Inspection on 06/03/07 for St Denis Lodge

This inspection was carried out on 6th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

St Denis Lodge 24/09/07

St Denis Lodge 25/01/06

St Denis Lodge 13/07/05

St Denis Lodge 14/02/05

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE St Denis Lodge Salisbury Road Shaftesbury Dorset SP7 8BS Lead Inspector Sally Wernick Unannounced Inspection 6th March 2007 10:15 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 Denis Lodge DS0000061609.V332083.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. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Denis Lodge Address Salisbury Road Shaftesbury Dorset SP7 8BS 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) 01747 854596 01747 855410 St Denis Lodge Ltd Miss Patricia Butler Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th January 2006 Brief Description of the Service: St Denis Lodge is well-established care home situated on the outskirts of Shaftesbury town centre close to the Royal Chase roundabout. The home is registered to accommodate a maximum of 21 people aged 65 years and over in the category of Old Age (OP). The owner and registered individual (RI) is Ms Beverley Martin and the registered manager is Mrs Patricia Butler. St Denis Lodge residential home is a large Georgian property set in its own landscaped gardens. Accommodation for service users is arranged over the ground and first floors and all but one of the bedrooms have en-suite WC facilities. The accommodation is of a very high standard and provides a comfortable and attractive environment. Communal rooms include a lounge, dining room and separate conservatory: assisted bathing facilities are available on the first floor and a separate WC is situated close to communal areas. The home aims to provide a service to people who have low to moderate care needs, and is well-suited to people who retain a degree of independence. However, the homes environment is such that physically frail elderly people can access all parts of the house: there are two passenger lifts available for use. Service users are encouraged to remain at the home for as long as they wish with support from health care professionals. St Denis Lodge offers a good range of social activities and community contact is maintained: services include personal care, all meals, cleaning of rooms and laundry. There is a large off road car park to the side of the home for visitors convenience. Fee range:-£595-£625.00 per week. See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and began at 10.15am on Tuesday 6th March 2007. This was a ‘key inspection’ where the homes performance against the key National Minimum Standards was assessed alongside progress in meeting a requirements and recommendations made at the previous inspection. The Registered Manager and Registered Provider assisted the inspector, as did other members of care staff. Methodology used included a tour of the premises, review of records and discussions with staff. During the inspection the inspector spoke with six residents two in their rooms and four in communal areas. The inspector also reviewed the contact sheet and service notes for the home. A Pre-inspection questionnaire was also sent to the manager in order that information could be provided prior to the inspectors site visit. That information where relevant will be included in the main body of this report. Prior to the inspection comment cards were sent out by the home on behalf of the commission. Of those returned thirteen were received from residents, seven were from health and social care professionals, one from a care manager, one from a G.P practice and seven from friends or relatives. Surveys received from residents included only one additional comment: “I am very happy here and the staff are excellent” The overall “tick box” response received from residents was positive particularly relating to good care and staffing levels. A local G.P’s practice indicated a positive response to the overall care provided and the levels of communication from the home. Friends and relatives commented: “I have nothing but praise and admiration for the care provided for my mother at St Denis Lodge by all the staff and the management”. “Our friend has settled in very happily” “The care given to my relative is second to none” “The standard of care and compassion is excellent and we are extremely pleased with all aspects of St Denis Lodge”. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There are no requirements as a result of this inspection. St Denis Lodge continues to provide a good standard of care to residents. There are some recommendations however which relate to good practice and which are identified to enhance and improve the quality of life for those living at the home. Residents should be able to enjoy a range of activities and/or interests whilst at the home based on individual preferences. The capacity for social activity will vary amongst individuals. This should be taken into account and individual plans developed to reflect this. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 7 Staff employed at the home do receive relevant training. NVQ’s however provide a benchmark from which standards of care can be assessed and developed. The home should continue to work towards 50 of the staff team achieving this qualification. The home will be developing its quality assurance systems and will be extending this to care professionals, families, staff and other stakeholders. It would be good if results could be published in a clear format to demonstrate how the home is meeting positive outcomes for service users. 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. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 8 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 Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 9 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): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure enables prospective residents and their supporters to make informed decisions about the home and ensure that only service users whose needs can be met by the home are offered places there. St Denis Lodge does not provide Intermediate care this standard therefore was not inspected. EVIDENCE: Two files of residents who had come to live at the home since the previous inspection were examined. All showed that prior to arriving at St Denis Lodge, care needs had been assessed by the home’s manager. The outcome of the assessments are confirmed in writing, so prospective residents can be fully assured that their care needs will be met. One resident spoken to said that the home had provided them with detailed information prior to moving in which matched their expectations fully. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 10 Pre-admission assessments contained information for managing personal and healthcare needs. All residents moving into the home received a copy of the terms and conditions and a brochure, which has been updated in line with a requirement made at the previous inspection. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good care planning system in place to ensure that staff has the information that they need to meet the needs of residents. The health needs of the residents are well met with support from a range of community health professionals. The medication at the home is well managed promoting the good health and well being of residents. Residents are treated with respect and their privacy and dignity are promoted. EVIDENCE: Three care plans were examined all were of a good standard. They followed on from the assessments made by the home, were easy to read and were informative about the needs of the resident and of how the home was to meet them. Information in the care plans was up to date with plans being reviewed St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 12 monthly. There was evidence that residents were consulted about their daily plan of care and were involved in the assessment process. Daily care notes support and evidences the delivery of care to residents and gives a picture of the care provided as well as visits by community health professionals. Records demonstrate that residents have access to GP’s, district nurses, dentists, opticians and attend for appointments as necessary. Risk assessments are carried out for each resident and appropriate steps taken to minimise any risks identified. Health professionals commented in written surveys to the Commission for Social Care: “On visiting patients at St Denis Lodge there is always a warm and informative welcome. Staff accompany us to the residents room and will stay with the resident if necessary, feedback from us is always welcomed and any advice/exercises are readily accepted and acted upon”. “We have a very good working relationship with the staff at St Denis Lodge. They provide a very high standard of care to the residents”. “It is a very well run care home, very friendly, very clean and very professional”. A system for the ordering, administering and recording of medication is in place at the home and only staff members that have completed a course in “medication” are able to carry out this task. Medicines were safely stored and countersigned where necessary. Some residents at the home do choose to self medicate and lockable storage is provided. Staff was observed throughout the inspection to be treating residents with courtesy, patience, kindness and respect. Residents spoken to during the course of the inspection spoke very highly of the staff describing them as “fun” “very caring” and “superb”. One resident said that staff always treated them with the “utmost respect”. St Denis Lodge DS0000061609.V332083.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. This judgement has been made using available evidence including a visit to this service. Entertainment and some recreational activities are provided that enable residents to enjoy some of their leisure time. Residents are supported in maintaining contact with their friends, family and the community and they are helped to exercise choice and control over their lives promoting independence. The meals are good, nutritionally varied and served in a pleasant environment. EVIDENCE: There is a range of activities available at the home and all of the residents spoken to on the day of inspection felt that the current arrangements were sufficient. Twice a week there are exercises classes as well as occasional quizzes, musical events, guest speakers and community church events. The hairdresser calls each week and satellite television is available. There are film evenings and the library service calls every three weeks. During the warmer months the home arranges monthly trips out and tables and umbrellas are placed in the garden for residents enjoyment. There are also occasional trips to St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 14 the theatre and other local events. Many of the activities at the home are group based and some residents in written surveys to the Commission for Social Care Inspection indicated that they would like alternative activities. It is recommended therefore that the home develop individual social care plans for residents at the home to identify ways in which individual’s lifestyle preferences and expectations may be more fully met. St Denis Lodge is a home of the residents and is run in a manner that supports them to live their lives making the choices they can. Those living at the home manage their own financial affairs supported by friends, family or advocates. Visitors are welcomed at the home and call at times that are suited to the resident and there is a point in each room for residents who choose to have their own telephone. Rooms are spacious, highly personalised, and comfortable. The standard of accommodation at St Denis Lodge is high. Residents spoken to confirmed that meals provided by the home are tasty and plentiful. The inspector observed home baking and a tour of the food area revealed fresh produce. Thirteen written responses from service users indicated that the food was good and the inspector observed a regular change of menu. One service user said that at times the choice was “monotonous” the overall response however was positive. St Denis Lodge DS0000061609.V332083.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 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a formal complaints procedure allowing residents and visitors to express any concerns. Adult protection procedures and staff training are in place to deal with allegations of abuse for the protection of the residents. EVIDENCE: The home has a clear and up to date complaints procedure, which is provided to residents and their supporters on admission to the home. No complaints have been received by the home or the commission during this inspection period. Adult protection policies and procedures are in place and all staff has received training in the Protection of Vulnerable Adults the majority have also attended “No Secrets” training with the local authority. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 16 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 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. St Denis Lodge provides spacious, well-maintained accommodation set in attractive grounds and mature gardens. The home is clean and there are no unpleasant odours making daily life for everyone more pleasant. EVIDENCE: St Denis Lodge provides homely, comfortable accommodation to a high standard. Rooms are personalised and clean and two lifts make for good access throughout the home. Communal rooms and bedrooms are bright and airy some with attractive views of the surrounding countryside and the garden, which is beautifully maintained. There is a comfortable conservatory and sitting room with quality furnishings and a large screen television with Sky and DVD facilities. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 17 On arrival at the home the only odour the inspector could detect was home baking. The standard of cleanliness was again high and the laundry has good washing facilities to thoroughly clean linen and control the risk of infection. Staff files indicated that staff has received training in infection control. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 18 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 good. This judgement has been made using available evidence including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff are sufficient to ensure that the assessed needs of residents are met. Robust recruitment procedures are in place to ensure the protection of residents living at the home. There is a programme of formal training designed to improve and develop staff knowledge and skills for the benefit of people living at the home. EVIDENCE: Throughout the inspection it was clear that there were sufficient numbers of staff on duty and staff rotas confirm this. Residents confirmed that staff is available if assistance is needed. There are dedicated cleaners at the home as well as catering staff, which ensures that the home is able to maintain good health and hygiene standards St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 19 The staff team at St Denis Lodge have worked at the home for a number of years and staffing generally remains stable. At the current time three have obtained NVQ seven are in the process of studying for that qualification. Robust recruitment procedures are in place and good staff files evidenced that. The home has a clear staff training matrix which demonstrates that all staff has undertaken their mandatory health and safety modules as well as specialist training in Parkinson’s disease in line with a recommendation made at the previous inspection, diabetes, death and dying and medication handling. Some training is delivered externally others through work based learning packs. Induction for new staff is thorough including principles of care and safe working practices. The following website is a useful guide and can also offer advice and information about induction and training programmes. www.skillsforcare.org.uk St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 20 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has the experience and qualifications to run the care home in the best interests of the residents. The quality assurance system in place does not yet fully reflect the views of residents, staff and stakeholders. Residents are assured of sound management of their financial interests. The health, safety and welfare of service users and staff are promoted and protected. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Registered Manager is very experienced in care and has completed the Registered Managers award. Regular training is undertaken by her to ensure she is able to maintain and develop both her knowledge base and skills. The home does distribute questionnaires to residents seeking their views on the quality of care at St Denis Lodge. Results of these surveys however are not provided to residents and their supporters so they are not aware of outcomes or the steps to be taken to improve quality of life at the home. Similarly questionnaires are not extended to family, friends, staff or other health professionals, which would offer a more reflective view on the quality of care provided. Resident’s at St Denis Lodge do where possible manage their own finances. Those who are unable to do so have a relative or other representative to assist them. Where necessary the home pays for services such as chiropody and a record is maintained. The amount is then invoiced to residents or their representatives for payment at appropriate intervals. In line with a requirement made at the previous inspection the home have provided written evidence that the electrical system is in order. Safety in the home is also well managed. Records showed that the fire safety system, precautions and staff training were up to date. Records were maintained for the servicing and testing of equipment used in the home and there was evidence of regular inspections of water quality. All staff has received their mandatory health and safety training. St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 22 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 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 23 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 OP12 Good Practice Recommendations The home should develop and implement an activities programme suitable for the individual needs of the accommodated service users and develop individual social care plans indicating how social and recreational needs can be met. 50 of the staff team should achieve NVQ 2 by the extended date of 2007. The home should develop quality assurance methods based upon seeking the views of service users and other interested parties, to ensure success in achieving the aims and objectives of the home. An annual development plan must be produced in an accessible format reflecting the outcome of the consultation. 2. 3. OP28 OP33 St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 St Denis Lodge DS0000061609.V332083.R01.S.doc Version 5.2 Page 25 - 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!