Inspection on 17/05/06 for Revelstoke Lodge

This inspection was carried out on 17th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 17/02/06

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 Key Unannounced Inspection 17th May 2006 & 29th July 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.V294151.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.V294151.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 Vacancy 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.V294151.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Physically disabled (aged 18 years and over) (both) OP Maximum registered 55 service users (both) Date of last inspection 17th February 2006 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.V294151.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection took place to assess if the requirement and recommendations made following the last inspection in February 2006 have been met. The inspection was carried out by 2 inspectors who case tracked 6 service users. (This included speaking to speaking to the Service Users and the staff who are their key workers where possible, examining their care plans and any other relevant documentation). The manager was available throughout the inspection and the project manager currently supporting the home on behalf of Southern Cross Healthcare was spoken to over the telephone. Following the inspection an anonymous complaint and conerns from the local review team about poor staffing levels at weekends and evenings were given to the CSCI resulting in an out of hours visit on Saturday 29th July 2006 at 11am. What the service does well: What has improved since the last inspection? Security of the home was improved at this visit as there was no access to the home without ringing the bell and having somebody answer the door. First floor windows that were checked were all restricted as required. The passenger lift has had a new part and has not broken down recently. The support of Southern Cross Healthcare and the appointment of a new manager at the home have already seen standards improve within the home and as a result the Commission has had fewer complaints or concerns raised. The patients spoken to also spoke of recent improvements that they had noticed. Revelstoke Lodge DS0000003603.V294151.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. Revelstoke Lodge DS0000003603.V294151.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.V294151.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): 1&3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some information and opportunities to visit the home are given to people to help them to decide if they want to live at Revelstoke Lodge. Detailed pre admission assessments are made and therefore people are admitted to the home appropriately. EVIDENCE: A tour of the home revealed that the residents did not have an up-to-date service users guide. The manager advised that these were in the process of being re-written to incorporate the new companys information. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 9 Pre admission assessments are carried out by the newly appointed manager or senior sister. The home has many regular respite admissions who’s pre admission assessment is usually carried out over the phone to ascertain any recent changes that may have an impact on their stay. The continuing care team use the home for younger adults and people with palliative care needs and admissions are not accepted by either party unless the manager has carried out a pre admission assessment and the continuing care team have discussed the Service Users needs in depth. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 10 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): 7,8,9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to ths service. There is a clear care planning system recently introduced that provides staff with the information they need to meet the service users needs. The systems for the administration of medicines are safe ensuring service users health needs are being met. Personal support/ nursing care is delivered in a way that promotes and protects patients privacy and dignity. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 11 EVIDENCE: Most of the individual care plans examined set out in detail the actions needed to be taken by nursing and care staff to ensure that all aspects of health, personal care and social care are met. One care plan for a Service User who regularly stays at the home for respite care was not updated to reflect the needs during this stay, however the Service User was able to tell the staff his needs and felt that they were met. Some of the care plans examined did not have all the sections completed in full, although the ones that were completed were the most relevant sections. The care plans have recently been introduced and the staff are aware of the need to ensure all sections are ultimately completed. Each Service Users room entered had a checklist for staff to complete which showed the contacts staff had with the patients during the day for example personal care, turns and checks during the night. The health care needs of those residents too frail to leave the home are managed by visits from local health care services. Patients’ personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and patients in daily living. The medications administration and storage procedures were examined and found to be satisfactory. Dressings used for Service Users were the ones prescribed for them, however the prescribed dressings had not been added to the MAR (medicine administration record) sheet and the only way to check that they were the ones prescribed was to find the original prescription. The inspectors observed the cleaners and a number of care staff knocking on residents doors before entering their room. They spoke in a friendly respectful manner to the patients in the rooms they were cleaning. Most of the care plans examined had information about what the patient likes to be called. Induction training covers privacy and dignity. