Inspection on 17/08/07 for Sovereign Lodge Care Centre

This inspection was carried out on 17th August 2007.

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

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 Sovereign Lodge Care Centre Carew Road Eastbourne East Sussex BN21 2AX Lead Inspector Melanie Freeman Key Unannounced Inspection 17th and 20th August 2007 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 Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 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. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sovereign Lodge Care Centre Address Carew Road Eastbourne East Sussex BN21 2AX 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) 01323 412285 01323 438423 Life Style Care (2005) Plc Rosina Skelton Care Home 60 Category(ies) of Dementia - over 65 years of age (36), Old age, registration, with number not falling within any other category (24) of places Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Service Brief Description of the Service: Sovereign Lodge Care Centre is owned and run by Life Style Care PLC and is registered to provide care for 60 residents in total, 24 for frail and disabled older people requiring nursing 36 for frail older people with dementia who require nursing. The home is situated in a residential area serviced by local bus services providing good links to the town centre and surrounding areas. Eastbourne train station and town centre is also within walking distance. Car parking is available on site. The home was purpose built for its stated purpose last year and provides excellent facilities for meeting this. Residents accommodation is found on the ground, first and second floors. On the ground floor there are 24 single bedrooms for those residents needing general nursing care. The first and second floor has 36 single bedrooms for those residents that have a dementia. All rooms have en-suite facilities and disabled access is available throughout the home with the provision of ramping and passenger lifts. Varied communal space is available along with outside space for walking and sitting. The home mostly provides nursing care to residents who are privately funded although some residents that are funded by social services can be accommodated. The home’s fees as from 01 April 2007 range from £470 to £800 per person per week. Additional costs are charged for hairdressing, chiropody newspapers/ magazines some outings and toiletries. The homes literature states that the homes ‘philosophy of care is to deliver individualised care to all service users’. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term ‘service user’ to describe those living in care home settings. For the purpose of this report those living at Sovereign Lodge Care Centre will be referred to as ‘residents’. This was a the homes first key inspection that included an unannounced visit to the home and follow up visit on the following Monday carried out by appointment. The unannounced assessment visit was facilitated by the registered manager who was working in the home for both visits. During the assessment visits the inspector was able to spend much of her time meeting with the staff, residents and their visitors and observing practice. A tour of the premises was undertaken and a range of documentation was reviewed including the homes statement of purpose and service users guide, care plans, duty rotas, medication records, and recruitment files. The care documentation pertaining to two residents were reviewed in depth along with a number of policies and procedures and records relating to health and safety. The inspector was able to eat a midday meal with the residents in one of the communal dining rooms. During the visit ten visitors were spoken to and were able to provide their views on the home and services provided. Following the visit two relatives were contacted by telephone along with four health/social care professionals. Information provided by the home within the Annual Quality Assurance Assessment (AQAA) has also been included in this report. This inspection has been completed with a proportionate approach and it must be bourn in mind that this is a new service that is operating at approximately a third of its full occupancy. The home has therefore been judged on its current provision and service. What the service does well: The admission procedure allows for a comprehensive assessment process of any prospective resident. The atmosphere at the home is relaxed, with communication between staff and residents open and friendly. The home is purpose built and has taken into account the specialist care needs of the residents that the home is registered to care for. It provides very attractive environment for residents to live in and for staff to work. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 6 It was evident that family members are welcome and a good level of communication is maintained with all visitors, visiting is not restricted. The quality and standard of the food in the home is good and residents complimented the food. 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. The summary of this inspection report can be made available in other formats on request. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 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 Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides prospective residents and relatives, with a good level of information about the home, its facilities, services and the costs involved. The admission procedures ensure residents are suitably assessed prior to their admission by a competent person, who ensures that the home admits only those residents who’s needs can be met by the home. Intermediate care is not provided at Sovereign Lodge Care Centre. EVIDENCE: The home has a comprehensive statement of purpose and service users guide both are displayed in the front entrance area of the home and the registered Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 9 manager confirmed that all residents are given a copy of the service users guide. It was however noted that these documents had not been updated since the home has become operational so it says ‘will’ and does not record accurately the current management and staffing structure. Records seen confirmed that terms and conditions of residency are confirmed in writing and relatives spoken to said that the financial arrangements were clear. An assessment of the admission process followed included the review of the documentation relating to the last four admissions to the home. This identified that once an enquiry is made information is then sent to inform those of interest. The enquiry is then followed up with the registered manager carrying out a pre admission assessment. These were found to be comprehensive and to use information from different sources. Once the pre admission assessment has been completed the home confirms in writing if the home is able to meet the prospective residents needs. Residents in the home have very differing needs that need specialist input from both registered nurses and carers. The registered manager is aware that staff need to have further training in respect of these care needs is arranging this however staff currently do not have all the necessary training. All resident’s representatives spoken to said that they had been to the home before deciding that it may be suitable for their relative. During the inspection visits it was noted that people interested in the home were able to see the home without an appointment. Intermediate or rehabilitative care is not provided at Sovereign Lodge Care Centre. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Individual plans of care set out residents needs and care is delivered in such a way that promotes and protects the residents’ privacy and dignity. With residents health care needs being supported by community resources as necessary. The systems for the safe administration for medicines need to be improved with clear and accurate record keeping. EVIDENCE: Two individual plans of care were reviewed in depth as part of the inspection process one of these had a fairly well developed plan of care although choices and preferences could be further explored. The other care plan was very limited it only identified the resident’s personal care needs despite this residents other complex care needs. The care documentation seen overall however demonstrated that varied risk assessments are used to inform the Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 11 care provided and to promote residents and staff safety. The home is also using life histories to ensure residents are seen as individuals. Records illustrated that calls for support and advice from health care professionals are requested as necessary. There was evidence to confirm that the care plans are being reviewed and a daily record is written staff spoken to had a good understanding of individual residents needs. There was however no evidence that the plans of care are written in consultation with residents or their representatives, discussions with resident’s relatives confirmed this. Observation in the home confirmed that staff were meeting residents needs in a flexible way allowing residents to wake and have breakfast when they wanted. All feedback about the home was positive about the care provided in the home. And comments included ‘My mother has improved greatly since she has been at this home she has come on leaps and bounds’. ‘I am very happy with the care and the home is brand new. My wife is happy here.’ Comments from visiting professionals were also positive but felt ‘it was early days’ for the home and believed that the home needed to be established before they could really form a view on the home although it had ‘the potential to be an excellent home’. All care staff spoken to had a good understanding of residents needs and demonstrated a sympathetic and kind approach which, respected their dignity and privacy. The whole atmosphere in the home promoted a relaxed environment which residents and relatives benefited from. During the assessment visit to the home it was noted that staff had a very good rapport with residents spending time with them and their visitors having conversations and interacting in a positive and respectful way. Staff knew all the residents well and addressed them by their preferred name, which was clearly recorded within the care documentation. The practice observed on both the ground and first floor demonstrated good practice was being followed in respect of the medicine administration. However a review of the medicine administration records identified that there was a number of unexplained gaps on the administration charts and a record relating to a medicine stored, as a controlled drug did not record accurately where they were being stored and the home had not arranged for their safe and timely disposal. These matters relating to medicines were identified to the registered manager for her to investigate and respond to appropriately. The care documentation seen confirmed that the home has an awareness of care pathways when caring for residents who are dying and observations confirmed that staff provide a good standard of nursing care to residents with a high dependency. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 12 Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Links with friends and relatives are encouraged and choices made are respected. Resident’s opportunities for stimulation through leisure and recreational activities are not fully developed in the home to meet individual needs. Residents receive a wholesome and appealing diet. EVIDENCE: Although the home has a fulltime staff member that co-ordinates the social activity in the home at the time of this inspection this person was on sick leave and alternative arrangements had not been organised. This lack of stimulation was noted in the home, as residents with a dementia did not have any activity in place to try and engage with them or to occupy them. One resident on the Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 14 ground floor said he was ‘bored’ and the activity provided when he first arrived in the home had stopped. The registered manager advised that alternative arrangements have been discussed and will be put in place next week. Visiting is seen as an important part of residents life and very much encouraged with many visitors coming to the home on a daily basis with some staying for a meal, as on the day of the inspection visits. All visitors were seen to be greeted and welcomed to the home, many of them are well known to the staff who were seen to have a good rapport and relationship with them. The meals were well complimented and there is strong emphasis on quality home cooking with fresh produce. The inspector ate a midday meal with the residents in the very attractive ground floor dining room. The meal provided was found to be well presented and to have a good taste. The dining experience was very pleasant with the cook taking an active role ensuring residents had the meal they wanted and reviewing how the food was being received. Care staff were in attendance and ensured any assistance needed was given and that residents had drinks. All residents spoken to said how much they liked the food, which they described as ‘very good’. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 and 18. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a suitable procedure for dealing with complaints made to it and respects each individual’s rights. The home’s procedures do not ensure that the correct alerting procedures are followed once an allegation or suspicion of abuse is highlighted. EVIDENCE: The home has a suitable complaints policy and procedure, which is made available to residents and their representatives. Records seen illustrated that all concerns and issues even small problems like issues with the laundry are recorded along with what the home has done to resolve the issue. The home has received one formal written complaint and there was evidence to confirm that this had been fully investigated by the registered manager who has taken statements and responded in writing to the complainant. All residents have representatives identified within the care documentation. The homes procedure on adult protection is not correct and does not record the correct lead authority to be notified if an allegation or suspicion of abuse is raised. This was discussed with the registered manager who recognised the Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 16 shortfall in the procedure she was also made aware that there are new local procedures on safeguarding vulnerable adults that need to be incorporated into the homes own procedures. Staff training records confirmed that staff received training on the protection of vulnerable adults. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20,21, 22, 23, 24, 25 and 26. People who use the service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides an attractive, safe and comfortable, well-maintained environment with facilities that meet the homes stated purpose. The home is clean and hygienic and has the necessary equipment and adaptations to facilitate resident’s independence and comfort. EVIDENCE: Sovereign Lodge Care Centre has been purpose built with the needs of the residents that were to be accommodated in mind and ensuring their safety. It therefore provides excellent facilities with a layout that suites both residents who may be physically disabled and those who have a dementia. It is light and airy and provides space for equipment and for residents to wander. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 18 Many of the residents and relatives said the environment in the home was a major reason in choosing the home, as it was so attractive and new. Resident accommodation is on three floors and each area has its own communal space allowing for varied and flexible use. All rooms are single and have en suite facilities. The home has well equipped toilet and bathing facilities and the home has wide corridors and doorways to allow the movement of equipment and the free movement of residents in wheelchairs. The home has been furnished and decorated to a high standard. In addition there are good facilities for staff working in the home that include a shower. There is a large well-equipped laundry room that promotes good infection control measures. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staffing numbers and skill mix provides a well-trained and motivated staff team that meets residents health and personal care needs. The homes recruitment procedures followed were found to be robust. Systems need to be progressed to ensure all staff have training to meet the specialist care needs of residents in the home. EVIDENCE: The occupancy of the home included 14 residents on the ground floor who are in receipt of general nursing care and 11 residents on the first floor who have a diagnosed dementia. The staffing arrangements ensure that there is a registered nurse on each floor over the 24 hours. This has allowed for a high level of registered nurse supervision throughout the home. On the day of this inspection visit the absence of two care staff necessitated the registered manager to work as a carer until other staff could be called to assist. She acknowledged there have been problems with forming a stable staff team compounded by staff sickness, holidays and by staff not turning up for work once recruited. Staff and relatives said that staff had been stretched Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 20 causing some frustration and stress. Staff were also concerned that the duty rotas were not available in advance so they sometimes had to telephone to find out what shifts they were working the next week and were not able to plan their life’s. The registered manager confirmed that further recruitment was progressing and that a deputy manager was taking up post at the end of the summer and that this would relieve the difficulties. In addition staff were concerned that there was no paid time for a hand over to ensure good communication between staff coming on and going off duty. The registered manager