This inspection was carried out on 8th November 2005.
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.
CARE HOMES FOR OLDER PEOPLE
St Andrews Lodge Care Home Riber Crescent Basford Nottingham NG5 1LP Lead Inspector
Dee Shelvey Unannounced Inspection 8th November 2005 11:00 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 St Andrews Lodge Care Home DS0000026472.V262078.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 Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service St Andrews Lodge Care Home Address Riber Crescent Basford Nottingham NG5 1LP 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) 0115 9245467 0115 9245485 Trinity Care Ltd Mrs Gillian Margaret Bell Care Home 80 Category(ies) of Dementia (80), Mental disorder, excluding registration, with number learning disability or dementia (80) of places St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Out of the total number of beds up to 10 beds can be used for service users aged between 50 & 65 years Service Users shall be within categories DE (80), or MD (80). Date of last inspection 31st May 2005 Brief Description of the Service: Southern Cross Healthcare Ltd, the registered provider, had a contract with the Health Authority to accommodate people that are in need of continuing care. The contract is currently under review. St. Andrews Lodge provides nursing care for 80 older people with Mental Illness and for those with Dementia. The registration allows for up to 10 people between the ages of 50- 65yrs to be accommodated. The home is split into two separate units, Garden and Assisi. Sited in an established residential area the home had sufficient car parking and a well maintained garden. All areas of the home were accessible to service users. St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over 3 and ¾ hours. The inspection focused on the garden unit and consisted of reading documents and records, speaking with service users, relatives and staff. What the service does well: What has improved since the last inspection?
The format for care planning had been reviewed and now includes information on recreational needs and auxiliary health needs e.g. oral health and chiropody. There is evidence that relatives are consulted during the care planning process. Service users who do not have the capacity to manager their own finances and who have no family to assist them have been referred to the City of Nottingham Council to take court of protection procedures. This offers excellent protection for the service user. The company have a training co-ordinator who draws up a yearly programme based on the needs of the staff. Individual records of training were available for each member of staff. St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 6 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. St Andrews Lodge Care Home DS0000026472.V262078.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 Andrews Lodge Care Home DS0000026472.V262078.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): 2,3 and 4 Service users receive a full assessment of needs and will know prior to entering the home that identified needs will be met. The service user will have a statement of terms and conditions explaining what services are included in the cost. EVIDENCE: The home has a contract with the health service for the provision of services but also provides a simple statement for service users. The case files examined contained comprehensive assessments of need and evidence of service user and family involvement in the process. St Andrews Lodge Care Home DS0000026472.V262078.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 and 8. Service users health care needs will be included in care plans and appropriate care provided. EVIDENCE: Care plans contained comprehensive information on health needs and there was evidence of appropriate referrals to health specialists. When a resident had an acute need the care plan was placed in a separate file to ensure that staff would focus on monitoring and recording progress of treatment. Visitors spoken with said they were kept informed of any changes to their relatives health. St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 10 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 and 14. Service users experience a life style that satisfies their needs and are enabled to exercise as much control of their lives as they are capable of. EVIDENCE: Assessments contained lifestyle preferences and included information on spiritual needs and social/recreational interests. To ensure that these needs were being met the home had introduced a new monitoring record. If it then appeared that some service users were not engaged in any social activities steps would be taken to remedy the situation. To provide both service users and families with independent advice and assistance the manager, during the care plan review discussions, has gradually informed people of the Careaware service for providing advocates. St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 11 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): These standards were not assessed on this occasion but were met at the last inspection. EVIDENCE: St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 12 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): 20,22 and 26 The home provides a safe, clean and tidy environment for the residents but is in need of refurbishment in some areas. Residents are provided with a good range of equipment to enable them to maintain their independence. EVIDENCE: The home was clean, tidy and warm on the day of inspection and visitors spoken with confirmed that this was how they found the home. There were some carpets that required cleaning and some armchairs with large holes in the armrests. Refurbishment had started in the Assisi unit but there was no timetable for work to commence in the garden unit. Each unit had a keypad lock installed to prevent people who are unsafe or lack judgement to wander from the building unattended. There was access to well maintained gardens. Each room had a floor sensor to alert staff during the night should a resident at risk of falling get out of bed. There was a range of equipment available for residents use including standing aids and hoists. In addition appropriate equipment for assisting residents with toileting and bathing was available.
St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 There was a well trained staff team in sufficient numbers to meet the needs of the service users. EVIDENCE: Staff files were examined and found to be very much improved with all records arranged chronologically. The records provided evidence of a well balanced staff team who have access to appropriate training. Staff complete a period of induction training at the start of their employment and are then positively encouraged to take up a course leading to an NVQ qualification. The garden unit was appropriately staffed with sufficient care staff to meet the individual needs of the service users. There are two qualified nurses on duty during the day and one at night. Service users and relatives spoken with expressed satisfaction with the staff team and were satisfied with the numbers on duty. One person commented that staff were approachable and helpful. St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 14 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): 33,35 and 38 The home is well managed, run in the best interests of service users and offers protection to vulnerable service users. EVIDENCE: Care plans for people not able to manage their own affairs and not having any relatives to assist now contain referrals to Nottingham city council for court of protection procedures. This will ensure safety from financial abuse. The home runs a quality assurance scheme to inform future practice and to ensure that service standards are maintained. Annually all service users, families and visiting health professionals are provided with a questionnaire seeking opinions on the home. The results are analysed and published. In addition comment cards are available at all times in the reception area. St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 15 The home had a satisfactory health and safety policy and records provided evidence of equipment being properly checked at appropriate times. An infection control policy was in place covering the use of protective clothing, waste disposal and laundry facilities. All appropriate fire safety awareness tests were done and staff had been involved in fire drills. During the tour of the premises no health and safety hazards were seen. St Andrews Lodge Care Home DS0000026472.V262078.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 3 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X 3 X 3 X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 St Andrews Lodge Care Home DS0000026472.V262078.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. 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 OP19 Good Practice Recommendations To provide a timetable for the refurbishment of garden unit. St Andrews Lodge Care Home DS0000026472.V262078.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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