Inspection on 27/11/06 for St Lawrence`s Lodge

This inspection was carried out on 27th November 2006.

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 12/09/07

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 27th November 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Lawrence`s Lodge DS0000005578.V319892.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.V319892.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 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.V319892.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). 26th January 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. 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 are £315. Additional charges are also made for hairdressing and chiropody services, newspapers and personal toiletries. The home’s statement of purpose and service user guide were not available. St Lawrence`s Lodge DS0000005578.V319892.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 by one inspector and an ‘expert by experience’. The site visit took place on 27th November 2006 and covered a period of seven and a half hours from 9:30am until 5:00pm. The Commission for Social Care Inspection are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently testing a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people who have been appointed by Help the Aged, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for older people. During the inspection time was spent talking to residents, relatives and staff and observing the home’s routine and staff interaction with residents. The expert by experience also had lunch with the residents. A total of three residents’ identified needs were looked at in detail. Individual details of their experiences and care were examined from the point of admission to their current care. The inspector looked around the building and a selection of staff and residents’ records was examined, including records of care, medication records, employment and training records. The inspector checked what the Commission had asked the home to do at the last inspection (January 2006) had been done. Two requirements had been made at this time and both had been met in full. Questionnaires were left at the home for use by residents, their relatives and the staff to comment on the service. Some of the responses have been incorporated in this report. A resident commented: “The home is very easy going. I can go out with my family when I want. I am very happy here.” St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 6 The expert by experience noted in her report that a resident said they had moved into the home out of choice and because “it was the best in town. What the service does well: What has improved since the last inspection? What they could do better: The home should improve the quality of information made available to prospective residents so they will be able to see what the home has to offer them. The residents should have a contract (terms and conditions) with the home so they can be sure of a reasonable level of service, and they know what they have to pay. Although residents said they would speak to the manager or staff if they had a complaint, the manager needs to make sure that residents and visitors know there is a formal procedure which she will work to. Some of the decoration in the bedrooms, the bathroom on the ground floor and the communal areas would benefit from redecoration. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 7 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.V319892.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 Lawrence`s Lodge DS0000005578.V319892.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): 1, 2 & 3 Standard 6 (intermediate care) is not provided at St Lawrence’s Lodge. Quality in this outcome area is adequate. The residents do not have access to information about the home that would enable them to make a better informed choice. The home’s system of assessment reflected individual preferences and social requirements. This meant that the home could be certain they could meet the prospective residents’ diverse needs. This judgement has been made using available evidence, including a visit to this service. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 10 EVIDENCE: The deputy manager said the home has an ‘information pack’ that doubles as the statement of purpose and service user guide. She said this would be left with a prospective resident so that they or their representative could read what the home had to offer. The residents who spoke with the inspector and the expert by experience had not seen a copy of the information guide. The document was also not available to the inspector. The same residents were unable to recollect if they had seen or signed a contract (terms and conditions) with the home. This means they did not know how much they were paying for their board and accommodation, how they could complain or how much notice they had to give should they wish to move from the home. The individual files did not contain a copy of a contract and the deputy manager was unable to find signed copies. Individual care needs assessments were contained within the three care files examined as part of the inspection. The home also has a process of assessing potential residents’ needs carried out by a senior member of staff. Prospective residents and their relatives are invited to visit the home so that they can meet other people and see the accommodation for themselves. By completing such an assessment, the home can be sure that individual needs can be met. St Lawrence`s Lodge DS0000005578.V319892.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. The care planning process social requirements. This provide appropriate care benefit from the individual clearly identifies the residents’ individual health and ensures the carers know the action to be taken to on a day-to-day basis, enabling the residents to care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were examined as part of the inspection process. They clearly set out the residents’ individual personal care needs. 