Inspection on 22/02/06 for Robert Bean Lodge

This inspection was carried out on 22nd February 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Robert Bean Lodge 08/05/08

Robert Bean Lodge 30/05/07

Robert Bean Lodge 30/08/06

Robert Bean Lodge 06/09/05

Robert Bean Lodge 06/09/04

Robert Bean Lodge 28/07/04

Robert Bean Lodge 04/03/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Robert Bean Lodge Pattens Lane Rochester Kent ME1 2QT Lead Inspector Sue McGrath Unannounced Inspection 22nd February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Robert Bean Lodge Address Pattens Lane Rochester Kent ME1 2QT 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) 01634 831122 01634 531113 Medway Council Mrs Vivianne May Simmons Care Home 44 Category(ies) of Learning disability (4), Old age, not falling registration, with number within any other category (40) of places Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The 4 beds registered for Learning Disability are for Respite use only. Date of last inspection 6th September 2005 Brief Description of the Service: Robert Bean Lodge is a purpose built home which includes a community day centre. All of the accommodation is on the ground floor in single rooms. The accommodation is divided into four units, each containing ten bedrooms and separate day space. Medway council runs the establishment, which is registered for forty older people. The home is on a bus route and has off road parking available. The home employs care staff, working a roster, which gives 24-hour cover. The home also employs other staff for catering and domestic duties. In addition the home is temporarily accommodating a Learning Disability respite care service. This is registered for 4 persons and is selfcontained with its own staff team. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection under the terms of the Care Standards Act 2000 and took place on the 22nd February 2006 between 10.00 and 13.00. One inspector was in the home and the main focus of the inspection was on the progress of the home in meeting with requirements made at the last inspection, the general environment and the well being of the residents. During the inspection documentation and records were read, including care plans. A tour of the building was undertaken and many of the residents and some visiting family members/friends were spoken to. Time was also spent talking to staff and members of the management team. As this report was made following an unannounced visit and may not cover the standards in sufficient depth for the reader to make a judgment about the home, it is recommended that a copy of the last announced inspection report dated 6th September 2005 be also obtained. What the service does well: What has improved since the last inspection? The majority of the radiators have now been covered as required from previous inspections. Work has also nearly been completed on the bathroom refurbishments. Weekly exercise sessions are now enjoyed by the residents. Robert Bean Lodge DS0000036756.V285405.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. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-6 Prospective residents in the residential unit are provided with the information they need to make an informed choice about moving into the home. Respite clients are not provided with current information. Residents benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families also benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. A written statement of terms and conditions protects Resident’s legal rights to occupancy. EVIDENCE: The Statement of Purpose did not contain any information on the additional respite wing, even though this was only a temporary measure it needed to be included. An additional statement was added to the document during the inspection. The manager of the respite wing is to forward the more detailed Statement of Purpose and Service User guide for that specific unit to the Commission. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 9 The manager confirmed that all prospective residents were visited and a full assessment was undertaken before a place was offered. This was confirmed by a resident at the last inspection. Records confirmed that a full care manager’s assessment was also in place. The manager also confirmed that all residents have a written contract which they or their representative sign. The home does not offer recuperative care. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 11 Residents are mainly protected by the home’s policies and procedures for dealing with medicines. Residents are treated with respect and can be assured the home will handle the issue of illness and ageing sensitively. EVIDENCE: The administration of medication was assessed and generally was seen to be adhering to the guidelines from the Royal Pharmaceutical Society of Great Britain. A few minor adjustments would improve the system being used. The homes policy stated that all medication are to be signed for by two people, in practise it is only being signed by two when it is a controlled drug. This needs to be updated to reflect practise and meet with the requirements of the Royal Pharmaceutical Society of Great Britain. Discussion took place around the storage of eye drops as it was noted that some of the instruction stated eye drops to be stored at room temperature after opening and some to be stored in a fridge. The manager was advised to ensure correct storage was taking place and to follow the written guidelines that come with the eye drops. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 11 There was some confusion over some of the signatures on the MAR sheets, as only one initial was being used and two staff that administers medication had the same initial. It was recommended that copies of full signatures are obtained from staff and that at least two initials are used. The thermometer in the medical fridge was broken so temperatures could not be recorded. It was advised that a replacement thermometer be purchased to ensure full compliance with the guidelines from the Royal Pharmaceutical Society of Great Britain. The home had a policy on care and comfort for residents who were terminally ill and their wishes regarding terminal care and arrangements after death were discussed and recorded. The manager stated that residents would be able to spend their final days in their own room, surrounded by their personal belongings, unless there were strong medical reasons to prevent this. The requirement from the last inspection around regular eye and dental check has been removed as it could be evidenced that regular checks were offered. The requirement from the last inspection relating to falls management has also been removed as evidence was seen on care plans that recommendations are being incorporated into the residents care plans. The requirement from the last inspection that residents receive regular physical exercise has also been removed as the home now has a designated exercise session on a weekly basis. The residents stated they really enjoyed this weekly session. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Residents are able to make choices and, as much as possible, lead a life that meets their individual preferences. Recreational and social needs are currently not well met. Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Residents benefit from the appetising meals and balanced diet offered by the home and those service users requiring specialist diets are well catered for. EVIDENCE: Many of the residents were spoken with and all said they were very happy to live at Robert Bean Lodge. One respite resident stated that his room was very nice and that the food was good and that he was always given a choice for diner. Another lady who was enjoying respite care stated the she really looked forward to coming in on a regular basis and would definitely consider coming in permanently one day. She said that staff responded quickly at night should she need anything. She also stated that all the staff were kind to her. One permanent resident said ‘that before to coming into Robert Bean Lodge I had Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 13 suffered several nasty falls at home, but I have not fallen anywhere near as much since my arrival’. Other residents were very complimentary about the visiting hairdresser and stated how nice it was to be able to have their hair done at the home. One regular comment was the lack of organised activities. Staff confirmed that where possible they tried to organise some activities but it was difficult due to the other duties they had to perform. The home did have a designated activities co-ordinator but she had been on long term sick and this was now affecting the morale of some of the residents. The home must ensure that regular supervised activities continue to tale place for the stimulation and enjoyment of the residents. A requirement will be made. Residents confirmed that they enjoyed receiving visitors and that their relatives could visit whenever they wished and were always made welcomed. One resident spent a long time talking to the inspector, she confirmed that she was happy to live at the home but was missing her own home. It was her decision to spend time in her room and she was grateful that her wishes could be adhered to. She enjoyed knitting and reading and doing puzzles but did miss going out. She was happy that she was well supported by her family and enjoyed going home for Christmas. She had her own phone in her room so that she could maintain contact with her relatives and friends whenever she wished. The lady also stated that the laundry system was ‘very good’ and that the food was also ‘very good with plenty of variety’. She stated that she could have drinks whenever she felt like it and that her only complaint was with the lack of organised activities. All of the comments about the food were very positive The dining areas were seen to be pleasant and meals unrushed. Special therapeutic diets could be provided when advised by health care and dietetic staff. All of the food including liquefied food was presented in an attractive and appealing manner. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents are protected by a robust complaints system and service users and relatives feel their views are listened to and acted upon. Residents’ legal rights are protected. The home has robust adult protection policies and procedures to ensure that residents are protected from abuse. EVIDENCE: Information gathered at the last inspection confirmed that residents and relatives confirmed they felt able to raise concerns and complaints and were aware of the homes procedures. Residents again confirmed they knew how to complain if necessary. The manager confirmed that most of the residents were registered for postal voting and would be assisted to vote at any election if they so wished. The home had an Adult Protection policy and procedure, which included whistle blowing and staff spoken to confirmed they had received Adult Protection training and demonstrated knowledge and understanding in this area. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20, 21, 25 and 26 Residents benefit from living in a clean, safe, well-maintained environment and have safe access to comfortable indoor and outdoor communal areas. EVIDENCE: An unescorted tour of the premises was undertaken and they were found to be clean and tidy and free from offensive odours. The home had pleasant garden areas, which the residents said they enjoyed in the summer months. Each unit had its own lounge and dining area and in addition the home had a visitors room. The bathroom facilities had been upgraded and refurbished, with only a few minor pieces of work to be completed. These were much improved and provided modern and safe wash areas. Work had nearly been completed on covering all of the radiators as required at the last inspection. All of the rooms were centrally heated and emergency lighting was provided and tested regularly. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 16 Good examples of sound infection control procedures were seen during the inspection. Protective clothing was supplied as required. No action had been taken so far with regards to the requirement regarding resident’s needs and wishes regarding the provision of carpets and of upgrading beds as appropriate. The requirement will remain in place. Other standards were assessed at the last inspection. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 28 The service users benefit from staff that are trained and competent to do their jobs and who enjoy good morale. EVIDENCE: Information given at the last inspection in pre inspection paperwork and the rotas seen on the day of this inspection confirmed that the home was adequately staffed. On the day of the inspection two agency carers were working in the home. Both were spoken with and both confirmed that they worked regularly at Robert Bean Lodge and both stated they had undergone induction prior to staring work there. Both were aware of the fire drills and relevant emergency procedures. Both were aware of the care plans and the level of support required by the residents they were caring for. Permanent staff were also spoken with and were familiar with the needs of the residents and appeared happy in their work. Good interaction was seen between staff and residents. It was apparent that good teamwork was happening within the home. A high number of staff had completed NVQ level 2 or above. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 36 Residents benefit from having a manager who is supported well by senior staff and provides clear leadership throughout the home and by staff who demonstrate an awareness of their roles and responsibilities. Financial systems to safeguard residents interests need to be improved. EVIDENCE: It was evident that the registered manager was able to communicate a clear sense of direction and leadership and was seen to be fully involved with the day to day running of the home. Insurance cover was in place and sound financial records were kept by the home. The home’s business plan was not inspected on this occasion. The issue regarding service users personal monies was again discussed. Medway’s Finance officer and Andrea Leveret from CSCI had meet previously Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 19 and it was confirmed that the council is moving over to a new finance system in April 2006. It was expected that this system would enable the home to meet this regulation. Discussion with some of the staff confirmed that they received regular supervision from senior staff and felt well supported. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 X 3 3 X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 2 X 3 X X Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP25 Regulation 13(4a) Requirement The registered person must ensure that radiators have low temperature surfaces or are appropriately covered to prevent burning. It is recognised that this work is nearly complete. This requirement has been carried over from the last inspection. Action plan required The Registered Person shall not pay money belonging to a service user into an account unless the account is in the name of the service user or any of the service users to which the money belongs. This requirement has been carried over from the last inspection. Action plan required The registered person must ensure that residents needs and wishes are assessed regarding the providing of carpets and upgrading beds as appropriate. This requirement has been carried over from the last inspection. Action plan DS0000036756.V285405.R01.S.doc Timescale for action 14/04/06 2. OP35 20(1a) 14/04/06 3. OP24 16(2)(c) 14/04/06 Robert Bean Lodge Version 5.1 Page 22 required. 4. OP22 23(2a) The registered person is required to ensure that they produce an action plan detailing how it plans to meet the recommendations made in the Kent Association for the Blinds assessment of the premises and facilities. This requirement has been carried over from the last inspection. Action plan required. An up to date Statement of Purpose and Service User Guide is provided to the Commission with regards to the temporary respite wing. 14/04/06 5 OP1 4 and schedule 1 14/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP35 Good Practice Recommendations The following is recommended :Southampton City Council have managed to find a good solution to the issue around reg 20, and the need to avoid pooling service user monies. The system theyre adopting is called Clients Monies Service (CMS) from Nat West. It involves one account, with separate sub-accounts within it. The subaccounts carry their own number and are interest bearing, therefore ensuring interest is calculated on the amount in each account etc. Monies can be managed in relation to each sub-account by the authoritys finance department through a modem link to the bank. It is recommended that the home provide organised activities. It is recommended that the homes activities coordinator is trained to undertake exercise groups and other activities that she may be required to facilitate. It is recommended that a new fridge thermometer be purchased for the medical fridge. DS0000036756.V285405.R01.S.doc Version 5.1 Page 23 3 3. 4 OP12 OP12 OP9 Robert Bean Lodge 5 OP9 It is recommended that staff signatures be recorded for staff that administer medications. Robert Bean Lodge DS0000036756.V285405.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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