Inspection on 11/02/09 for Raunds Lodge Nursing Home

This inspection was carried out on 11th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Raunds Lodge Nursing Home 10/04/07

Raunds Lodge Nursing Home 10/04/06

Raunds Lodge Nursing Home 05/01/06

Raunds Lodge Nursing Home 18/05/05

Raunds Lodge Nursing Home 23/09/04

Raunds Lodge Nursing Home 26/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Raunds Lodge Nursing Home 63 Marshalls Road Raunds Wellingborough Northants NN9 6EY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Perrins     Date: 1 1 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Raunds Lodge Nursing Home 63 Marshalls Road Raunds Wellingborough Northants NN9 6EY 01933625404 01933625404 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Raunds Lodge Nursing Home Limited care home 31 Number of places (if applicable): Under 65 Over 65 0 31 dementia old age, not falling within any other category Additional conditions: 31 0 The maximum number of service users who can be accommodated is 31. The registered provider may provide the following categories of service only - Care home with nursing - Code N to service users of the following gender - Either - whose primary needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE. Date of last inspection Brief description of the care home Raunds Lodge provides personal and nursing care for elderly frail service users, and those suffering from Dementia. At the time of inspection the home was undergoing major renovation and so had a reduced number of people living there. This work is due to be completed in September 2009 and will update and improve the older part of the building. The home is located in Raunds, a small town halfway between Rushden and Thrapston. There is a bus service within the town, and also from towns and villages in the surrounding area. The main A14 and A6 roads are close by. Fees range from Care Homes for Older People Page 4 of 27 Brief description of the care home 359.01 to 680.00 pounds per week. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection which means that we focused on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of four hours was spent reviewing previous inspection reports the other information that CSCI has received about this service. Care Homes for Older People Page 6 of 27 The inspection visit lasted six hours during the morning and afternoon of a weekday. During the inspection three people were case tracked. This involves looking in detail at all aspects of their care and experiences at Raunds Lodge, including looking as their individual plans of care and other records, talking to them and talking to their care staff. Because people with dementia are not always able to tell us about their experiences we also used observations of peoples state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. The Manager was present during the morning of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admissions procedure is well managed ensuring that peoples needs can be met by the home. Evidence: Raunds Lodge has a statement of purpose and a service user guide which give people who may want to move to the home information about the home and the services offered. The information about the building in both is not currently accurate as it does not reflect the changes made to accommodate the renovation work or detail what the finished building will be like when the renovations are complete. The admissions process appears to be well managed with people being assessed before they move in to ensure that the home can meet their needs. People have the opportunity to visit the home before they decide to move and initially move in on a trial period to ensure that the home is right for them. Care Homes for Older People Page 10 of 27 Evidence: One relative told us in a survey We looked at a few homes in the area and this one was the best and most suitable. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home have their health and personal care needs generally well met. Evidence: Each person who lives at Raunds Lodge has an individual plan of care which details how they need and want to be cared for. The manager explained that she checks everybodys individual plan of care each month to ensure that they are up to date. Records show that peoples nutritional needs are assessed and that their weight is monitored at least monthly. People are also assessed for the risk of developing pressure sores. Where people have pressure sores, bruising or other marks on their body these are recorded on a body map diagram. The body maps seen in peoples files were not always easy to interpret as information had been recorded on the same chart for different dates. Records show that people have access to a range of health care professionals such as general practitioners, community psychiatric nurses, dentists, chiropodists and Care Homes for Older People Page 12 of 27 Evidence: opticians and benefit from preventative health measures such as flu vaccinations, medication reviews and general health checks. Medication appears to be well managed with all tablets checked accounted for and medication administration records appropriately signed for. Medication is currently stored in a medication cabinet in a locked temporary walk in cupboard. The home does not currently have the facility to store controlled drugs. Controlled drugs are prescribed medicines which some people abuse them by taking them when they have not been prescribed. There are laws and regulations about how these drugs should be stored and administered. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to take part in activities arranged within the home. Evidence: Raunds Lodge employs an activities co-ordinator in the afternoons during the week to do a range of activities with the people who live in the home. Unfortunately on the day of inspection she not able to come in to work. The home also has volunteers who come and do activities with people three afternoons per week. On the day of inspection a volunteer was helping people to make valentine cards and decorations. The volunteer explained that everyone who wanted to be involved was able to be. One lady who was in bed in her room said that volunteer had come in and helped her to make card. The manager explained that a valentine dinner had been arranged for some of the residents to have with their partners. Lunch was observed and consisted of sausage, mashed potato, green beans and cauliflower followed by chocolate moose or fish with vegetables. The cook explained that people can choose their menu the previous day. Menus viewed appeared varied with a cooked main meal at lunch time and a choice of hot or cold snack in the evening. One person told us that the food is very good here. People were observed Care Homes for Older People Page 14 of 27 Evidence: being gently encouraged to eat by the staff. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints procedure and systems to ensure that they can respond to any concerns raised. Evidence: The home has a complaints policy which tells people what they should do if they have concerns. The policy outlines how the home will respond if someone raises a concern and includes the timescales for that response. The home has not received any complaints since the last inspection. On two occasions concerns have been raised under the locally agreed safeguarding adults procedure one related to the assessment of a persons needs not being clearly documented and the other related to staffing levels. The home have taken steps to address the issues raised as the manager now audits all care plans on a regular basis. Staff spoken to were aware of how to raise concerns. Some people were observed sitting in reclining chairs which they were not able to get out of without assistance. The home does not currently have any written records to show that this has been assessed to make sure that it is not being used as a form of restraint and that it is in the persons best interests. Care Homes for Older People Page 16 of 27 Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current programme of building work at the home will ensure that people have spacious and comfortable accommodation. Evidence: Much of the front of the property is currently cordoned off due to the building work taking place within the older part of the property. A temporary entrance is in use into the new part of the building. The manager explained that the door bell is going to be linked to call bell shortly as at present it is not always heard. There is a ground floor lounge in the new part of the building and a bedroom on the first floor is being used as a temporary second lounge. A temporary kitchen is also being used. There are a number of bedrooms on the ground and first floors. Bedrooms seen had been personalised with pictures, ornaments and effects.The laundry room was viewed and appeared to adequately cater for the needs of the people at the home. As well as the stairs there is a passenger lift for people to access the first floor and a choice of bathrooms or a wet-room for people to use. The property has a small garden to the rear but this is not fully accessible at present due to the building work taking place. The home was clean and well maintained in the areas that are currently in use. One Care Homes for Older People Page 18 of 27 Evidence: relative told us in a survey Raunds Lodge provides a safe, clean and friendly home. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are friendly and caring but do not always have the opportunity to spend quality time with the people who live at the home. Evidence: The manager explained that three staff are employed in the morning and two in the afternoon and that staffing levels are flexible if peoples needs increase. The home is currently recruiting staff as some staff left recently when their work permits expired. The manager stated that home employs some staff through an agency which specialises in recruiting staff from over seas as they find it difficult to recruit staff from the local area. During the inspection there were several instances observed in both the upstairs and downstairs lounge where there were no staff present in the lounge for up to twenty minutes at a time. On one occasion someone wanted to use the bathroom and on another someone wanted assistance to reposition themselves in the chair but no staff were on hand to assist them. When staff were present there were occasions when they appeared to be very busy and did not seem to have time to sit and chat to the people who live at the home or to spend any quality time with them. One member of staff told us that the staff all work very hard. Care Homes for Older People Page 20 of 27 Evidence: Staff recruitment appears to be well managed with people having all the required checks to ensure that they are suitable to work with older people. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is working to continually improve the quality of care and services offered to people living at the home. Evidence: The current manager told us that she is in the process of applying for registration with the Commission for Social Care Inspection and has recently finished her registered managers award. As well as regularly auditing care plans the manager explained that she also spends time each week talking to the people who live at the home to ensure that they are happy with the care they are receiving and to address any issues that they may wish to raise. The home have recently sent out surveys to everyone living at the home. At the time of inspection only one of these had been returned which gave positive feedback. Care Homes for Older People Page 22 of 27 Evidence: The manager explains that she checks all of the medication monthly. Records seen show evidence of the necessary health and safety checks being carried out including fire safety checks, electrical equipment testing and servicing of equipment such as hoists. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The storage of medication must be reviewed to ensure that it complies with the latest requirements of the Misuse of Drugs Act Amendment 2007. This is necessary to ensure that all medication, including controlled drugs can be stored safely. 31/08/2009 2 18 17 The home must make sure that any restriction of a persons liberty has been assessed as being in their best interests in line with the latest guidance and legislation. To ensure that peoples rights are safeguarded. 05/05/2009 3 27 18 Staffing requirements must be assessed taking account of peoples needs and the size and layout of the building. Sufficient staff must then be deployed to 02/06/2009 Care Homes for Older People Page 25 of 27 meet the needs of the people living at the home. To ensure peoples health, safety and welfare. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The statement of purpose and service user guide should be updated to reflect the current programme of renovation and detail what the finished building will be like when the renovations are complete. A separate body chart should be used for each date when a recording needs to be made on one to make the information easier to interpret and to show more clearly if the sore or mark is improving or deteriorating. 2 8 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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