Inspection on 12/09/07 for St Lawrence`s Lodge

This inspection was carried out on 12th September 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

St Lawrence`s Lodge 27/11/06

St Lawrence`s Lodge 26/01/06

St Lawrence`s Lodge 31/08/05

St Lawrence`s Lodge 06/01/05

St Lawrence`s Lodge 14/07/04

St Lawrence`s Lodge 11/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE St Lawrence`s Lodge 275 Stockport Road Denton Tameside M34 6AX Lead Inspector Janet Ranson Unannounced Inspection 12th September 2007 2:00pm 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 Lawrence`s Lodge DS0000005578.V349184.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 Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Lawrence`s Lodge Address 275 Stockport Road Denton Tameside M34 6AX 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) 0161 336 2783 F/P 0161 336 2783 Mrs Janet Elvin Miss Helen Goodman Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20), of places Physical disability over 65 years of age (7), Sensory Impairment over 65 years of age (1) St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 20 OP, up to 20 DE (E), up to 7 PD (E) and up to 1 SI (E). 27th November 2006 Date of last inspection Brief Description of the Service: St Lawrence Lodge is a residential care home adapted to meet the needs of 20 service users. Previously a Victorian vicarage, the adaptations now provide accommodation on two floors. In total there are 18 single rooms, three of which have en-suite facilities, and one shared room. The communal area is on the ground floor. The home is open plan in nature, having a large lounge and smaller dining area to the rear of the room. The dining area opens onto the small garden that is well used in the better weather. A conservatory has been added to provide an area for those residents who smoke. Adapted baths and toilets are located throughout the home. Car parking is available to the side of the building. The home is situated in a residential area, close to the centre of Denton. There is a shopping centre and market within walking distance. The adjacent towns of Ashton and Stockport are accessible by public transport. The service users who live at St Lawrence Lodge have been assessed as requiring residential care. The Commission for Social Care Inspection has registered the home to provide care for older people who may have dementia or a physical disability. Fees for accommodation and care at the home range from £331.77p to £361.77p. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the key inspection, which included an unannounced site visit. The site visit took place on 12th September 2007. The manager had completed a document that gave the inspector certain information about the service. During the site visit time was spent talking to the residents, some of the care staff, the deputy and registered manager. A visiting relative also assisted the inspector with her comments. The inspector looked the home’s routine and how the staff worked and talked with the residents. A total of four residents identified needs were closely looked at. Individual details of their experiences and care were examined from when they first came into the home to their current care needs. The inspector also looked around the building. Survey questionnaires were posted to relatives so they could comment on the service. What the service does well: What has improved since the last inspection? Three carers have undertaken specialist, accredited training so they can provide therapy and stimulation for those residents who have dementia. Improvements have been made to the general environment. Floor covering has been replaced, bedrooms decorated and new furniture purchased. A conservatory has been built to provide an area for those residents who smoke and to meet with the new legislation. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. St Lawrence`s Lodge DS0000005578.V349184.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 St Lawrence`s Lodge DS0000005578.V349184.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): 2, 3 & 5 (Intermediate care is not provided at St Lawrence Lodge) Quality in this outcome area is good. Systems are in place to ensure the residents’ needs can be fully identified and met by the home. Prospective residents and their representatives are able to visit the home in order that they can assess the service for themselves. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection there was a requirement for all the residents to have a contract (statement of terms and conditions) when they move into the home. This is so they (or their representative) are aware of the service they can reasonable expect in return for the fee they have to pay. This requirement has been fully met. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 9 Care needs assessments were contained within the four care files examined as part of the inspection. St. Lawrence Lodge also uses a system of assessing the potential resident’s needs that is carried out by a senior member of staff. By completing such an assessment the home can ascertain individual needs and ensure they can be met. It is the homes practice to invite prospective residents and their relatives to visit the home to see for themselves what is on offer. A relative said that the friendly welcome they received from the staff during their visit assured them that their relative would be safe and feel at home at St Lawrence Lodge. St Lawrence`s Lodge DS0000005578.V349184.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. The care planning process identifies the residents’ individual health and social requirements. They provide the carers with action to be taken to provide appropriate care on a day-to-day basis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were examined as part of the inspection process. They set out the residents’ individual personal care needs and were based on the initial assessment. The care plans document the action to be taken by the carers to ensure all aspects of health, personal and social care are met and reviewed. Risk assessments were also in place reviewed and monitored in the same way. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 11 Documentation held in one file showed how the home worked with the resident’s family in an attempt to overcome a potential risk to the individual from falling out of bed. Where the need is identified, the resident’s health is monitored and addressed by the appropriate health care professionals. The district nurses are involved on a regular basis as are the chiropodist, audiologist, dietician and speech therapist. A visitor described how the local mental health care team was helping her relative. She said she felt sure any other home would have asked her relative to move. The community psychiatric nurse (CPN) is involved with the carers in making sure the residents dementia can be understood and managed. This means that the relative is now more settled and less distressed. The inspector observed the manner in which a senior carer assessed a resident who had suddenly become unwell. The resident was taken to hospital in an ambulance supported by a carer. The situation that could have caused the other residents to become upset, was professionally managed by the carers who both showed great empathy. It was apparent throughout the inspection that the staff responded to the residents and the visitors in an informal and relaxed manner. There was a lot of light hearted banter but the carers were always respectful in their speech and actions towards the residents and the visitors. The manager described how a resident who had lived at St Lawrence’s Lodge for ten years, had always said she wanted to remain at the home and not go to hospital for her final days. This resident’s last wish was respected with the support of a specialist nursing team. It meant that the resident died in her own room surrounded by her own possessions having been cared for by people who had known and respected her. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 12 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 excellent. The choices offered to the residents meet with their requirements and needs and enable them to exercise elements of control over their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is no dedicated person to provide the residents with activities. However most afternoons the carers arrange games, arts and craft sessions and as on the day of the inspection, manicures. Each month there is a visit from an entertainer. Three senior staff have attended a course so that they can provide stimulation specifically for those residents who have dementia. This is highly specialised therapy that is carried out twice a week it is called Sonas. It aims to involve and stimulate those residents who may no longer have the capacity to become involved in other activities. The carers were obviously enthusiastic and described how the residents were becoming more involved and joining in with St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 13 the sessions. It was the CPN who recommended they apply for the course. A visitor said she was very impressed with the sessions, the manner in which it was carried out and the impact it was having on her relative. Earlier in the year a small group of residents and staff had a holiday in Blackpool. The carers are actively fund raising so that another holiday can be arranged. This is in response to the residents who want to return to Blackpool for another holiday. It was apparent from observation that the residents’ relatives were well known and welcome to the home. The visitors were at ease with the staff and the other residents. Visitors could be seen throughout the home during the inspection. There was plenty of light hearted banter between the residents and the staff. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 14 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. The residents have access to a complaints system that is visible to them throughout the home. Staff knowledge and understanding of adult protection issues provides a safe environment to protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a policy and procedure concerning reporting and investigation of complaints. This is available to the residents in written form and is displayed throughout the home. A visitor said she was aware of the way to complain (to the manager) and was certain any complaints would be dealt with sympathetically. The manager maintains a complaint record, and according to the document returned to the inspector The carers also have access to a whistle blowers policy which gives them protection should they have the need to make a formal complaint to the manager. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 15 There have been no complaints about the home made directly the Commission for Social Care Inspection and no Safeguarding Adults investigations carried out. The manager has received training to become the Safeguarding manager for the home. This means she can provide the training to the other carers so that they can recognise abusive situations and the correctly report them. St Lawrence`s Lodge DS0000005578.V349184.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 good. The residents live in a safe and well-maintained environment and the service users’ rooms suit their individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A maintenance man is employed at the home. This person deals with the dayto-day repairs and redecoration in the home. The manager ensures the programme of upgrading bedrooms to include soft furnishings, redecoration, floor coverings and furniture continues. The lounge has also been redecorated and a new carpet been fitted since the last inspection. The bathroom has also been decorated. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 17 For those residents who smoke, a large conservatory has been added to the side of the dining room. It was apparent that the residents are encouraged to bring items of furniture and personal effects with them. This gives the bedrooms individuality and must help the resident to settle down in their new environment. The residents who spoke with the inspector said they were happy with the home and the accommodation. There are aids and adaptations in place to meet with the resident’s individual needs. The home was clean, tidy and comfortable with no bad odours noted. It was evident that those resident’s who are independently mobile were able to move around all areas of the home at will. St Lawrence`s Lodge DS0000005578.V349184.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. The residents receive care from an enthusiastic, well-trained staff that responds to the residents and visitors in a respectful manner. The homes recruitment policy and procedure provides protection to the residents from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From observation during the inspection the numbers of staff on duty met with the resident’s assessed needs. A rota was available for inspection. According to the submitted information no staff had left the home since the last inspection this was confirmed by the manager during the inspection. There had only been a small turnover of staff at the last inspection this must provide the residents and their relatives with continuity. One hundred percent the carers have either achieved National Vocational Qualification at levels 2 or 3, or are enrolled on the course. The manager continues to seek out training for the staff to maintain and improve their stills and knowledge. Systems are in place to make sure the health and safety mandatory training is kept current. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 19 The staff appear confident and relaxed in their manner. Many of them have worked at the home for a long time this includes the senior team. The manager maintains an “open door policy” which means she is available for the residents, their visitors and the staff. The contents of the staff files has not changed since the last inspection where they were inspected to a good standard. All the appropriate checks were in place to ensure the safety of the residents at all times. St Lawrence`s Lodge DS0000005578.V349184.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, 37 &38 Quality in this outcome area is good. The manager of the home has the skills, experience and qualifications to run the home in the resident’s best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has the appropriate skills and experience to manage St Lawrence Lodge where she has worked for the several years. She has achieved her National Vocational Qualification at level four and the required St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 21 Registered Managers Award. There was further evidence to show that she continues to update her knowledge and skills by attending various courses. For those residents who are no longer able to deal with their money, the home has a system to protect their financial interests. Small amounts of personal allowances are retained for safekeeping. Satisfactory records with receipts covering all expenses are retained for auditing and inspection purposes. The care plans and risk assessments were found to be up to date and regularly reviewed as are the homes policies and procedures. The home is beginning to use a quality assurance system that is specifically designed for care homes purposes. It would appear that feedback on the service is sought in an informal manner from heal professionals and other visitors. In order that the residents can have a greater say in how the home is run the manager should carryout satisfaction surveys at regular intervals. The registered provider visits the home at regular intervals to provide the manager with support in addition to carrying out her legal responsibilities under regulation 26 of the Care Home Regulations. The manager was reminded to make sure the senior team complied with regulation 37 of the Care Home Regulations. This means that any death, illness and other events that may occur in the home are reported within 24 hours to the Commission for Social Care Inspection. No hazards to health were noted during the inspection. St Lawrence`s Lodge DS0000005578.V349184.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 3 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X 2 3 St Lawrence`s Lodge DS0000005578.V349184.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. 2. Refer to Standard OP33 OP37 Good Practice Recommendations The resident’s views and satisfaction of the service they receive should be sought at regular intervals. The manager should make sure the requirements contained in this regulation are carried out. St Lawrence`s Lodge DS0000005578.V349184.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Lawrence`s Lodge DS0000005578.V349184.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. 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