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 12 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): 12,13,14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the patients cultural, social and recreational needs and the importance of maintaining contact with family and friends and engage the patients in a variety of ways. The meals in the home offer both choice and variety and cater for special dietary needs. EVIDENCE: Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 13 The duty rota and talking to staff during the inspection and care managers following the inspection confirmed that there are currently sufficient staff resources provided to allow time for activities and stimulation, with 2 activity organisers being employed. The home operates a key worker system, which enables closer patient/staff relationships. This works well with patients who have one to one care. The home displays information about activities within the home and relevant community events and activities. When residents have particular interests every effort is made by staff to help the resident maintain their interest and keep up any community involvement. Information relating to this was seen in a number of the care plans examined, although it was quite hard with some of the sections not completed, to see what an individuals particular interests/ outings are unless you already know the person well. Since the last inspection there has been one anonymous complaint about the quality of the food provided by the home. This was thoroughly investigated by the provider and comments made by Service Users during this inspection indicate that the meals have improved. One said ‘the food is better, there are more staff available at lunchtime to help with those who need assistance to eat, so food isnt left to get cold’. Staff were able to assist promptly to cut up food during this respite stay, another commented that the food could be better , it is a bit boring would like more foreign food that understands that isnt always possible. Very little wastage was seen from the lunchtime meal. Several patients required PEG feeding, details of which were in the plans of care. The equipment and feeds are stored in the patients’ rooms. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 14 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 & 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system. Staff have a knowledge and understanding of adult protection issues which protects patients from abuse. EVIDENCE: A number of complaints have been made against the home over the last year. Since the project manager from Southern Cross Healthcare has been supporting the home the way complaints have been handled has improved and the new manager has demonstrated the way in which she deals with complaints using the laid down Southern Cross Healthcare procedures. Unless there are exceptional circumstances the service always responds within the agreed timescale. As a result the number of complaints has reduced. Care managers contacted following the inspection spoke highly of the positive changes and the way the home now responds to concerns raised. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 15 An anonymous complaint and concerns from the local review team came to CSCI following the main inspection visit. The issues were regarding poor care practices mostly resulting form staff shortages at weekends and in the evenings. This resulted in an out of hours visit on Saturday 29th July 2006 to assess the situation. (The complaints will be given to the provider to investigate using their own complaints procedure and a requirement to review staffing levels will be made in this report). The policies and procedures regarding protection of residents are regularly reviewed and updated and are available to staff at all times. The manager has demonstrated that she knows who to refer incidences to and how to manage staff appropriately when necessary. She is aware of the need for accurate documenting of events and has seen care given challenged, which she has then been able to discuss with the relative using completed documentation. The outcomes from any referral to care managers or adult protection services are now managed well with issues being resolved to the satisfaction of all involved. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 16 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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home and the grounds is in need of some attention to provide the patients with an attractive and homely place to live. The overall quality of the furniture and fittings is satisfactory providing a safe environment. The home is clean and hygienic Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 17 EVIDENCE: A tour of the home showed that there are some radiator covers that are loose but that generally the home is well maintained, the environment is tired/dated and in need of redecoration. The management has recognised this and have plans to improve the environment within the home, which includes separating the younger adults unit from the older peoples unit as required in previous inspection reports. There is a choice of bathing facilities, both assisted and unassisted, showers and baths and there are a number of toilets strategically placed around the home. The communal areas provide a choice (2 lounges, 1 dining room and smaller lounge/diners near to the patients rooms) with opportunities to meet relatives and friends in privacy or in their own rooms. The sister on duty said that although the company has infection control policies there were areas she was concerned about. As the infection control link nurse within the home she arranged for the health protection nurse for Plymouth to visit the home to carry out an infection control audit. This was done only a couple of days before the inspection and the report is not yet available although the sister did say some areas of concern had been ‘picked up’. A copy of the report will be forwarded to CSCI when it is available. The home was clean and tidy on the day of the inspection. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 18 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): 27,28,29 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including 2 visits to this service. Patients needs are met by a satisfactory mix of nurses, carers and ancillary staff who are trained and competent to do their job. The homes recruitment policy and practice protect the residents. EVIDENCE: The manager and the duty rota confirmed that staffing levels have increased recently. Two of the nurses on duty spoken to said that they felt there were now sufficient staff to meet patients needs. The care staff are supported by catering, domestic, administrative and maintenance staff. An anonymous complaint and concerns from the local review team came to CSCI following the main inspection visit. The issues were regarding poor care practices mostly resulting form staff shortages at weekends and in the Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 19 evenings. This resulted in an out of hours visit on Saturday 29th July 2006 to assess the situation. The staff on duty could not hear the door bell which resulted in the inspector eventually gaining access to the home via a side door that was propped open. The nurse in charge was working in an area far from the door and near to a Service user playing loud music. When the inspector was leaving the home the nurse checked the bell was working, it was but it was not able to be heard far away from the