Inspection on 13/08/07 for Squirrel Lodge Residential Home

This inspection was carried out on 13th 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

Squirrel Lodge Residential Home 11/08/06

Squirrel Lodge Residential Home 21/02/06

Squirrel Lodge Residential Home 28/09/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Squirrel Lodge Residential Home 541 London Road South Lowestoft Suffolk NR33 0PD Lead Inspector John Goodship Key Unannounced Inspection 13th 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 Squirrel Lodge Residential Home DS0000064004.V348673.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. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Squirrel Lodge Residential Home Address 541 London Road South Lowestoft Suffolk NR33 0PD 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) 01502 515423 squirellodge1@tiscali.co.uk Squirrel Lodge Ltd Mrs P M Hunton Care Home 22 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (22) of places Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named person whose name was made known to the Commission on 31/10/06 aged 65 years and over who requires care by reason of dementia. One named person whose name was made known to the Commission on 24/01/07 aged 65 years and over who requires care by reason of dementia. 11th August 2006 Date of last inspection Brief Description of the Service: Squirrel Lodge started as a small home for the three older people in 1984. It was first registered in 1987 and has been adapted and extended over the years and now provides residential care for up to twenty-two older people. It is set back off the main road into Lowestoft and is close to community facilities including local shops, the promenade and the beach. The home has private gardens with level pathways and the majority of rooms have patio doors opening to the well-maintained external areas. The home has a gravelled car parking area to front. At the time of inspection, the fees ranged from £341.00 to £373.40 per week. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and covered the key standards which are listed under each outcome group overleaf. This report includes evidence gathered during the visit together with information already held by the Commission. The inspection took place on a weekday and lasted six hours. The manager was present throughout, together with staff on the morning shift and, later, those on the late shift. The other owner was available during the afternoon. The inspector toured the home, and spoke to four of the residents, some in their own room and some in the communal areas. He also interviewed a senior and a junior member of staff, and spoke to other staff around the home. The inspector also examined care plans, staff records, maintenance records and training records. A questionnaire survey was sent out by the Commission to residents , relatives, and staff. Six residents, nine relatives and two staff responded. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. The manager had also completed a form sent to them by the Commission called the Annual Quality Assurance Assessment. The contents of this have also been used in the report. What the service does well: The care and attention given by the staff are praised by most residents and relatives. The homely style and atmosphere were noticeable during the visit. The home is well maintained, and several people commented on how clean it was kept. The dining room was quiet and pleasant to be in, and the lounges were comfortable and well furnished. One relative wrote: “My relative receives the best care I could wish for her.” Another wrote: “I was very lucky to find a placement for my relative here. They have been so helpful and caring.” Another wrote: “The staff are very friendly and caring. They know the people well and interact with them in a cheerful way.” Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 6 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. Squirrel Lodge Residential Home DS0000064004.V348673.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 Squirrel Lodge Residential Home DS0000064004.V348673.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. Standard 6 is not applicable to this home. Quality in this outcome area is good. Prospective residents can be assured that they will have sufficient information to decide if this home is where they wish to live. The home will also collect information to assure the person that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose was up-to-date and included the information items required by the regulations, such as the facilities and services offered, the organisational structure and the qualifications of staff. The owner said that the Statement of Purpose was sent out when enquiries about the home were received. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 9 The Service Users’ Guide (called a Welcome Pack) was issued to people who were offered residential care. This gave more details of the daily routines in the home. The form of contract was seen, together with the separate letter which was issued at the same time advising of fees. All residents who responded to the pre-inspection survey apart from one confirmed that they had received the contract. There was an Individual Placement Contract in each care plan detailing fee payment methods and dates when fees were due. The home had three larger rooms which were shared. The practice of the home, when a vacancy arose in a single room, was to offer that vacancy to a person in a shared room, if they had expressed a wish for a single room. This meant that any new admissions were normally only able to be offered a shared room. Although the manager said that prospective residents were always aware that they would be sharing because they would have been shown the room and introduced to the other occupant, one person did put on the survey form that they were not aware that they would have to share for such a long time. Another resident confirmed that, before moving in, they had visited the home several times for coffee and lunch. Files and care plans contained the pre-admission assessments made by the manager or deputy. All twenty-two places were filled at the time of the inspection. Squirrel Lodge Residential Home DS0000064004.V348673.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): 7,8,9,10,11. Quality in this outcome area is good. Residents can be assured that their health, personal and social care needs are set out in an individual care plan. They are able to contribute to the development and review of their care plans, with their views and needs taken into account. However they cannot be assured that all staff will be fully informed about their changing needs in a timely way. Residents are protected by the home’s medication policy and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of care plans was examined. They were in separate parts, in different rooms. One part contained a copy of the contract, the pre-admission assessment and an inventory of possessions brought into the home. Another part was a working file containing the daily report, risk assessments, personal care logs, medical logs, and weight records. One file contained the risk assessment for a resident who was self-medicating. