has improved since the last inspection? What they could do better: The mixed client group spend little time socialising and even at mealtimes the younger adults appear to make use of the dining room facilities, whilst the older, frailer service users are supported by staff within the lounge. Whilst generating more interactive entertainments might be difficult and challenging it would be nice to see the service user groups more integrated, as the benefits for the older residents especially could be constructive. As already indicated the management has failed to adequately tackle the requirements and recommendations raised during the inspection of 17 November 2004, with the management still needing to complete the review and replacement of damaged furniture(s), although some bedrooms have Portland Lodge Version 1.10 Page 6 apparently been frefurbished, cover all radiators, provide staff with access to medications training, obtain a suitable controlled drugs register, maintain adequate records of meals served, fit a thermostatic valve to a sink (with extremely hot water supply), undertake regular tests on emergency lighting, provide each service user with an up to date and accurate care plan and address the deteriorating external decoration of the property. The management could and should also be aware of the need to monitor the appearance of the property in order to ensure a homely, tidy and pleasant environment is created and sustained at all times. Evidence of the management’s lack of attention to the premises could be seen in the failure to remove an item of clothing from a first floor window sill (external), which was noticed to be in the same position at the November 2004 inspection. Whilst it is acknowledged that this item of clothing might be there at the request of one service user, the management should recall that the appearance of the home reflects on all residents and that if this particular behaviour is difficult to challenge or address that a referral to the appropriate professional supports might be worth consideration. Clincal waste bags were left unsecured and open to both the eliments and vermin, old domestic and garden waste was stacked up in the back yard awaiting collection and the flaking external paintwork still required addressing or a planned date for the commencement of redecoration work forwarded to the Commission. Internally the home would benefit from lamp shades being reinstated, exposed wiring within the entrance hall making good and the door bell repairing, so people can attract the attention of staff when visiting. The amount of social stimulation for service users during the visit was minimal and people were left sitting in protective clothing (aprons) for most of the inspection, it was also necessary to tackle staff over moving and handling practices, with lifts being undertaken that are now banned. Other areas of the staff’s practice that required challenging during the visit included issues around the storage of medications, with topical applications and oral preparations stored within the same cupboard, care plans still require reviewing and updating, some service users having no care plans in place, despite it being relatively simple to identify some core care needs from the running records and discharge information. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Portland Lodge Version 1.10 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 Portland Lodge Version 1.10 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) St 3. The pre-admission information is neither signed nor dated and information gathered is not used to underpin service users’ plans. EVIDENCE: Four service users’ plans were inspected during the visit, with varying degrees of pre-admission information available: assessment sheets, placement agreements, discharge plans, etc. Whilst the levels of information available to the staff is reasonable, what they do with the information they gather is insufficient with one service user yet to have any care plans produced and two others having single care plans provided. Pre-admission assessment visits are undertaken by members of the senior staff team or the manager, according to staff, however as the assessment sheets are neither signed nor dated, as highlighted, this is hard to verify. Portland Lodge Version 1.10 Page 9 The inspection of the information collected prior to admitting a service user is reasonable and addresses/identifies most of the person’s immediate and midterm care needs. Portland Lodge Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 7, St 9, St 10. The home’s approach to care planning is poor, with insufficient plans in place to meet the multiple needs of the service users. The home’s approach to the management of service users’ medications is poor, with medications inappropriately stored, staff insufficiently trained and recording practices for controlled medications remain unsafe. There was evidence to suggest that issues around dignity and respect may not always be fully considered, with people left wearing aprons throughout the morning and one person’s privacy compromised when accessing toileting facilities, although the latter should be considered as an isolated incidence. EVIDENCE: As previously highlighted four care plans were thoroughly inspected during this visit, although all files were reviewed to ensure basic information such as photographs, etc. were available, six of the files reviewed were found to be missing photos. Of the four plans reviewed the inspector found only one with more than a single care plan in place and these were out of date and no longer applicable to the service user. Two plans contained single care plans and the remaining file Portland Lodge Version 1.10 Page 11 contained no care plans, despite obvious care needs identifiable for each person. To compound this situation none of the plans inspected contained any evidence of having been recently reviewed or updated. The fact that the care planning files were so badly maintained is leading to errors in practice or to care being delivered in direct contradiction to the advice and guidance provided by health care professionals. As evidenced by the instruction provided by a Speech and Language Therapist who advised that all drinks for a particular service user should be thickened with ‘Thick and Easy’ and that the resident should use a teaspoon when eating, to reduce the possibility of choking and asphyxiation (taking food into the lungs, a consequence of swallowing problems). However, when observed the resident in question was using a dessert spoon to eat unsupervised and