Inspection on 05/01/06 for Somerset Lodge

This inspection was carried out on 5th January 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

Somerset Lodge 09/11/06

Somerset Lodge 06/05/05

Somerset Lodge 15/09/04

Somerset Lodge 27/04/04

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

CARE HOMES FOR OLDER PEOPLE Somerset Lodge Perrett Way Ham Green Pill North Somerset BS20 0HE Lead Inspector Paul Grey Announced Inspection 5th January 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 Somerset Lodge DS0000020289.V266672.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. 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. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Somerset Lodge Address Perrett Way Ham Green Pill North Somerset BS20 0HE 01275 372224 01275 372424 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) Aspects and Milestones Trust Mr Michael Robert Nunn Care Home 30 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30), Mental disorder, excluding learning of places disability or dementia (30), Mental Disorder, excluding learning disability or dementia - over 65 years of age (30) Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Staffing Notice dated 16/05/2000 applies Manager must be a RN on Parts 3 or 13 of the NMC register May accommodate up to 30 persons aged 50 years and over Date of last inspection 6th May 2005 Brief Description of the Service: Somerset Lodge is registered to accommodate up to 30 people aged 50 years and over with severe mental disorder. The home is a single storey building set in the grounds of the old Ham Green Hospital. Somerset Lodge consists of two units one catering for service users with higher nursing needs; the other catering for 8 service users with severe mental illness, but a lower level of nursing needs, who are encouraged to have more autonomy in the running of the unit. All service users have their own rooms and access to a secure wellmaintained garden. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in the presence of the manager. The Inspector noted a robust service, delivering a good standard of care with a well-established staff team. The Inspector noted evidence of good practice, a caring team and a developed infra structure to maintain and review the standard of care. The inspection took place over 7 hours, it involved the Inspector observing staff, speaking with staff, observing service users, speaking with service users, and perusal of documents on the premises. The Inspector would commend the manager and the staff team on the standard of care offered at the home. What the service does well: What has improved since the last inspection? 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. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 6 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 Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 7 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): 1,3,4 Prospective service users have the information they need to make an informed choice about living at the home. The home assesses service users needs prior to the moving in. Service users and their representatives know that the home will meet their needs. EVIDENCE: The Inspector was able to bruise the homes statement of purpose. This was written in plain English and clearly outlined the services provided at the home and the level of accommodation. The Inspector noted a description of staff qualifications and experience. The Inspector noted whilst auditing care files a range of extensive preadmission assessments. The homes preadmission assessments appropriately covered service users physical, social, and emotional needs and appeared sufficiently detailed to enable the home to make an informed choice as to whether they were able to meet service user needs. The Inspector noted Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 8 evidence of assessment of service users mental state and cognitive abilities, social interests hobbies etc. The Inspector noted the documentation to be of a high standard. The home presented clear evidence of service users needs and how the service would meet those. The manager explained to the Inspector that service users with specific ethnic social or religious needs could also be catered for. It was clear to the Inspector that the staff team have the skills to deliver a high standard of care to service users. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 9 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): 7, 8, 10, The home sets out the service users health, personal and social care needs in a plan of care. The home supports service users to make decisions about their lives with assistance as needed. The home treats service users with respect and the service user’s right to privacy is upheld. EVIDENCE: The Inspector audited four service user care files. The Inspector noted that service user care plans were clearly based on the homes assessment process. The Inspector noted in the care files sampled, that the plans gave detailed information regarding how a service users needs would be met. The Inspector noted the plans had been drawn up by staff and was signed by the service user whenever capable. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 10 Of the care files reviewed one had not been reviewed since the care plan was written in August 2005. With the exception of this care File the home are met national minimum standards generally. The Inspector noted from service user records that staff assist service users where needed. The home has the capacity to fully care the service users. Service users at the home are assessed by appropriately trained staff who identify the potential for developing pressure sores and intervening appropriately. The home can monitor service users psychological health and can intervene appropriately. The home can support service users obtain specialist medical or dental or therapeutic services were needed. A number of very frail residents were in bed and had air mattresses to prevent pressure sores. Staff are vigilant in monitoring any wound care using digital photographs to record and monitor the progress of treatment. The Inspector noted during the time of inspection that staff were mindful of service users privacy and dignity at all times. Service users had their own clothes which were labelled with their own names, staff addressed service users by their preferred name. Staff were seen to treat service users with respect. During inspection the manager was observed to knock on closed doors and be aware of the service users need for privacy and dignity. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 11 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, 13, 15 Life at the home satisfies service users expectations and preferences regarding their social, cultural and recreational interests. The home support service users to maintain contact with friends and family. The home supplies service users with wholesome appealing and balanced food. EVIDENCE: The Inspector noted the homes routines of daily living were geared to the needs of the service users. Meals could be delivered to service users in their rooms, although service users were encouraged to eat in communal areas. In documentation the Inspector noted evidence of service users interests. Service users were given opportunity for stimulation in a creatively decorated activities room called the cottage. Staff have decorated this area and turned it into a small homely cottage type sitting room. Here a range of leisure time activities were arranged. The Inspector noted evidence of good practice exceeding national minimum standards. The manager informed the Inspector that service users are encouraged to have visitors within a reasonable hours. Service users are entitled to see friends and visitors in a private area such as a bedroom should they wish. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 12 The Inspector visited the kitchens and was shown the homes 3 weekly rotating menu. The manager informed the Inspector that the home had changed its source for pre-supplied meals to improve the standard of what was on offer. At the time of inspection the Inspector noted the meals appeared pleasant and appealing, with mealtimes appearing unhurried and pleasantly sociable. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 13 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): 16, 18 Service users and their relatives can be confident that any complaints will be listened to and taken seriously. The home protects service users from abuse. EVIDENCE: The Inspector noted evidence of a simple, clear and accessible complaints procedure. At the time of inspection there were no outstanding complaints the manager informed the Inspector that a record was kept of all complaints including details of the managements action. The home has robust procedures for reporting any suspicions of abuse, neglect or degrading treatment. The home has whistleblowing policies and policies and procedures outlining the homes action in the event of reported abuse. The homes recruitment policy protects service users from those who may be and suitable to work with vulnerable adults. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 14 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): 19, 21, 24, 26 The home is safe and well maintained. The home provides sufficient washing facilities. The home provides service users with safe, comfortable bedrooms. The home is clean pleasant and hygienic EVIDENCE: The home is well maintained and well decorated internally. Whilst the homes clinical origins are obvious, the staff team have gone to some lengths to make the environment as homely as possible. The Inspector noted the home had a suitable number of accessible toilets and washing facilities the service users. These were clearly marked and suitably sized the staff to help with personal care where appropriate. Sluice’s were located separately to service users toilets and bathing facilities. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 15 Service users are provided with their own rooms which are furnished and equipped to ensure the service users comfort. Service users may bring some of their own furniture, subject to health and safety. All bedrooms with fitted with a lino type floor covering, given the needs and the variety of service users this would appear appropriate. The home was clean and hygienic throughout. The Inspector noted evidence of risk control measures in practice and appropriate laundry facilities on the premises. The Inspector noted the premises were clean and pleasant throughout. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 16 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, 29 The home meets service users needs with sufficient numbers and skill mix of staff. The home protects service users with its recruitment policies, procedures and practices. EVIDENCE: The Inspector noted sufficient staff to be on duty at the time of inspection. During the inspection the Inspector noted staff interacting with service users and when needed staff were able to respond rapidly to service users needs. The Inspector also noted the use of 2 additional staff who were providing activities of the service users. The Inspector noted that the home had the equivalent of 1.8 full-time staff hours to deliver an activity programme. This was good practice. The Inspector took some time to fully audited staff recruitment records. The Inspector audited 5 records. All contained appropriate POVA, CRB and references. The qualified nurses pin numbers and registration status was available to the Inspector. This was good practice. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 17 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): 31, 32, 36, 37 The home is run by a manager who is fit and competent to be in charge. The home and service users benefit from the ethos and management approach of the home. Staff at the home are appropriately supervised. The home protects service users rights and best interests with its recordkeeping. EVIDENCE: The manager is qualified both as a general nurse and a mental health nurse. He has had a wealth of training and experience in the field of dementia and keeps up to date with new developments and practice. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 18 The Inspector noted clear evidence of strategies in place by the manager to allow staff and service users to affect the way in which the service is delivered. The Inspector noted evidence of thoughtful touches throughout the service, such as the cottage. Staff spoken with gave positive evidence about the service. The impression the Inspector received was that there was a clear sense of direction and leadership throughout the home. The Inspector audited staff supervision. The Inspector noted the home has revised its supervision processes and drawn up a series of pro forma is the staff. Supervision is cascaded down from the manager to the qualified nurses to the carers. The Inspector noted evidence of regular supervision in accordance with the national minimum standards. The Inspector audited a range of records at random. These were maintained on the premises, up-to-date and stored appropriately. Confidential information was stored in accordance with the data protection act. Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x 3 x x 3 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x x 3 3 x Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? no 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. Refer to Standard Good Practice Recommendations Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Somerset Lodge DS0000020289.V266672.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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