Inspection on 02/12/05 for Revelstoke Lodge

This inspection was carried out on 2nd December 2005.

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 17/05/06

Revelstoke Lodge 17/02/06

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 2nd December 2005 09:30 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.V270666.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People 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.V270666.R01.S.doc Version 5.0 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 (12), Physical disability of places over 65 years of age (12) Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions 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 5th July 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 12 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 12 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 en-suite facilities; most rooms are individually decorated. The communal rooms offer space for dining and recreation.The home has recently ben aquired by Southern Cross which operates a large number of care homes nationally. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 2 hours and 55 minutes and was conducted with the general manager. The focus of the inspection was to determine improvements made following the requirements and recommendations made at the announced inspection in July 2005 and an additional visit made on the 4th October 2005 following concerns raised at an adult protection strategy meeting held on 29th September 2005. The home has recently been acquired from Ashbourne Healthcare by Southern Cross and the inspection discussed the impact that this has so far had on the home. The home was preparing for its annual Christmas Bazaar the next day and looked very festive. What the service does well: What has improved since the last inspection? Staffing levels have increased since the last inspection and retention of staff is better. There has been an increase in training, both in house and externally, in order to try to meet the needs of the current client group. Supervision sessions are commencing and it is hoped that this coupled with annual appraisals will help to form the training programme for the coming year. Staff meetings are being held more frequently. A senior carers meeting (arranged and chaired by themselves) was taking place during the inspection, following the meeting the minutes have to be submitted to the manager for review and any issues arising discussed with her. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 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.V270666.R01.S.doc Version 5.0 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.V270666.R01.S.doc Version 5.0 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): 3 OP (2YA) Comprehensive pre admission assessments are made and therefore people are admitted to the home appropriately. EVIDENCE: The general manager and/or the clinical manager carry out pre admission assessments prior to making a decision as to whether the home can meet assessed needs or not. The completed documentation forms the basis of the care plan if the person is admitted. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 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, 9 and 10 OP (6, 9, 16, 18 and 20 YA) The health care needs of the residents are identified and met. Interactions between staff and residents promotes and protects patients privacy and dignity. EVIDENCE: The plans of care in use are being further developed so that outcomes can be measured as part of the audit process. They contain the basic information required for care staff to ensure that all aspects of health, personal and social care are met. They are completed using the social services care plan (if Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 10 publicly funded), by talking to the service user and/or their representative, discussing the means by which needs will be met. The procedures for receipt, storage and disposal of medicines are followed by the trained staff. 50 of the trained staff have undergone medicine management up dates following a recent incident, the manager is hoping that all staff will have attended this training by the end of January 2006. A tour of the home confirmed that staff treat service users with respect and dignity. All staff undergo ‘residents welfare’ training and protection of adults training as part of their induction process and shadow senior staff until they are able to work independently within the home. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 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): 14 OP ( 7 YA) The support given and interaction with the Service Users maximises their capacity to exercise choice and control over their lives. EVIDENCE: The younger adults often benefit from one to one care and with that person are able to be as independent as possible within the home. They are encouraged to exercise choice about how they spend their day and an activity co-ordinator is available to provide group and /or individual activities if they are requested. A service user was seen using the computer to access the internet during the inspection. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 12 Older people also have staff dedicated to them and a named nurse. These staff can encourage service users to make informed choices about how they spend their time in the home. There are some service users who are quite independent and spend their days as they wish asking staff for help when they want it. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 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): None of these standards were assessed during this inspection EVIDENCE: Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 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, 24 and 26 OP (24, 26 and 30 YA) The standard of the environment within the home and the grounds is reasonable providing clients with attractive and homely place to live. The home is generally clean and hygienic. EVIDENCE: A tour of the home was carried out and whilst the environment was generally good there was one room with a lamp shade missing, one or two radiators Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 15 whose covers were loose and had not been reattached and some minor health and safety issues that need to be addressed. The patio area would also benefit from being tidied up. All rooms have the required fixtures and fittings included a wash hand basin, wardrobe, bedside table and accessible electric sockets. Rooms were personalised with service users own possessions. Locks to doors and lockable space can be provided as required and following a satisfactory risk assessment. The home was clean and tidy and was looking very festive for the Christmas Bazaar taking place the day after the inspection. A shower on the ground floor smelt damp and musty as if the extractor fan was not working. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 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): 29 and 30 OP ( 31, 34 and 35 YA) The homes recruitment policy and practice protect the clients. Clients needs are met by a satisfactory mix of nurses, carers and ancillary staff who are trained to do their job. EVIDENCE: The general manager is continuing to review staffing levels in order to be sure that they are sufficient for the level of dependency of the current service users. A copy of the duty rota was provided during the inspection and has been provided to the commission on a weekly basis for the last 3 months. The staffing levels have increased recently to the minimum required by the previous registering authority. Staff retention has also improved. There are catering, domestic, administrative staff and a maintenance man employed to support the carers in meeting the needs of the service users. The current system of recruitment is in line with company policy and includes requiring 2 written references and a CRB check. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 17 Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 18 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): 33, 35 and 38 OP ( 39, 23 and 42 YA) The systems for quality assurance and service user consultation are satisfactory with evidence that indicates that service users views are sought and acted upon. The systems in place in the home promote and protect the health and safety and welfare of the clients and staff. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 19 EVIDENCE: The general manager showed the inspector the responses to the recent questionnaire sent out to service users and /or their representatives. Each service user has their own account sheet that details any expenditure they have, receipts are kept and income and outgoings can also be crossed referenced with information, kept by the administrator, on a database. Two clients monies were checked by the inspector and were found to agree with the amount documented on the account sheet. Secure facilities are provided for safekeeping of money and valuables. The Statement of Purpose encourages people to have valuable items separately insured. The training records confirm that fire safety, moving and handling and infection control training is up to date. Windows on the first floor that were checked were restricted. The front door has recently had an entry key -pad fitted to improve the security of the home. All staff receive induction training that includes aspects of health and safety and safe working practices. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 3 4 X 5 X 6 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x ENVIRONMENT Standard No Score 19 2 20 X 21 X 22 X 23 X 24 3 25 x 26 3 STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X 37 X 38 3 Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP19 Good Practice Recommendations The environment in the home should be improved by ensuring there are enough maintenance hours provided to keep it well maintained. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 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. Revelstoke Lodge DS0000003603.V270666.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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