CARE HOMES FOR OLDER PEOPLE
Radway Lodge Vicarage Road Sidmouth Devon EX10 8TS Lead Inspector
Teresa Anderson Unannounced Inspection 11th January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Radway Lodge Address Vicarage Road Sidmouth Devon EX10 8TS 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) 01395 514015 The Radway Partnership Mrs Sheila Mary Tallon Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th September 2005 Brief Description of the Service: Radway Lodge is a detached house situated in a central position in the town of Sidmouth. The home provides accommodation with personal care for up to 15 older people. Bedroom accommodation for residents is on the ground and first floors and all the bedrooms are for single occupation. There is a stair lift to the first floor. There are some steps throughout the home that makes access difficult for service users who are wheelchair dependant. There is a communal lounge and a separate dining room on the ground floor. There are pleasant gardens and outside seating areas. Although the home does have a care park, this fills quite quickly. On road parking is available. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. It took 2 hours to complete during which time the inspector spoke with 7 of the 13 residents, 2 members of care staff and the cook. Records in relation to medication were inspected. This report looked at those Standards which were not met or which were not inspected during the inspection in September. As such, this report should be read in conjunction with the report that was produced following that inspection. What the service does well: What has improved since the last inspection?
At the last inspection residents thought that the variety of meals could be improved. This has been achieved. The menu has been changed from a 2 week to a 4 week menu and many new dishes have been added. Residents report that they really enjoy the food, that it is varied and that the ‘home made cakes are lovely’. The loose slabs at the front of the house have been made safe and the kitchen has been attended to. Devon Fire and Rescue were contacted by the home following the last visit and arrangements have been put in place to ensure that fire regulations are being followed. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 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. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 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 Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 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 the following standard(s): These standards were inspected and met during the inspection in September 2005. EVIDENCE: Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 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 the following standard(s): (9 and 10). Residents are not fully protected by procedures in relation to the handling of medication. Residents benefit from having their privacy and dignity respected. EVIDENCE: Since the last inspection improvements have been made in how medication is handled. However, there are still improvements to be made and a clear audit trail to be implemented. The Medication Administration Record (MAR) sheets show that not all staff are signing when they have received medication into the home. Hand transcribed medications are not being signed by two members of staff and the ‘homely remedies’ policy is not being adhered to. Residents report that their privacy and dignity is always respected. For example, staff knock on doors before entering and treat them as individuals. The inspector saw respectful and helpful interactions between staff and residents throughout this inspection. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 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 the following standard(s): (12, 13, 14 and 15) Residents benefit from activities that keep them engaged and from contact with the local community and are able to exercise control over their daily lives. Residents’ benefit from a varied and nutritious diet that suits their needs and preferences. EVIDENCE: Records are kept of the activities organised on behalf of residents. These include visits from the donkey sanctuary, visits to local garden centres and entertainments venues and visits from local musicians. Many residents enjoy playing bingo and report that the activities on offer give them enough to do. They also say that they live their lives the way they want to. For example, getting up and going to bed when they like, eating where and when they like and ‘doing what they like, when they like’. Christmas was described as ‘smashing’ with ‘lovely decorations and food’. Visitors are free to come and go and the home has good contacts with the local community. Many of the residents lived locally before coming to live at Radway Lodge and have maintained local contacts. Menus demonstrate that the food is varied and that alternatives are offered. Residents say the food is always well cooked, nicely presented, enjoyable and appetising. Homemade cakes are served in the afternoon and supper menus have recently been revised and improved. Alcohol and/or juices are served.
Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 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 the following standard(s): (18) The protection of residents could be further improved through training. EVIDENCE: Care staff demonstrated a good knowledge of issues relevant to protection and abuse. They know where to seek advice if needed and are aware of the ‘Alerter’s Guidance’. The training provided to care staff should be extended to housekeeping staff. Residents said they feel safe and well cared for and that they had never had a problem, but if they did would report it to the manager. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 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 the following standard(s): (19 and 26). Residents live in safe and pleasant environment. EVIDENCE: Radway Lodge is homely, appropriately furnished and hygienic throughout. Whilst the porch is looking ‘tired’ residents told the inspector that planning permission had been received to improve this area. They also report that a conservatory is to be built. The loose slabs outside the home have been dealt with and made safe, and alterations in the kitchen mean this is now free from flies. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 13 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) This home has yet to meet the target that 50 of the care staff will be trained to NVQ Level 2 or above. EVIDENCE: Six of the sixteen care staff (37.5 ) employed to work at Radway Lodge are trained or are training to NVQ Level 2 or above. Whilst the home has not reached the 50 target, they are working to achieve this. Staff demonstrated that they have the skills necessary to care for residents. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): (31, 33 and 38) Residents benefit from a manager they respect and respond to and from a system that ensures that the home is run in their best interests and is run with their safety needs in mind. EVIDENCE: The Registered manager is trained to NVQ Level 3 and has many years experience in the caring profession. Staff and residents talked of their confidence in the manager and their respect for her. The inspector did not meet with the manager during this inspection, but it is a credit to her that her staff were able to assist in this inspection with ease. Whilst the homeowner has completed the Registered Managers Award, it is recommended that the Registered Manager also undertake this. Staff report that residents and staff meetings are held ‘when needed’. A recent staff meeting was called by a member of staff who felt it was inappropriate that the beds of male residents were dressed with pink sheets. This practice
Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 15 has since been altered. Residents told the inspector they are happy with current arrangements for managing the home and do not want to be more involved. The Director is responsible for deciding upon and implementing a cycle of quality assurance. When asked, residents could not think of anything that might improve the home and were happy with their level of involvement. All fire doors were closed or held open using approved systems. The lounge and dining room doors are to be fitted with door holders that are linked to the fire alarm meaning they will automatically shut when the alarm sounds. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 16 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 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 x 17 x 18 2 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x x x x 3 Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 (2) Requirement The registered person must make suitable arrangements for the handling and administration of all medicines received into the care home. (This relates to the need to ensure that (1) all medicines received into the care home are recorded (2) all hand transcribed medications are signed for by two people (3) the homely remedies policy is adhered to First requirement date = 09/10/05 Timescale for action 01/04/06 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 OP18 Good Practice Recommendations The registered person should ensure that all staff (including housekeeping staff) receive training in the
DS0000022011.V271940.R01.S.doc Version 5.1 Page 18 Radway Lodge 2. 3. OP28 OP31 protection of vulnerable adults. The registered person should ensure that a minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent). The registered person should hold the Registered Managers Award or be studying for it. Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Radway Lodge DS0000022011.V271940.R01.S.doc Version 5.1 Page 20 - 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!
