Inspection on 18/04/05 for South Africa Lodge Nursing Home

This inspection was carried out on 18th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

South Africa Lodge Nursing Home 02/08/06

South Africa Lodge Nursing Home 21/09/05

South Africa Lodge Nursing Home 15/09/04

South Africa Lodge Nursing Home 22/04/04

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

CARE HOMES FOR OLDER PEOPLE South Africa Lodge Nursing Home Stakes Hill Road Waterlooville Hampshire PO7 7LA Lead Inspector Val Sevier Unanounced 18/04/05, 9.30am 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 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. South Africa Lodge Nursing Home H54.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service South Africa Lodge Nursing Home Address Stakes Hill Road, Waterlooville, Hampshire, PO7 7LA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 023 92 255556 South Africa Lodge Limited Mrs Maria Stavert CRH 54 Category(ies) of DE, DE(E), LD, MD, MD(E) registration, with number of places South Africa Lodge Nursing Home H54.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. No service users under the age of 50 will be admitted. 2. No more than twelve (12) service users may be accommodated between the age of 50 years and 65 years. Date of last inspection 15/09/04 Brief Description of the Service: The service is a provided is a nursing home for older people with mental health difficulties. There are 54 individual rooms 53 of which are en suite. The service is offered on two floors that are divided into group living facilities. The home is within large grounds and service users have access to a garden which is currently being landscaped to meet residents needs. The environment of the home is clean, well decorated and the furniture and fittings are appropriate. South Africa Lodge Nursing Home H54.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 6.5 hours. The manager Mrs Stavert and the deputy assisted the inspector. The inspector was able to speak with several staff, 6 relatives and to spend time with the residents in the lounges after lunch. The atmosphere was happy and there were many comments from residents and visitors about the progress of the garden which is currently being landscaped. A picture of how it will look when finished was in the hallway for all to see. Residents are free to move about the home although there are some restrictions for some individuals these were clearly documented. The home is now fully staffed with the exception of a second activities person. What the service does well: What has improved since the last inspection? The storage and administration of medication has improved since the last inspection. The manager has also arranged with the health trust for staff to receive updating training in this area. There has been an improvement also in the recruiting of staff with all relevant checks having been carried out. South Africa Lodge Nursing Home H54.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. South Africa Lodge Nursing Home H54.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection South Africa Lodge Nursing Home H54.doc Version 1.20 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 standard(s) 3,4 and 5. Standard 6 is not applicable at this home. The home has a good understanding of residents needs using the assessment process. The staff have a good knowledge of residents support needs this was evident from positive relationships which have been formed between the staff and residents and supported by the training received. EVIDENCE: The inspector looked at 6 care plans and each individual had had an assessment prior to moving to the home. The assessments are comprehensive with information about physical and psychological needs of the individuals. It was observed that the information gained through the assessment had been used to complete the care plans. A relative spoken with on the day, explained what had happened at the assessment for her relative and how she had been involved when the resident was unable to speak for them. The relative felt that the needs could be met. The inspector was able to observe interaction between the staff and residents at the home. The manager had explained that staff had undertaken training in South Africa Lodge Nursing Home H54.doc Version 1.20 Page 9 dementia and communication and this was evident in the observed interaction. Staff spoken with had an understanding of the needs of individuals and said they felt able to ask the manager and deputy if they were unsure. The admissions policy and service users guide state that prospective residents and their relatives or representatives are encouraged to visit the home. Relatives spoken to on the day, said that they had been welcomed on the visit to the home and had been able to speak with other relatives before making a decision. South Africa Lodge Nursing Home H54.doc Version 1.20 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 standard(s) 7,8,9,10 and 11. There has been a gradual improvement in the care plans and the information in them since the manager joined the home, with involvement of other professionals as needed. There is now a consistency in them and that is commended. From the last inspection it was seen there has been a big improvement in the management of medication. Staff were seen to behave appropriately with residents identifying their emotional and physical needs, staff are commended in this. EVIDENCE: The inspector viewed six care plans in