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 11 There was evidence that care plans were regularly reviewed, and identified care needs and how they should be met. Staff who were spoken to demonstrated that they were aware of residents’ needs. All residents surveyed, apart from one, said that they always or usually received the care and support they needed. One resident told the inspector that although staff were generally all right and “met most of my care needs”, they did not stick to the care plan. However 75 of relatives who replied to the survey said that their relative always or usually received the care agreed. The residents’ care records appeared jumbled and disorganised, and not easy to read or to identify what may have changed. In the staff survey several staff commented that basic information was given at handover. One said: “Care plans are at hand but never read because of no time and are never informed when they are changed.” Another wrote: “We are often not told when an individual resident’s needs change.” There was a policy that an entry should be made in the daily record at the end of each shift only if there had been a significant event or change of need. It is recommended that this policy should be reviewed, that the format and style of the care plans should be reviewed to make them easier to record in, more comprehensive and to provide an at-aglance sheet listing recent changes. A resident was critical that if their parent missed a bath day because there were not enough staff, they had to wait until the next scheduled bath day. However this resident’s daily record showed that one bath had been missed, and the bathing record showed that they had been bathed two days later. This person normally had two baths a week. A relative wrote: “The general care is good. But my relative’s eyes get sticky and often need wiping, and their teeth need cleaning properly. Hand and nail care could be improved, and cleaning their face and chest after a meal. Changing them more frequently to cope with the incontinence would stop the room smelling which it didn’t before.” Two residents were being cared for mostly in bed. The level of care needed here was said by a member of staff to have put a strain on staff. They claimed that no additional staff were allowed to be brought in. However the AQAA stated that manager and the deputy manager participated in “hands on “ care work at times of staff shortages or heavy demand. One of these residents was terminally ill and was visited by the GP or the community nurse every day. This person had chosen not to go into hospital and had refused certain medical treatment, which had been agreed by the relatives. An audit of the medication arrangements had been carried out by the home’s pharmacy supplier in July 2007. This had found everything in order and procedures sound. It advised that the home should dispose of its unwanted medicines more frequently. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 12 A sample of Medication Administration Record sheets were examined, and stock levels checked against those remaining in the packs. There were no gaps in signatures and the quantities tallied. Staff were heard to address residents with respect and to treat them with dignity. They always knocked before entering a room. Two relatives said that their relative had their own telephone in their room. Two staff told the inspector that Squirrel Lodge was a very caring home, which always puts the residents’ needs first. One said that they would be happy to see one of their own family cared for in the home. Squirrel Lodge Residential Home DS0000064004.V348673.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): 12,13,14,15. Quality in this outcome area is good. Residents can be assured that there will be some activities which they can choose to take part in. Residents’ nutritional needs are monitored, and they have varied and nutritious menus responsive to residents’ comments, with safe catering procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said that all the residents get visitors, and half of them were taken out by their visitor. One resident told the inspector that they went out once a week with their daughter. The home also arranged outings, for example a recent trip to Beccles, and at the end of the month a trip on a wheelchair accessible boat was planned. Staff, relatives and residents listed some of the events and entertainment put on at the home. These included choirs, bingo, jewellery making and dominoes. Several residents said they were aware of the activities but chose not to take part. One relative commented that their Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 14 relative could not cope with group activities, and could not follow the television, so had no interests or stimulation. One resident said there should be more activities “we can participate in, such as gentle exercise to music, craft work and quizzes.” The AQAA stated that there was provision for a monthly religious meeting in the home. Birthdays were always recognised and celebrated. Special events were organised at Christmas time. The home was intending to understand residents’ preferences better and possibly form a residents association with their agreement. Of the residents who completed the survey, only two said they always liked the meals. Four said they only sometimes liked them. Comments included: “It depends on the cook.” Care plans inspected showed that residents were weighed regularly. One relative was concerned that when their relative had their meal in their room, they did not get enough support with feeding, or making sure the food was within reach. The manager reported that this person’s needs were being reviewed. During the lunch, appropriate support was seen to be given to all. The AQAA stated that changes to the menus had been made following residents’ comments. More varied lunch menus had been introduced. The menu on the day of inspection was meat pie and vegetables, with a hot dessert. The meal was hot and well presented. It was not clear what the alternative was, although the manager said there was always other dishes available. The printed menu did not offer a particular alternative, and it was up to the resident to ask. More active promotion of choice would be an improvement, as one resident