main entrance. This would unlikely to be a problem in the week during office hours when there is an administrator on duty. The nurse said that staffing was OK this weekend but this is unusual as quite often there are shortfalls in the staffing levels. This results in the nurse having to ring off duty staff to see if they can cover a shift or if they can’t then the head office on call has to be contacted for permission to book an agency worker, the nurse then has to ring the agencies to see if they have any available staff. This is time consuming and may result in no extra staff if the agency have not got any. This in turn impacts on the care of the Service Users who have to wait longer for their care needs to be met. The complaints will be given to the provider to investigate using their own complaints procedure and a requirement to review staffing levels will be made in this report. All staff are expected to work to a training plan, which the manager said are being met at the moment. Staff spoken to said that access to training was available and information about relevant courses was on display in the 2 staff offices in the home. Staff training files and supervision information are kept for each staff member and are stored appropriately. Recruitment practices have improved since the project manager and newly appointed manager have been managing the process. At this inspection all of the staff files examined had all of the required information in them including 2 written references, application form and a CRB check. They also had information about the persons induction process. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 20 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): 31,33,35,37 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is new management in place and guidance from Southern Cross Healthcare for staff to ensure residents receive consistent quality care. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 21 The systems in place in the home generally promote and protect the health and safety and welfare of the clients and staff. EVIDENCE: This is the newly appointed managers first general managers job. She has been the clinical manager at the home for over a year and has helped the home, supported by Southern Cross Healthcare, through a difficult period over the last few months She continues to be supported by the project manager from Southern Cross Healthcare until at least the end of July and then will be supported by the regional operations manager. Following several meetings with the manager over the last few months the inspector knows that she is aware of and works to the basic processes set out in the NMS. The service is planned to be user focused, and generally works in partnership with family of patient’s and professionals. Service Users spoken to during the inspection confirmed that family are involved with decisions about their care as necessary. Care managers spoken to following the inspection enjoy current good communication and work well with the staff at the home. The manager is learning the systems that Southern Cross Healthcare have developed that monitor practice and compliance with the homes plans, policies and procedures. She is now ensuring these processes are properly implemented throughout the home. Patients if they wish and are able to, are helped to take responsibility for managing their own money and are offered facilities to keep valuables and money safe. There is a safe in the home for general storage of money and valuables. Where the home is responsible for patent’s money the administrator works to a rigorous system, he maintains very clear records that are routinely kept up to date and can be used to track individual residents finances. The inspectors looked at the records of some of the people they had case-tracked and found them to be in order. Individual records seen during the inspection were generally up to date, in good order and stored securely apart from in the staff offices where patient information is on handover sheets, which seem unnecessary as it is duplication of information, in care plans which are kept in filing cabinets that are not locked (the office is often empty) and on patient lists displayed on the wall. The manager showed the inspector the Southern Cross Healthcare documents for recording maintenance and health and safety checks. These have already started to be completed by the maintenance man and give clear information about what checks have to be done and when they are completed. The same system also covers risk assessments. These are completed by the relevant person and can be made specific to the homes environment. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 22 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 2 X 3 3 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 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 3 17 X 18 3 ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 X 25 X 26 3 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 3 36 X 37 2 38 3 Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 23 NO 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 OP27 Regulation 18(1) (a) Requirement Staffing levels, especially at weekends and in the evenings, must continue to be reviewed and monitored to ensure a consistent level of care is provided at all times. A plan of action of how the home are going to carry this out must be submitted to CSCI. Timescale for action 20/10/06 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 OP1 Good Practice Recommendations The Statement of Purpose and Service Users Guide should be reviewed and updated to include Southern Cross Healthcare information and distributed to all current Service Users. The manager should ensure complete implementation of the new care plans continues with all sections being completed to give a full picture of each Service User. A planned programme of routine maintenance and redecoration needs to be produced and implemented. DS0000003603.V294151.R01.S.doc Version 5.1 Page 24 2. OP7 3. OP19 Revelstoke Lodge The garden at the back of the home needs to have continued improvement to allow access for service users and a better outlook for those whose rooms look out over this area. (Carried over from previous inspection in February 2006) The front exterior of the home should have weeds and dead plants removed. 4. 5. OP27 OP37 The problem with staff not hearing the front door bell needs some consideration. Repeaters throughout the building may help this situation. Security of patient information in the staff offices should be improved. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 25 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. Revelstoke Lodge DS0000003603.V294151.R01.S.doc Version 5.1 Page 26 - 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!