conjunction with a sample of medication records and others health monitoring tools used at the home. When looking that the care plans it was seen that other professionals were also involved as necessary. Some individuals required continuing support from psychiatric services for example. The home is supported by the local hospital with a senior nurse practitioner in mental health calling at the home monthly and when needed. This person assists with care planning and offers training when it is identified for particular needs. The care plans had clear identified needs and action to be taken to assist the residents. It also had the strengths and abilities of the individuals which staff could then help to maintain. There were risk assessments and action to reduce risk such as hip protectors. The care plans South Africa Lodge Nursing Home H54.doc Version 1.20 Page 11 had been reviewed regularly and daily notes had been written enabling the inspector to have a picture of the daily life at the home for some. From written evidence of care plans and speaking with staff it would appear that the staff are equipped with knowledge and skills to care for the needs of people at the home. It would also seem speaking with staff and relatives that no one is afraid to ask questions about issues of concern about needs. It was seen in the care plans that physical health needs are also addressed with one resident going to the audiology department on the day of the inspection and being pleased with their new hearing aids on their return. It was also seen that residents have access to opticians and dentists as needed. Relatives spoken with were involved in the care planning having meetings with the manger. They felt this was important as the residents although involved due to their personal issues are unable to give information or informed consent. It was also appreciated as the relatives spoken with had been the carers for in some cases years, and they felt that this kept them involved in the care. The deputy is responsible for the ordering, storage and oversees the administration records for medication auditing them once a month. There is a noticeable improvement in the records seen. The deputy explained that the pharmacist and GP are supportive regarding medication. Relatives spoken with said that they had been involved as necessary with medication especially if it had been difficult to give to an individual, they appreciated being asked and this approach fits with the policy of the home. Staff were observed speaking and assisting the residents with dignity and respect. Affection was given appropriately to those residents who sought it. It had been seen on care plans that the preferred choice of name had been recoded and staff were heard to speak to residents by the name they wished. South Africa Lodge Nursing Home H54.doc Version 1.20 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 standard(s) 12,13,14 and 15. The social needs of the residents at the home are as varied as they are individuals and with the loss of the second activity person not all needs are met. The home is encouraged to resolve this in order to accommodate as many needs as possible. Dietary needs of residents are well catered for with a varied selection of food that meets resident’s tastes and choices, this is an improvement. . EVIDENCE: There is currently one activities person working at the home five days a week 8-4. This person undertakes group and individual activities including taking people out. It was seen in care plans that social and recreational interests had been recorded and the activity person completes an observation when an individual participates in an activity. Relatives spoken with praised the big activities such as Christmas parties or other significant events but were unaware that there was an activity person available other than to take people out and that is not feasible for all. Visitors sign in at the home and information for them and others is available in the hallway by the signing in book. One resident has a befriender who takes her out regularly and advocacy is established as needed for individuals. South Africa Lodge Nursing Home H54.doc Version 1.20 Page 13 The menu is available daily in the hallway and in the lounges. The residents are offered a choice of meal and their preference is recorded with copies kept. Fruit was seen to be available and residents can choose where to have their meals. Residents spoken with said they liked the meals, relatives also said they were happy with what they had seen and some had meals with their relatives when they visited. The manager believes that the quality of the meals has improved and that this has had a positive impact on the health of the residents. South Africa Lodge Nursing Home H54.doc Version 1.20 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 standard(s) 16 and 18. It would seem the staff in conjunction with the manager have worked at establishing a sense of openness at the home so that relatives and residents can voice their concerns. Staff also feel that they can voice concerns especially regarding the care of the residents. EVIDENCE: There have been no complaints made since the last inspection to either the home or to the CSCI. Relatives were aware of how to complain and said they felt comfortable in speaking with the manager or deputy about any issues. There have been no allegations regarding adult protection at the home. The manager undertakes training the staff in this area, and staff spoken with were aware of the whistle blowing policy and the training. South Africa Lodge Nursing Home H54.doc Version 1.20 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 standard(s) 19 and 26 The home is well maintained and feels homely. EVIDENCE: The inspector undertook to walk around the home. One bedroom has been added since the last inspection with the conference room having been changed into an ensuite room. No other changes with the exception of general maintenance of the home to ensure safety. It was seen to be clean and homely with one resident having their belongings around their chair in the lounge. The garden is being landscaped and a picture of how it will be when completed was available for all to see. South Africa Lodge Nursing Home H54.