said that this was not actually the case however agreed to clarify this and to record accurately the hours worked on the duty rotas. Residents and visitors were very positive about all staff and praised some staff individually. There comments included ‘Staff here are all very good’ ‘My sister and I have always found the staff very friendly and approachable nothing seems to be too much trouble’ ‘Sovereign Lodge provides a coring home where patients needs are met by a kind and caring staff with a concern for the residents dignity which is extremely important when dealing with the elderly. During the inspection a good rapport was noted between staff and residents. The recruitment files pertaining to the four staff were reviewed as part of the inspection process and identified that the recruitment practice was good. Some of the staff have completed an NVQ in care at level 2 or above and three staff are completing an NVQ in care. Mandatory training is co-ordinated and provided by an outside trainer and induction training is provided and coordinated by the registered manager. It was noted that staff training on Dementia and challenging behaviour is being organised. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36, 37 and 38. People who use the service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent well-trained person in an open and friendly manner with suitable quality monitoring systems. Resident’s financial interests are safeguarded. Staff are appropriately supervised and health and safety of residents and staff are protected although policies and procedures need to be developed to underpin best practice in the home. EVIDENCE: Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 22 The registered manager is a very experienced registered nurse having been qualified for 29 years and worked 19 of them in the care home sector at various levels of management and gained a specialist qualification in elderly care, and has had experience in commissioning new homes. She has also completed the registered managers award and NVQ level 4 in management. She is supported by an administrator but is waiting for a deputy manager to stabilise the management structure. People spoken to were complimentary about the manager her availability and approachable manner one relative said ‘the manager is approachable and personable and is keen to listen to my views. The registered manager has a good understanding of quality monitoring systems and an audit system has been established and is completed in conjunction with the regional manager with feedback being provided to the staff. Questionnaires to gain residents and their representative’s views are to be used in the future once the home has been operational for a longer period. Most residents have a small amount of money held by the administrator, which is used for any extras, or shopping. This money is topped up by resident’s representatives and the administrator provides appropriate receipts. It was however noted when the accounts were checked that it was difficult to find the corresponding receipts. Systems need to be developed to ensure a clear audit trail. It was also noted that the administrator was not following any procedure and this should be developed to ensure safe practice that protects resident’s monies. The registered manager confirmed that she was being regularly supervised and that she in turn has been supervising staff working in the home keeping a record of when this is completed. Most records seen in the home were full however it was noted that the homes policies and procedures need to be reviewed and updated as they were all dated 2005 and some areas were not covered with an appropriate procedure. For example there was no procedure for ensuring safe hot water and the prevention of legionnaires disease. The home has a full time maintenance man who deals with all health and safety and maintenance issues. Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 23 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 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 4 4 4 4 4 4 4 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 2 3 Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No previous 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 OP1 Regulation 4 (1)(c) 5(1)2) Requirement That the service users guide and statement of purpose is updated to contain the required in a suitable format to meet all interested peoples needs. That training is provided for all staff where specialist needs have been identified to ensure all care needs of residents are met. That the care plans record individual choices and preferences and provides clear individual guidelines from a person centred approach to care. That the plan of care is drawn up in consultation with the service user or their representative if appropriate to ensure their agreement and understanding of the care to be provided. 4. OP9 13 (2) That all medicine records relating 01/09/07 to medicine management are accurate and complete. That all records relating to the storage, disposal and administration of controlled drugs are up to date, complete DS0000069563.V345388.R01.S.doc Version 5.2 Page 25 Timescale for action 01/10/07 2. OP4 12(1) 18(1) 15 01/11/07 3. OP7 01/10/07 Sovereign Lodge Care Centre and accurate. 5. OP12 16 (2)(m) That the home provides suitably qualified staff and resources to provide individual social contact and activity for residents in the home at throughout the week. That the home updates its safeguarding vulnerable adults (adult protection) policy and procedure in line with the local policies and procedures. That a stable staff team with appropriate skills are established. That the home provides suitable and up to date policies and procedures to underpin safe and best practice in the home. 01/09/07 6. OP18 13 (3) (6) (7) (8) 01/10/07 7. 8. OP27 OP37 18 24 01/11/07 01/11/07 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 Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Sovereign Lodge Care Centre DS0000069563.V345388.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!