Inspection on 17/02/06 for Revelstoke Lodge

This inspection was carried out on 17th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Revelstoke Lodge 16/06/09

Revelstoke Lodge 24/06/08

Revelstoke Lodge 22/06/07

Revelstoke Lodge 17/05/06

Revelstoke Lodge 02/12/05

Revelstoke Lodge 05/07/05

Revelstoke Lodge 01/12/04

Revelstoke Lodge 16/06/04

Revelstoke Lodge 24/02/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE Revelstoke Lodge Boringdon Road Plympton Plymouth Devon PL7 4DZ Lead Inspector Mandy Norton Unannounced Inspection 17th February 2006 10:00 X10029.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 Revelstoke Lodge DS0000003603.V281630.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 and Care Homes for Adults 18 – 65*. 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. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Revelstoke Lodge Address Boringdon Road Plympton Plymouth Devon PL7 4DZ 01752 343001 01752 345575 revelstoke.lodge@ashbourne_homes.co.uk 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) Ashbourne Homes Limited Ms Irene Violet Anne Jasper Care Home 65 Category(ies) of Old age, not falling within any other category registration, with number (55), Physical disability (13), Physical disability of places over 65 years of age (12) Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION 3Conditions of registration: 1. 2. 3. Physically disabled (aged 18 years and over) (both) OP Maximum registered 55 service users (both) One additional service user (named elsewhere) under the age of 65 years 2nd December 2005 Date of last inspection Brief Description of the Service: Revelstoke Lodge is registered to accommodate a maximum of 65 service users. The home provides care for up to 53 service users of either gender over the age of 65 years requiring nursing or personal care with physical illness, disability or frailness and a maximum of 13 service users aged 18-65 years with physical disability. Accommodation is provided on two floors, there is level access both internally and externally via ramps and a passenger lift. The Commissions understanding is that a dedicated environment and staff team is to be provided for the care of the 13 younger service users although approval of this plan has yet to be received from the registered provider. Bedrooms are mainly single though several doubles are available. Some bedrooms offer the added benefit of ensuite facilities.. The communal rooms offer space for dining and recreation. The home has recently been acquired by Southern Cross Healthcare which operates a large number of care homes nationally. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the 3rd inspection this year (1 previous announced and 1 previous unannounced and 1 additional visit have been carried out between April 2005 and February 2006). The inspection was in response to recent concerns about management processes and medication management. The inspection was carried out by 2 inspectors who spoke to a number of service users, relatives and staff during the inspection. A variety of documentation was examined and a brief tour of the home was carried out. What the service does well: What has improved since the last inspection? What they could do better: The quality of the meals could be improved. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 6 All first floor windows should be restricted. The temperature of the treatment room was too hot. The passenger lift was not working on the day of the inspection and should be repaired as soon as possible (a risk assessment has been completed and forwarded to CSCI). Internal refurbishment needs to continue to ensure a homely, comfortable environment is provided for the service users. The garden at the rear of the home needs to be developed and maintained for the benefit of the service users. The front door, although benefiting from a key- pad system needs to be secured at all times. 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. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this inspection EVIDENCE: Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are 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 and 9 There is a clear care planning system being introduced to adequately provide staff with the information they need to meet the service users needs. The systems for the administration of medicines have been reviewed and are now safe ensuring service users health needs are being met. EVIDENCE: The project manager who is based at the home for 2 days a week supporting the current staff team was able to show the inspector the new care planning Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 10 system that is being implemented throughout the home. It looks well organised and allows for staff to record all aspects of care associated with an individual service user. As part of the care plan a care record will be kept in each room for carers to complete once they have delivered the care. The systems for the administration of medicines has been reviewed following 2 drug errors being made and 2 complaints about the management of controlled drugs within the home in the last 8 months. The new systems in place were examine and found to be satisfactory and in line with laid down legislation. The trained nurses responsible for medicines administration have undergone refresher training to ensure they are fully aware of their responsibilities. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The meals are poor with little evidence that service users have been offered quality meals or much choice. EVIDENCE: A recent complaint about the quality of the food made to CSCI has been investigated by Southern Cross Healthcare. As a result the catering staff (employed by Eurest) have met with company representatives and areas for improvement have been identified. Already a toaster has been provided in the kitchenette area to enable staff to make fresh toast for the service users. It was identified that some of the poor meals were supplied when a relief cook was on duty. This situation has been resolved. Condiments are now to be Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 12 provided on all tables at mealtimes should any of the service users wish to add flavourings to their meals. Some information has been fed back to the catering manager about how service users like their vegetables cooked. A meeting (at Revelstoke) is planned for March 2nd for service users and /or their relatives to attend along with catering staff to discuss the service users likes, dislikes and any other catering issues. Two relatives and a service user spoken to during the inspection confirmed that the meals are inadequate and not consistent in quality. They were told about the up coming meeting and will be attending. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) 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 Southern Cross Healthcare has a robust complaints system in place with evidence that complaints made are listened to and acted upon. EVIDENCE: There have been several complaints made about a variety of issues over the last few months. Since Southern Cross Healthcare have taken over the running of the home the response to complaints has improved and the CSCI has seen appropriate investigations taking place and action taken on the findings in order to improve the quality of care the service users receive. The complaints procedure is displayed within the home. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) 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 The standard of the environment within the home and outside is adequate. EVIDENCE: A tour of the home showed that some areas of the home are in need of redecoration and refurbishment and that a planned programme of routine maintenance and redecoration needs to be produced and implemented. The garden area at the back of the home is overgrown and needs to have some time spent on it in order to improve the out look for some service users Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 15 and to make it accessible to others. The court -yard area in the ‘middle’ of the home is accessible to service users and has some seating available. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed during this inspection EVIDENCE: Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The systems in place in the home need to be improved in order to promote and protect the health, safety and welfare of the service users and staff. EVIDENCE: Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 18 On the day of the inspection the passenger lift was out of order and had been for some days. The home had carried out a risk assessment and had implemented effective working practices to reduce the impact of this on service users. The project manager stated that the part required for the lift was on order and the lift maintenance company were aware of the urgency of the matter. The treatment room where some staff spend prolonged amount of time and medications and dressings are stored was found to be too hot. This might have an adverse affect on some of the items stored in the room. Southern Cross Healthcare need to ensure that all of the first floor windows are restricted in accordance with Health and Safety legislation. During a tour of the home the some windows were found to be restricted and some were not. The front door should be secured at all times. On arrival at the home the inspectors were able to gain access to the home despite there being a key-pad system in place. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 19 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 X 2 X 3 X 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X 37 X 38 1 Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 20 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 OP38 Regulation 12 (1) (a) Requirement The passenger lift must be repaired. The first floor windows must all be restricted. The front door must be secure at all times, with people able to access the home using the keypad system in place. Timescale for action 28/02/06 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. 2 3 Refer to Standard OP7 OP15 OP19 Good Practice Recommendations Introduction of the new care planning system should continue, with staff being aware of the need to complete them effectively and in a timely fashion. Southern Cross Healthcare should continue to implement improved catering arrangements and provide meals in line with the wishes and assessed needs of the service users. A planned programme of routine maintenance and redecoration needs to be produced and implemented. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 21 The garden at the back of the home needs to be improved to allow access for service users and a better outlook for those whose rooms look out over this area. Revelstoke Lodge DS0000003603.V281630.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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