staff when challenged knew nothing about ‘Thick and Easy’ and stated the home had access to no such product, despite it being available on prescription. It should be pointed out, however, that the instruction might, of course, no longer apply to the service user, whose general condition might have significantly improved. However the home has not sought to re-refer the resident to the Speech and Language Therapist or General Practitioner for review and so the guidance should still be followed. The issue is further complicated by the conflicting information provided by the discharging ward at St Mary’s Hospital, where the service user is noted to require assistance with eating and drinking, but also to be self-caring with this need and taking a normal diet. The discharging nurse has also made no reference to the speech and language therapist report, all issues which should have been identified by the assessing staff member and clarified prior to the person’s admission or soon afterwards. The home’s medication system was another area of the home’s general practice that was found to be lacking direction and cohesion. At the last inspection it was advised that records relating to controlled drugs be documented within an appropriate register, as the system being used by the home was deemed unsafe and inadequate. However on this inspection it was evident that nothing had changed following the inspection, although the manager stated she had rung one possible supplier who could not help. The expectation would be that more than one supplier be contacted, in order to facilitate the successful appropriation of a controlled drugs register, etc. It was also advised that one staff member trained to handle and administer medications to service users was insufficient and that access to approved training should be made available to all care staff. Again nothing has changed since the last inspection, although again the manager says she has contacted the Isle of Wight College regards their training programme, which was over subscribed. Portland Lodge Version 1.10 Page 12 Further evidence of the need to train more staff in the management of medications was identified at this inspection with topical applications (creams) stored alongside oral preparations (tablets, liquids, etc.) and non-controlled medications kept in the controlled medications cabinet, haloperidol, risperidone, dihydrocodine, etc., despite both actions being contrary to current legislative guidance. One aspect of practice, observed during the inspection, which raised question for the inspector was whether or not, at times, staff were disregarding people’s right to the promotion of dignity and respect. The practice of leaving frail older people sat in aprons to prevent clothing being spoilt, etc. associated to institutionalised practices that are no longer considered best practice or in the best interest of residents. This issue coupled with the inspector’s observation of a resident accessing a commode, left in their room with the door open, suggesting that staff do not always consider the wider ramifications of their actions, although the inspector accepts that the latter incident was likely not to be an intentional practice. However, the management should seek to address this issue with staff, or to consider alternative reasons behind its occurrence, such as insufficient staff being on duty to properly care and attend to the needs of the residents. Portland Lodge Version 1.10 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 standard(s) St 12, St 15. The experience of the younger and older service users differs greatly with regards to social activities and recreational pursuits. The home provides a choice of main meals to service users. Meals are basic, wholesome foods that are reasonably presented and seemed to be enjoyed by the service users. Menu or meal records were poorly maintained and a chalkboard within the dining room was advertising a meal available two days earlier. EVIDENCE: Activities and entertainments for service users seems to be a mixed bag, which depends largely on whether or not you are an older or younger service user. In discussions with several of the younger adults it was clear that they enjoy fairly active and independent social lives and are able to come and go within reason, as they please, one service user having access to a door key if he is planning on returning to the home late in the evening. Other activities undertaken by the younger adults include self-directed shopping trips, the accessing of day services and clubs, socialising with friends and the development and maintenance of relationships. Portland Lodge Version 1.10 Page 14 One of the service users has also taken on responsibility for updating the chalkboard in the dining room, which as indicated above, was two days out of date. It is important for the orientation of older people, especially, that information contained on the board, including menu options and the date, etc. is updated appropriately, this has been discussed with the manager. Throughout the inspector’s time within the home and specifically within the lounge little in the way of social interaction or entertainments were available for the older service users. Whilst the television was on people seemed generally disinterested in this means of entertainment, a situation compounded by the fact that the control was dominated by a single assertive service user who was not considerate of the needs or wishes of his fellow residents. His domination of the general environment largely went unchallenged by staff, who seemed to prefer avoidance as apposed to confrontation with this individual. In discussions with this resident it was ascertained that he enjoyed a relatively good social life and that he had recently attended a day centre and participated in a whist drive, (although it had not worked out quite as anticipated and he may decide not to return to the club), attends church on alternate Sundays, which he enjoys and is able to wander out into the small back garden to smoke. Smoking is a big issue for several of the service users, younger and older, and the home has attempted to accommodate people’s desires to smoke within the home as best they can. The arrangement made by the manager is less than ideal, as the smoking zone or area is located in a corner of the dining room, has no natural ventilation and is on full display to all non smoking service users, staff and visitors. The manager has purchased an air purifier in an attempt to manage redundant smoke and by and large this works successfully, with no odours detectable or