CARE HOMES FOR OLDER PEOPLE
Queens Lodge Nursing Home Haslingden Road Blackburn Lancashire BB2 3HQ Lead Inspector
Mr Graham Oldham Unannounced Inspection 09:30 16 November 2005
th 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 Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Queens Lodge Nursing Home Address Haslingden Road Blackburn Lancashire BB2 3HQ 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) 01254 681805 01254 697148 Fern Holdings Limited Mrs Hilary Waters Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (40) of places Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. A maximum of 40 service users requiring personal care who fall into the category of OP. 18th July 2005 Date of last inspection Brief Description of the Service: Queens Lodge is a pupose built detched home situated on the outskirts of Blackburn. The home is located in a semi-rural position with views over fields. The home can accommodate up to 40 elderly residents requiring nursing care, personal care or have a physical disability.Queens Lodge is family run and owned privately by Fern Holdings. The home is located on a bus route opposite from Queens Park Hospital. Car parking facilities are available at the front of the home and the extensive gardens have been designed to allow easy access for residents and their families. Accommodation comprises of a variety of communal rooms, 28 single bedrooms and 6 shared rooms. All bedrooms have en-suite facilities. The decor is pleasant and a passenger lift is available to access both floors. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 16th November 2005. Much of the information gained was obtained from talking to residents and staff members. The views of residents were obtained on a variety of topics. Two residents were case tracked. One resident was unable to contribute to the inspection and two staff members gave an account of his care. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking the plans of care, other documentation and talking to residents and staff. Two staff members were talked to about care issues. The resident who was case tracked preferred to remain with her group of five friends and all contributed to the inspection process. Some of the views have been reported collectively with specific comments contained within the body of the report. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building and grounds was conducted. What the service does well:
The owners and staff have worked consistently to react to requirements and recommendations to meet the minimum standards. Quality assurance systems were good. The home completed a survey of residents, families and stakeholders. The results are a percentage of those who responded and may not reflect the views of everybody: 23 of residents took part in the survey. 100 of residents made positive comments about the activities program. 2 residents made suggestions for additions to the program, which have been passed to the activities officer. 100 of residents made positive comments about the food. 100 of residents were happy with the care and services offered and did not wish to change any aspect of it. 100 of residents made positive comments about the menus and variety of meals offered. 53 of family members responded. 100 thought the home achieved its aims and objectives. 100 thought resident’s wishes were acknowledged. 100 gave positive comments about staff. 100 gave positive comments about food. Two negative comments were received about a bedroom size and reducing television noise when visiting. Advice was issued in the summary to use a quieter lounge. 45 of G.Ps responded. 100 thought the quality of care the home gave was positive. 100 made positive comment about staff. 100 made positive
Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 6 comments about the accommodation. 100 said they would recommend the home for patients requiring residential care. Food served at the home was well received by residents. Comments included, “the food is very good”, “food and choice is good” and “I like the food here”. All the other residents questioned thought food was good. The food served at the home was to resident’s tastes. The decoration and furnishings of the home were of a high standard and met the expectations of residents. The activities provided at the home were satisfactory to residents. Visiting was unrestricted. One visitor said, “there are no problems with visiting. Staff are welcoming and very nice. The home is very good”. All residents involved during the inspection were satisfied visiting was open and could be taken in private. Visiting was promoted at the home. Residents were happy with the home and staff. Comments included, “the home is very good”, “it’s the best home in the country”, “it’s lovely” and “it’s a very good home”. All six residents said the home was well run. The positive attitude of management and staff ensured there was an enjoyable and homely atmosphere for residents. What has improved since the last inspection? What they could do better:
While no requirements or recommendations have been made at this inspection it is hoped the management and staff continue to work and improve standards for the benefit of residents. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 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. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 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 Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 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): 3 Each prospective resident was assessed prior to admission to ensure their needs could be met at the home. EVIDENCE: Two plans of care were examined during the case tracking process. Plans of care contained assessment documentation from social services or the local hospital trust. Plans of care also contained an assessment carried out by the home. The assessment documentation gave staff the knowledge they needed to care for residents. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 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 the following standard(s): 7, 8 and 10 Resident’s health, personal and social needs were set out in a plan of care. Resident’s health care needs were met. Resident’s were treated with privacy and dignity. EVIDENCE: Two plans of care were examined during the case tracking process. One resident was able to assist the inspector in the case tracking process. Two staff members were questioned in depth about the care given to the two residents. The plans of care, testimony of one resident and details supplied by staff members matched the care assessed and agreed. Five other residents confirmed care was good. Comments included, “my daughter deals with the nurses and talks to me. I don’t bother much with my care plan” and “the care is pretty good, we have the life of Riley”. Residents appreciated the care given by staff. The plans of care had been reviewed monthly. Plans of care had been developed to enable staff to care for residents. Plans of care contained evidence residents attended health care specialists. Staff questioned were able to identify the health care specialists the two residents case tracked attended. All six residents questioned as a group said they attended “chiropodists”, “opticians” and “hospital consultants”. One resident said the district nurse attended to her at the home. Residents attended specialists to enable their health care needs to be met.
Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 11 All residents said staff treated them privately and with dignity. One resident said, “if they did not we would soon and tell them” and jokingly “we keep them in order”. Staff were careful to preserve residents dignity which allowed residents to feel comfortable with personal care. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15 Residents were offered leisure activities to match their lifestyles. Visiting was unrestricted and enabled residents to maintain contact with family and friends. Food served at the home was satisfactory to residents. EVIDENCE: Residents said, “we play bingo, join in arts and crafts sessions, do music and movement exercises, read, go in the garden, have entertainers at the home and go out with relatives”. One resident also liked to read. One resident liked to embroider. One resident enjoyed crosswords. Most important to the six residents was to socialise and have fun with each other and staff. Suitable activities were provided to enable residents to lead fulfilling lives. All six residents questioned said visiting was open and private if they wished. Visitors were observed to come and go as they pleased. One visitor questioned confirmed visiting was unrestricted. The rights of visitors to meet their families were protected at the home. All five residents said food at the home was good. The residents also confirmed they had a choice of meal. A meal was served during the inspection and residents were observed to be fed in a discreet and individual way. Meals and mealtimes at the home were satisfactory for residents and gave them a varied and nutritious diet.
Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 13 Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 There was a complaints procedure for residents to voice their concerns. EVIDENCE: All six residents expressed the view that they could make a complaint to the manager or one of the nurses and their views would be given consideration. During conversation with the inspector there was a good deal of banter and residents said on several occasions that they were ‘in charge’ and very comfortable in talking to members of staff who had worked at the home for a long time. The continuity of staff and accessibility of management enabled residents to voice their concerns and opinions, which gave them some ownership of where they lived. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 15 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 - 25 The home was warm, clean and comfortable. Furnishings and equipment was domestic in style and met residents needs and individual tastes. Suitable equipment such as hand rails or disability equipment had been provided where necessary. Toilets and bathrooms were of a type that met residents needs. Shared space was provided to give a variety of activities and uses for residents. EVIDENCE: The inspector conducted a tour of the home during the inspection process. All communal areas and most bedrooms were inspected. Rooms had been individualised to resident’s tastes. Comments from residents included, “we share a room and are good friends. There is no problem with sharing”, “my room is very comfortable and I would recommend it”, “I like my room and have my own photographs and ornaments” and “I have my own pictures and photographs. It’s a home from home”. Residents also said, “its very clean”, “the home is well kept” and “they are very particular about keeping the home clean”. One resident also said, “the laundry is a first class service”. There was a planned maintenance programme and the home was decorated to a high
Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 16 standard. Equipment was observed for residents with mobility problems such as wheelchairs, walking frames, grab rails and hoisting equipment. Bathrooms had suitable adaptations. Equipment for pressure relief was observed during the tour. Rooms were clean, tidy and contained sufficient equipment to provide residents with a comfortable environment. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 17 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): 28 More than 50 of staff employed at the home had completed NVQ training to meet the requirements of the CSCI. EVIDENCE: 52.5 of care staff had achieved NVQ2 qualifications or above. Two staff members questioned confirmed they had undertaken training. One said she had undertaken “first aid, infection control, health and safety, moving and handling, food hygiene and training to meet the requirements of the nursing council”. The second staff member said, “I have a certificate in care practices and a mentor to new staff employed at the home. I have completed training in first aid, food hygiene, infection control, health and safety, moving and handling, dementia care, bowel care, the protection of vulnerable adults and have completed my NVQ2 course. I love it here and get great support from the sisters and owners”. The training undertaken gave staff the knowledge to care for the resident group accommodated at the home. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 18 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): 33, 35 and 38 Quality assurance systems were in place at the home. Residents managed their own financial affairs. Health and safety policies, procedures and the maintenance of equipment was good at the home. EVIDENCE: Quality assurance systems included residents meetings, staff meetings and questionnaires. Questionnaires had been completed for residents, family members and stakeholders. Results were published and available for inspection. There was a business plan. Quality assurance systems enabled management to react to the changing needs and expectations of residents, families and stakeholders. The responsible person said, “resident’s or their families handle their own finances. We do not manage the finances of any resident”. The financial affairs of residents were safeguarded from possible abuse. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 19 Electrical and gas installation and equipment had been maintained. Certification was observed during the inspection. The fire system and emergency lighting system had been maintained. Health and safety policies, procedures and legislation were available for staff to become familiar with. Staff received training in health and safety related topics. Accidents had been recorded in an acceptable manner. Health and safety procedures protected staff and residents from possible harm. Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 20 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 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 4 3 3 3 3 3 X STAFFING Standard No Score 27 X 28 4 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 4 X 3 X X 3 Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 0 Refer to Standard 0 Good Practice Recommendations None at this inspection Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Queens Lodge Nursing Home DS0000022510.V254991.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