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The level of staff and training programme would seem to meet the needs of the residents. The recruitment process and checks to ensure residents safety have improved since the last inspection. EVIDENCE: The inspector was able to see the rotas for the week of the inspection and older ones. All indicated that the staffing at the home is two nurses, one on each floor and ten care staff five on each floor. The manager explained extra staff are available if the needs of the residents indicate that further staff are needed. The staff spoken with felt that there were adequate staff and that holiday and sickness are always covered to ensure residents needs are met. The nurses have responsibility for the shift and are supported by experienced care staff who undertake such tasks as the safety of bedrails, fluid charts and ensuring that hip protectors are used correctly for the right people. The manager updated the inspector on staff with NVQ the home has met the 50 needed so far. The manager has promoted a sense of wanting to achieve for staff and they have embraced the personal development offered by both NVQ and other training offered at the home. They have undertaken both NVQ 2 and 3 with the deputy having just finished NVQ4. Some staff spoken with had completed the course and found them useful, others had just started. South Africa Lodge Nursing Home H54.doc Version 1.20 Page 17 The home has a clear and improved recruitment policy that covers all the elements for the protection of residents including criminal records checks and references. Staff files that were read evidenced that this policy was being met. The manager has a training programme for the forthcoming year including mandatory training and areas needed to meet resident’s needs. Oral hygiene has been arranged and a refresher course on medicines offered by the health care trust and Hampshire council. Staff confirmed that training was available and they felt the information was used to assist them in caring for the residents. Mandatory and other training for needs and personal development is available the home is supported in offering training by the hospital and NHS Trust. South Africa Lodge Nursing Home H54.doc Version 1.20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35, 36 and 38. The home regularly reviews aspects of its performance through a good programme of self-review and consultation, which includes seeking the views of residents, relatives and others, with evidence that the views are listened to and acted upon. There was evidence that health and safety is attended to protecting the well being of all at the home. EVIDENCE: The manager undertakes annual surveys giving relatives questionnaires to complete. They are also invited to meetings with the manger to discuss care plans of their relative or residents they advocate for. The manager showed the inspector some completed questionnaires from visiting professionals, others such as maintenance persons and visitors which are kept at the signing in desk in the foyer, giving information throughout the year. There was a mixture of positive comments and suggestions, the manager showed how some of these had been actioned. South Africa Lodge Nursing Home H54.doc Version 1.20 Page 19 The administrator looks after four residents weekly allowance monies. Records are kept for incoming and expenditure. They are kept individually in the safe. There are currently 89 staff employed at the home the manager has undertaken that all receive supervision six times a year. So far this has been achieved. Staff spoken with were able to confirm this and a sample of the records on were seen. The manager has recently established a health and safety file pulling together all aspects of safety at the home including legislation and how to manage chemicals. The file is very comprehensive and includes risk assessments. The records regarding fire safety and training were seen and were up to date. Staff spoken with confirmed that they had undertaken training recently. South Africa Lodge Nursing Home H54.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 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 3 x x x x x 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 Standard No 16 17 18 Score 4 x 3 x x 3 x 3 x x 3 South Africa Lodge Nursing Home H54.doc Version 1.20 Page 21 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 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 Good Practice Recommendations South Africa Lodge Nursing Home H54.doc Version 1.20 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hants, SO15 1GW 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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