CARE HOMES FOR OLDER PEOPLE
St George`s Lodge 46 Chesswood Road Worthing West Sussex BN11 2AG Lead Inspector
Mrs J Wright Unannounced Inspection 16th January 2006 1:00 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 George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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 George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service St George`s Lodge Address 46 Chesswood Road Worthing West Sussex BN11 2AG 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) 01903 820637 Bushby Care Limited Mrs Susan Margaret Bushby Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th August 2005 Brief Description of the Service: St Georges Lodge is a care home, registered to accommodate up to twenty-six residents in the category of old age. It is a detached property, located in East Worthing approximately one mile from the town centre and relatively close to the sea and parks. The accommodation of twenty-six single bedrooms, the majority of which are en-suite, is arranged on two floors. There is a passenger lift to the bedrooms on the first floor, and a large garden/parking area to the front and the sides of the building. Bushby Care Ltd. privately owns the service, and the registered manager is Mrs. Susan Bushby. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second of a minimum of two statutory visits that an inspector must make to each care home during the course of a year. The first inspection, which was also unannounced, was undertaken earlier in the year. At this inspection the Inspector looked at standards that were not looked at during the previous inspection, as well as any outstanding issues from the last report or concerns raised about the home since the last inspection. Some standards that were assessed at the previous inspection were not assessed on this occasion; the reader is advised therefore to look at the reports of both inspections for a fuller picture of the home. The Manager was present for the majority of the inspection. During this inspection the Inspector examined records of care being provided to the residents; as well as records of any accidents, issues, or complaints, to make sure that the residents at St Georges Lodge were being taken care of. In addition to talking to the Manager, the Inspector spoke with Mr. Bushby, plus two staff members, several residents and a visitor, to listen to their views about the home. All the comments received from everyone that the Inspector spoke to were very complementary with regard to the home, the food, the owners and the staff members. At this inspection St Georges Lodge was audited against the National Minimum Standards for Older Persons. All the elements in each of the standards assessed were met. The Inspector would like to thank everyone who cooperated with her on the day of this inspection. What the service does well: The residents, who the Inspector met on the day of inspection, spoke highly of the staff members, the friendliness of the home and the food. The building is maintained safely, and to a good standard. Mr. Bushby is responsible for the upkeep of St Georges Lodge, and is in the home on a regular basis. Records required by the Inspector on the day of inspection, were found to be in order. A visitor to the home told the Inspector that the person they visit was very happy at St Georges Lodge and they were made to feel welcome by the staff when they came to visit. The Inspector spoke to many residents on the day of inspection and all said that they were really pleased with the standard of the home and of the care being provided, and one said that they “couldn’t be happier”.
St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 Page 6 The Inspector was told that St Georges Lodge does not use outside agency workers, thus ensuring that the residents always know their carers. 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. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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 George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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, 4 and 6 Each resident has a written contract/ statement of terms and conditions with the home. Residents and their representatives know St Georges Lodge will meet their needs EVIDENCE: The Inspector was shown a copy of the home’s statement of the terms and conditions, which contains all the requirements of the National Minimum Standards. The Manager assured the Inspector that all residents and their representatives are offered a copy. Prospective residents are assessed by a senior staff member prior to their being admitted to St Georges Lodge. Evidence from care plans and training records of staff confirmed that St Georges Lodge was able to meet the assessed needs of the residents accommodated there. St Georges Lodge does not offer intermediate care. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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 The resident’s health, personal and social care needs are set out in an individual plan of care. EVIDENCE: Resident care plans were examined and whilst they comprehensive, they do need to include a photograph of the resident. Residents are to sign their care plans if, following a review, there are any changes made to their care, to show they are in agreement. The Inspector was informed that specialist advice is sought where appropriate. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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 People living at St Georges Lodge are able to make the day-to-day decisions about how they want to live their life. There is a range of activities for those who wish to participate, and residents are encouraged to maintain contact with all their old friends and family wherever possible. EVIDENCE: There were a variety of activities on offer at St Georges Lodge, which include an accordion player, a singer and an art and craft instructor who come to the home on a regular basis. In addition the Inspector was told of a “Fashion Show” held recently, to enable those residents who are not able to access the shops, to choose any new clothes they may require, and of a singing group who were booked to come at the end of January. One of the residents regularly goes out to the local area, and many relatives call in regularly. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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): 16 Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. EVIDENCE: Residents told the Inspector they would be happy talking to Mr. or Mrs. Bushby or any staff member about any issues they might have, and felt that any thing troubling them would be looked into. There were no complaints recorded at the time of this inspection. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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, 21 and 25 Residents live in a safe, well-maintained environment, with sufficient and suitable lavatories and washing facilities. Residents have access to safe and comfortable indoor and outdoor communal facilities. EVIDENCE: Mr. Bushby keeps a record that shows that St Georges Lodge is maintained to a satisfactory standard. On the day of inspection St Georges Lodge was clean, and warm, with residents in the lounge, or resting in their rooms. St Georges Lodge provides sufficient communal space for the residents, which consists of a separate lounge and dining area. The Inspector was assured that some wheelchairs currently housed in the lounge are to be removed shortly. There are enough washing facilities available in the home, with accessible toilets close to the communal sitting areas and the dining room. Twenty-two of the twenty-six bedrooms are en-suite. On the day of inspection several doors were wedged open, the home was made aware of the safety implications with regard to this.
St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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): 28 Residents are in safe hands at all times EVIDENCE: St Georges Lodge was adequately staffed on the day of inspection. The Inspector saw evidence of ongoing training by the staff members at the home, and further training is planned. The Inspector was assured by the Manager that that all staff members had received manual handling training, fire training, Health and Safety training, medication training and food hygiene training. All training is recorded on the staff member’s files. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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): 34, 36 and 37 Residents are safeguarded by the accounting and financial procedures of the home, and staff are appropriately supervised. Resident’s rights and interests are safeguarded by the home’s record keeping and policies and procedures. EVIDENCE: The inspector saw that insurance cover is in place to meet the National Minimum Standards. There is a business and financial plan for the home, which would be made available upon request. Residents are encouraged to manage their own affairs with the help of relatives or advocates. It is apparent that the needs of the residents are uppermost at St Georges Lodge, and that the home ensures that resident’s rights and best interests are safeguarded at all times. Residents are encouraged to manage their own affairs with the help of relatives or advocates. St Georges Lodge was seen to offer formal bi-monthly
St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 Page 15 supervision to all care staff, the Manager supervising the two senior carers, who in turn supervise the remainder of the staff members. The Manager undertakes an annual appraisal of all staff. St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 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 X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X 3 3 X X X 3 X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 X 3 3 X St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? Not applicable 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. Refer to Standard Good Practice Recommendations St George`s Lodge DS0000062147.V274450.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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