wrote “We do not get a balanced diet and should get more choice at lunchtime.” The residents in the dining room who spoke to the inspector said there was usually something on the menu they liked. One relative noted that their relative in the home would sometimes agree to eat what was suggested to them even if they did not like it. “The seniors know her likes. The juniors will say ‘Oh well she asked for it’”. One resident said that the meals were all right as they only gave them small portions “which is what I want”. The home was following the “Safer food, better business” procedure recommended by the Environmental Health Officer (EHO). This included maintaining purchasing records of provisions which evidenced fresh fruit, vegetables, and meat were regularly used. The EHO had visited in January 2007. Minor repairs to the kitchen had been recommended, and these had been carried out. Each resident had lockable storage in their rooms to keep any valuables. The home looked after small amounts of money for some residents, which were Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 15 locked securely in the office. Residents were involved in the reviews of their care. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 16 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): 16,18. Quality in this outcome area is good. Residents can be assured that their views will be listened to and acted upon. There is a proper training programme in place to give residents confidence that they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a complaints procedure which contained all required details for the information of residents and visitors. Most residents said that they knew how to make a complaint, and would feel able to do so. Two said that the need had never arisen. The home had a complaints log but no complaints had been received by the home or by the Commission during the last twelve months. The owners discussed their intention to record concerns expressed by residents and relatives with their outcomes. Many of these would be settled the same day according to the manager, and a relative. The training record and the training plan showed that there was a schedule of in-house training in the protection of vulnerable adults throughout the year. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 17 Staff who replied to the survey and who spoke to the inspector agreed that they understood the topic. One person said that they had covered it under NVQ Level 2 as well. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 18 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): 19,20,22,23,24,25,26. Quality in this outcome area is good. Residents can be assured that the home provides a comfortable and wellmaintained environment and that they are able to personalise their rooms should they wish to do so. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents said in the survey that the home was always or usually clean and tidy. It was noted during the visit that this was so. There were no unpleasant odours. Many rooms looked onto the central garden. One resident said they enjoyed tending the garden in front of their bedroom. The garden was very well kept and residents said they enjoyed looking out on the flowers and going out in warm weather. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 19 Residents confirmed that they chose whether or not to bring their own furniture into the home or not. Rooms were individual and residents talked happily about the pictures they had on their walls, their ornaments, and the view from the window. The dining room was comfortably furnished with dark wood tables and chairs. The chairs had cushions on them and the room was carpeted. These made the room pleasant and gave a quiet and homely atmosphere. It was large enough to seat all residents. There was an area off the main lobby where wheelchairs were stored in an unused entranceway to keep them nearby for use but not obtrusive. The home had two moveable overhead hoists. These gave the flexibility to respond to the needs of residents as their needs changed. One bathroom also had a ceiling tracking hoist. Special door closers, which held the doors open until the fire alarm sounded, were fitted to the bottom of all bedroom doors in the older part of the home. This allowed those residents the choice of keeping their doors open or closed. Newer doors were linked electronically to the fire alarm. More space had been created in one of the shared rooms by the removal of the chimney breast. The manager stated that all rooms were subject to a spring clean once a fortnight. There was a sitting room at the rear of the home, where a resident could sit while their room was being cleaned if necessary. The manager stated that this room, although comfortably furnished with a view over the rear garden, was only usually used by one or two residents. It was empty when visited. There were plans to incorporate it into the new bedroom extension. No separate cleaning staff were employed as all care staff were required to include cleaning and laundry duties in their job description. This was a deliberate policy of the owners to ensure that there were no divisions of responsibility between staff, and that all staff were aware of the need for high standards of cleanliness and hygiene. The home had a good record of preventing cross-infection, with no recorded instances. The four residents who replied to the survey stated that the home was always or usually clean and tidy. One relative wrote that the home should employ domestic staff to relieve the carers. One carer felt that they were pulled between their caring duties and their domestic duties. The manager told them to put the care first, but then “moaned at them for not keeping up with the domestic work.” However two staff interviewed by the inspector believed that staffing levels were sufficient unless there were residents needing extra care time. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 20 The owners had bid for, and been given, a Government grant to improve the front lounge. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 21 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. Quality in this outcome area is adequate. Residents cannot be assured that sufficient numbers of staff are on duty at all times to provide for their needs. Residents can expect that they will be protected by the home’s policy on recruitment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents felt that there should be more staff on duty, so that more time could be given to each resident. One said that: “They are too occupied with the more confused residents.” A staff member wrote: “ The work pattern is still geared to when most of the residents were truly residential. Their needs have now changed but the staff levels have not.” However two staff interviewed by the inspector said that staff levels were normally sufficient, although the care needs of two residents recently had stretched the staff. During the early shift, there were two staff covering the whole period, with three staff covering parts of the shift. During the late shift, there were two staff covering the whole period, with one person covering a part of the shift. In both cases there was also a senior carer as shift leader. At night there were two waking staff, with a manager on-call. The impact of the additional hours Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 22 for cleaning and laundry could not be calculated during the inspection. It is recommended that a review is undertaken of the staff levels against all the duties of carers, and the ability to cover for occasional high dependency needs of some residents, for example those with dementia. The staff file for the two newest recruits was examined. They contained all the required identification and reference documentation. Both had started before receipt of the full CRB disclosure certificate, but POVA list returns had been received before their start dates. The files contained the record of induction both in-house and externally to meet the Common Induction Standards. Training records and plans for staff were examined. It showed that all relevant care staff had received in-house training in elements of care for those with dementia in the previous nine months. Five staff had also completed an extended distance-learning course on Dementia Awareness. Most staff had received in-house training in the protection of vulnerable adults in the previous 10 months. There was no specific training in the prevention of cross-infection. Medication training had been completed by those staff responsible for administration. In addition a staff member said that this topic was covered further on NVQ Level 3. Refresher training in Food Hygiene, moving and handling, fire and abuse had taken place in June and July 2007. Of the relatives who replied on the survey to the question on staff skills, 75 said that staff always or usually had the right skills. Two made the point that “the seniors do, but obviously the juniors are still learning”. The deputy manager had completed NVQ Level 4 and the Registered Manager Award, the trainee manager was undertaking NVQ Level 4, the administrator was nearing completion of the Registered manager Award, three staff had completed Level 3, and seven staff had completed, and four were undertaking, Level 2. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 23 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): 31,33,35,36,37,38. Quality in this outcome area is good. Residents can be assured that there is a system for obtaining their views on the running of the home to ensure it is run in their best interests. A process of staff supervision protects residents by continually monitoring and improving the skills of the staff. Their safety is assured by the home’s health and safety practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is one of the registered owners. They have been at the home for twenty-three years and try to create as homely an atmosphere as possible. The manager held regular meetings for the senior staff. There were no general Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 24 staff meetings. Two staff said they would like there to be. The manager said it was difficult to arrange times to suit all. A relative wrote: “when I have mentioned a problem either to the manager or one of the seniors, they have taken it on board and sorted it out.” There was a planned programme for staff supervision sessions. The schedule showed that most people were up-to-date. The current process of quality assurance, as stated by the manager, includes observation of care practices by senior staff, and by listening to staff and relatives. There was regular testing of views through such means as questionnaires, for example about the menus. Health and safety records were up-to-date. The manager had written in the AQAA that there were plans to further develop in-house quality assurance and monitoring. The fire log was up-to-date, showing regular testing of fire alarms, and emergency lighting, with contract maintenance of fire equipment and detectors. The fire doors had been upgraded as described under “Environment”. There was a room-by-room fire risk assessment. The accident log was properly completed showing no untoward events, and no pattern of accidents. The home reported appropriate incidents to the Commission under Regulation 37. As described under “Health and Personal Care”, the records of residents’ care should be reviewed for greater clarity, more up-to-date information and ease of use. The Liability Insurance certificate in the entrance hall had expired eleven days before the inspection. The owner said that the company had sent the renewal certificate but he had not yet put it up. He reported later that it was put on display shortly after the inspection eneded. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 25 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 3 3 3 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 X 3 X 3 3 2 3 Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 26 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. 1 Standard OP7 Regulation 15(2)(b) Requirement Care plans must reflect the assessed needs of the service users, be kept under review and maintained in such a way that ensure staff use them as the basis of care given. Timescale for action 13/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP8 OP12 OP15 OP15 OP27 Good Practice Recommendations A recording and auditing system should be implemented to ensure that the health care needs of residents have been attended to. Residents’ views should be obtained on the range and type of activities and events offered to them. Residents’ should be assessed for their nutritional needs, and their preferences obtained for the content of menus. Residents needing support to feed should be given that support regardless of where they choose to eat. The numbers and mix of staff should be reviewed, particularly regarding the needs of higher dependency residents, and the principle of a generic worker. DS0000064004.V348673.R01.S.doc Version 5.2 Page 27 Squirrel Lodge Residential Home 6. OP37 The format of care plans and residents’ files should be reviewed to ensure more up-to-date information is collected and is available to all staff. Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Squirrel Lodge Residential Home DS0000064004.V348673.R01.S.doc Version 5.2 Page 29 - 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. 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