noticeable, although this does not guarantee that all harmful chemicals associated to smoking are removed. Meals served during the inspection were generally good, with the service users spoken with clear that they enjoyed and appreciated the food provided. It was also pleasing to note during the morning that when a service user asked for something to eat and drink staff were quick to respond, bringing the resident a cup of tea and a plate of marmalade sandwiches, which went down very well. It was slightly disappointing to discover in the kitchen that catering staff are still not maintaining records of the foods served to residents, which was an issue discussed at the previous inspection and subject of a recommendation. In addition to this failure on the part of the staff was the already highlighted issue of the chalkboard not advertising the appropriate day’s menu, as would normally be the practice of the home. Instead the board advertised liver and bacon as the main meal, which had been served on 12 May and apple pie and ice cream as the sweet. It is understood that one of the younger service users Portland Lodge Version 1.10 Page 15 likes to maintain this board and update it accordingly, however it is the responsibility of the staff to ensure that this is done and to remind the service user if he has forgotten. Portland Lodge Version 1.10 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 standard(s) St 17. Service users were assisted to register with the electoral role and to participate in the general election. EVIDENCE: It was understood from the manager that everyone living at the home had registered on the electoral role, although no-one chose to vote via post or through a proxy. In conversations with service users it became clear that at least two of them opted to visit a local polling station to cast their votes, although it is not clear if anyone else participated in the general election. Portland Lodge Version 1.10 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 19, St 23, St 25, St 26 The environment is in need of attention both internally and externally. The accommodation provided meets the needs of the service users. The home has not satisfactorily addressed issues around water temperature and delivery of water at a safe temperature. Attention is required to external concerns regarding cleanliness and hygiene. EVIDENCE: On arriving at the home the inspector failed to gain entry to the property via the front door, as the doorbell is broken and staff could not hear the inspector knocking. A small note on the door advises visitors that access to the home is possible via the rear of the property and so the inspector made his way into the home through the back gate, passing on the way six bags of clinical waste left open Portland Lodge Version 1.10 Page 18 to the elements and vermin and a pile of domestic rubbish including garden waste, old domestic appliances, old paint tins and electrical parts. A limited tour of the premises was undertaken during the inspection, limited denoting that not every bedroom was visited. The tour of the premises highlighted that attention to the external aspects of the home, raised at the last inspection, had not been completed and the manager has been asked to supply a projected completion dated for the work required. Internally, a number of minor issues were identified: a step adjacent to Room 4 is difficult to see and requires illumination, lamp shades are still missing from light fittings, a length of exposed wiring is visible below the mirror in the hall and a number of bulbs need replacing around the property. In conversation with the service users it was clear that they were generally happy with their environment and enjoy living at Portland Lodge, although it was mainly the younger adults who were able to voice their opinions. Some people were keen to establish with the inspector that they could have their bedroom set out as they wished, one or two of the younger service users’ health issues influencing their decorative and furnishing requirements. As discussed with the manager, behaviours influenced by health or ill-health, etc. should not be considered barriers to care delivery, although where these behaviours or requests impact on other service users consideration should be given to involving outside professionals. In conversation with the manager, it was stated that the home had received considerable inward investment, with new carpet fitted around the home and three bedrooms refurbished. The home was generally comfortable and reasonably safe, although an issue raised at the last inspection, where it was discovered that the water delivered to a washbasin was too hot, has yet to be addressed. It is also important from a safety perspective to ensure that the lighting outside Room 4 is addressed to ensure the step there is properly illuminated. The interior of the home was noted to be clean and reasonably tidy, with no odours detected during the tour of premises and given the manager’s claims regarding monies re-invested in the premises, it is likely the home’s environment will improve, however it is important given the issues identified above not to lose focus and to keep planning and addressing issues as they arise. The exterior, as already highlighted, however, was untidy and unsafe with clinical waste and domestic waste inappropriately stored and an item of personal clothing positioned on a window sill present since before the last inspection. This apparent lack of attention towards the appearance of the Portland Lodge Version 1.10 Page 19 home, coupled with the deteriorating decorative state, is leading to a neglected a shabby looking façade. Portland Lodge Version 1.10 Page 20 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) St 27, St 30. Care staffing levels may need reviewing in the future if the privacy and dignity needs, etc. of the service users cannot be met. Access to training for staff is inadequate to ensure they have the skills required to meet the needs of service users. EVIDENCE: The staff confirmed that daily two carers are on duty each shift, the manager creating a four-segment shift pattern, which according to the duty roster operates between: 07.45 12.45 16.45 19.45 to to to to 13.00 17.00 20.00 08.00 In addition to these staff the manager stated that catering and domestic staff are available as is a maintenance person who covers both Portland Lodge and its sister home. On the day of the inspection it was established that eighteen service users were registered as residing at the home, although one of these people was in hospital at the time. As