CARE HOMES FOR OLDER PEOPLE
St Aidan Lodge St Aidan Lodge Front Street Framwellgate Moor Durham DH1 5EJ Lead Inspector
Mr Bill Drumm Unannounced Inspection 7th November 2005 09:30 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 St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service St Aidan Lodge Address St Aidan Lodge Front Street Framwellgate Moor Durham DH1 5EJ 0191 3709691 0191 3865806 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) Ideal Care (North) Limited Ms Carol Ann Shannon Care Home 62 Category(ies) of Dementia - over 65 years of age (32), Old age, registration, with number not falling within any other category (30) of places St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 30 Older Persons and 32 Older Persons with Dementia Date of last inspection 8th June 2005 Brief Description of the Service: St Aidan Lodge is a purpose built care home situated in the centre of Framwellgate Moor, on the outskirts of Durham City. It caters for 62 residential service users on two floors, with the kitchen, laundry and additional facilities located in a basement area. St Aidan Lodge is registered to provide residential care for 30 older people situated on the ground floor, and 32 older people with dementia situated on the first floor. The home is spacious, with a variety of communal space, including lounge and dining areas, a smoking room and spacious garden area. All bedrooms are large single rooms with en-suite toilet and washing facilities. Rooms are well equipped and furnished and there are a number of suitably equipped and adapted bath and shower rooms. St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 4 hours on 7th November 2005. The home did not know the inspection was going to take place. The plan for the inspection was to check whether the home had met previous requirements and recommendations; to talk with service users about living in the home; to meet with staff and the home’s management team; and to look at records. What the service does well: What has improved since the last inspection? What they could do better:
Whilst every resident at the home has a care plan, the recording and review of the plans needs to be better. This is to make sure that identified care needs are met. The way in which residents medication is administered and recorded needs to be improved to make sure that residents get the correct medication safely.
St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 6 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. St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 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 St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes were assessed on this occasion. EVIDENCE: St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,9,10 Whilst all service users have a plan of care that also contained risk assessments in some instances they did not give an accurate account of the care required to meet residents needs. Bad practice in the administration of medication means that service users health and welfare is at risk. EVIDENCE: Four care plans were examined. Staff had clearly put a lot of work into developing these, and lots of good information was available. Staff were updating and recording in the contact sheet on a regular basis. It was obvious that service users needs were being met, however the actual plan of care detailing instructions to staff had not been updated when the service users needs had changed. For example in one of the plans, the mobility care plan stated that this person was mobile with the use of a walking stick. Whilst in the daily record and from observation of this resident it was clear that this resident now relied on staff to assist them. During the inspection several doctors visited the home, and care plans indicated that residents had access to other health care professionals such as district nurses, opticians and chiropodists.
St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 10 Care and support was given to residents in a discrete and sensitive way ensuring that privacy and dignity was maintained. The system for administering medication was in disorder. Secondary dispensing of tablets was taking place. A plastic container containing loose strips of all types of tablets was stored on top of the drugs trolley, none of these strips of tablets contained residents names or details of administration. One service user who had returned from a hospital admission had not completed a course of antibiotics, prescribed at the hospital, because staff at the home had not checked off any new medication for the service user on return to the home. There was no clear audit trail for the return of tablets. The control drug register contained errors, this was due to the poor recording on receipt and return of medication. St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,&14 Flexible visiting arrangements allow the residents to maintain good and regular contact with family and friends. Residents living at the home are supported to have choice and control over how they choose to live. EVIDENCE: Residents confirmed that they could have as many visitors as they like and at any time they chose. People spoken to follow their own hobbies and participate in activities according to their wishes. There was a selection of library books available, and games such as skittles and board games were also available. The introduction of a full time activities organiser will benefit the residents at the home. She confirmed that residents liked participating in group activities, and that time was also set aside for individual sessions between her and some of the residents. From reading the minutes of the residents meetings there was evidence of bus trips that had been organised and visiting entertainers to the home. St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes were assessed on this occasion. EVIDENCE: St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19&26 The home was clean, well-maintained providing service users with a safe and pleasant environment. EVIDENCE: Individual bedrooms and communal areas were suitably furnished and decorated in a style liked by people living there. Residents spoken to said they liked being able to bring into the home small items of furniture along with pictures and photographs to make there own rooms more pleasant and feel more like home. The communal areas of the home were clean and residents confirmed that their bedrooms were also cleaned to a good standard. St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes were assessed on this occasion. EVIDENCE: St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes were assessed on this occasion. EVIDENCE: St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 16 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 x 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 x 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X x St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 17 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 The manager must review all care plans to ensure that the plan is up to date with the care that service users are receiving. The plan needs to be in sufficient detail to ensure that identified care needs are met by staff Secondary dispensing of all medication must cease. Immediately and maintained hence forth. the manager must review the way in which all medication is ordered, administered, stored and returned to pharmacy, to ensure that the practice of staff is safe and service users are not put at risk. Timescale for action 02/01/06 2 OP9 12 07/11/05 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 St Aidan Lodge DS0000007502.V252406.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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