identified earlier, the inspector has some reservations regarding the numbers of care staff available within the home based on practice issues Portland Lodge Version 1.10 Page 21 observed. At this time he is satisfied that the staffing arrangements are adequate, although the ability of the staff to cope and meet the needs of the service users continually will be a focus of future inspections. Access to training for staff was an issue at the previous inspection when, as identified, the home was found to have only one care staff trained to undertake medicine rounds. At this inspection it was established that this situation has not altered and still only one carer has undertaken any medications training. This particular staff member appears keen to undertake any training available and has recently obtained her moving and handling trainer’s award. However, during the course of the inspection she was observed twice involved in moving handling procedures, the first being completely at odds with current guidance, the person working opposite the trainer using a banned lift and neither party appropriately explaining to the resident what was about to occur. The second move was better, with improved communications with the service user, although again the second staff member was allowed to use a banned lift. The inspector challenged the staff member about why she had not tackled her co-worker about her use of illegal lifts, to be told she had, but quietly. It is important for staff to be properly trained in the use of correct moving and handling techniques, it is also important for staff trained to challenge colleagues and that trainers lead by example when undertaking moving and handling procedures with residents. Portland Lodge Version 1.10 Page 22 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) St 31, St 37, St 38. Given the evidence documented throughout the report, it could be suggested that the manager does not always take her responsibilities seriously and is failing to monitor staff practice appropriately across the home. The record keeping of staff is poor. Issues of health and safety are not appropriately addressed or managed at Portland Lodge. EVIDENCE: The manager possesses a recognised professional qualification, although has no formal managerial qualifications, which given some of the issues identified raises the questions of whether more appropriate training, in the form of The Register Manager’s Award might not help provide her with additional skills and knowledge. Portland Lodge Version 1.10 Page 23 It will be important for her to address the issues raised during this and the last inspection and to start monitoring and supervising the practice of junior staff whom she chooses to delegate responsibilities to, as presently her trust in their abilities is being undermined by their performance. As evidenced by their failure to maintain appropriate records, be those care planning records or meal and menu records, and their inability to adhere to good moving and handling principles. The manager needs also to remember that issues of health and safety are her responsibility and that the general maintenance of the premises and issues of waste management and storage need addressing as a matter of urgency. Portland Lodge Version 1.10 Page 24 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x x 3 x 2 2 STAFFING Standard No Score 27 3 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 3 x 2 x x x x x 2 2 Portland Lodge Version 1.10 Page 25 Yes 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 Standard 7 Regulation Requirement Timescale for action 09.07.05 Regulation The manager must ensure that 15 all service users are provided with up to date and accurate care plan(s). That the plans are regularly reviewed, signed and dated. That all areas of need are addressed via the care planning process and agreed with the service user. Regulation Arrangements must be made for 13 medications to be appropriately stored and documented. Regulation The home must keep up to date 17 records of all meals served. Regulation Attention is required to both the 23 external and internal areas of the home as identified within the report. The manager is required to provide the Commission with a date for completion of the external redecoration. Regulation Attention must be given to the 23 hot water tap, identified at the previous inspection, as requiring replacing. Regulation The home must make suitable Version 1.10 2. 3. 4. Standard 9 Standard 15 Standard 19 09.07.05 09.07.05 09.07.05 5. Standard 25 Standard 09.07.05 6. 09.07.05 Page 26 Portland Lodge 26 16 arrangements for the storage of clinical waste bags. 7. Standard 30 8. Standard 38 The home must make arrangements for domestic waste (stock piled at the rear of the home) to be removed and in the future regularly collected. Regulation The manager must make 18 arrangements for staff to access training appropriate to their needs and the needs of the service i.e. medications training, moving and handling training. Regulation The manager must address all 13 issues relating to health and safety identified within this report. 09.07.05 09.07.05 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 Standard 3 Standard 9 Standard 10 Good Practice Recommendations Assessment sheets should be signed and dated to prove when the assessment was undertaken and who undertook the assessment process. Arrangements should be made for sufficient staff to access medications training. Peoples dignity should be promoted at all times and people should not be left sat in aprons, once meals have concluded. Staff should also take care with regard to peoples privacy and dignity, etc. and ensure if people are likley to access toileting facilties, they can do so in private. The home should look to improve the activities options for older residents and perhaps consider ways of integrating the younger and older service user groups in entertainments. Information on the chalkboard should be updated daily in order to prevent confusion and misunderstandings. The area outside of Room 4 could be better illuminated, thus reducing the potential for trips or falls. The manager should access appropriate managerial training, with the view of developing new skills and Version 1.10 Page 27 4. Standard 12 Standard 12 & 15 Standard 25 Standard 31 5. 6. 7. Portland Lodge underpinning her professional knowledge. Portland Lodge Version 1.10 Page 28 Commission for Social Care Inspection Mill Court Furrlongs Newport, Isle of Wight PO30 2AA 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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