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 in place and reviewed. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 12 Where identified, the residents’ 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 and dietician. A care plan noted where a resident was choosing not to eat the evening meal but enjoyed supper. This person was under investigation by the doctor and there was a record to show that an eye was being kept on her weight. The senior staff are responsible for the administration of medication. There was evidence to show they had received training to correctly administer medications. Records are retained to show changes to medications and medical interventions. There is a policy and procedure in place to ensure all medications are administered in the correct manner. The medication storage was satisfactory. Based on observation, it was apparent that the staff respected the residents’ privacy by knocking and waiting before entering rooms. The expert by experience noted “a person was assisted out of a wheelchair so that he could sit at the dining table naturally with the other residents.” St Lawrence`s Lodge DS0000005578.V319892.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): 10, 11, 12, 13, 14 & 15 Quality in this outcome area is good. The choices offered to the residents meet with their requirements and needs and enable them to exercise elements of control over their lives. The activities suit the residents’ requirements for stimulation. Visitors are made to feel welcome and remain in contact with their relatives’ care. The contents of the menu appeared nutritious and meals were nicely presented, thereby promoting residents’ good health. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Based on direct observation, the residents benefit from relaxed informal contact with the staff. During the afternoon some of the residents and carers gathered in the dining room to make Christmas cards and decorations. There was plenty of cheerful banter between them. The residents were encouraged by the carers to reminisce about past Christmases. A resident explained how they enjoy quizzes in the afternoons. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 14 The expert by experience noted: “The atmosphere was very relaxed and therefore the service users appeared confident in their environment and very comfortable with all the staff. Two ladies confirmed their stay in the home was lovely.” A resident told the expert by experience that the staff respected the requirements made by his religious beliefs. This was also clearly documented in the care plan. Another resident described her continued involvement with the local church. Other residents described how they returned to the family home for short periods and one person was going out with her daughter and great-grandchild. Visitors could be seen throughout the inspection they were informally greeted by the staff. The inspector observed the main meal of the day at lunchtime, and the expert by experience sampled it. The carers served the meal. It was apparent that the residents had made a choice from the menu displayed within the home. The meal was a social occasion, with the residents chatting one to another and with the carers. Several residents commented on their enjoyment of the meal and thanked the staff. The carers knew two residents did not want their meal at this time but would have it later in the day. This was acknowledged and presented no problem to the staff. The meal was unhurried and assistance was provided in a discreet and considered manner. The expert by experience noted, “food was good, the choices were good and the carers attentive.” St Lawrence`s Lodge DS0000005578.V319892.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. The residents feel that their views are listened to and acted upon, even though they are unaware of the formal complaints system. 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: Those residents who spoke with the inspector and the expert by experience were not aware of the formal complaint process but did say they would either tell their relative of any concerns or speak with a member of staff. They said their expectations would be that the concern would be looked into and made better for them. Written responses in the comment cards also supported the lack of a formal system but confirmed the resident would speak to a member of senior staff or their family. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 16 According to the staff training programme (and confirmed by the deputy manager) 11 members of staff have completed training in the Protection of Vulnerable Adults. There is a further course arranged for April 2007 when the remaining staff will attend. Those carers on the National Vocational Qualification course at level 2 have also undertaken some training in the recognition of abuse. The responses in the staff questionnaires confirmed their responsibility to protect the residents from abusive actions. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 17 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. With minor exceptions of a cosmetic nature, 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: The home employs a maintenance man who deals with the day-to-day repairs and some redecoration in the home. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 18 The inspector looked around the home. Some of the decoration in the bedrooms and communal areas was looking shabby and tired. The majority of the bedrooms were nicely personalised and “lived in.” It was apparent from the smell of stale urine in some bedrooms that the occupants had a problem with incontinence. Large amounts of aids to continence that could be seen in these rooms are a constant reminder to the resident of their problem and, as such, seems a little undignified. The ground floor bathroom was also looking well worn and in need of redecoration. It is understood that a new carpet has been ordered for the large lounge, which will improve the environment for the residents. At the previous inspection it was understood and reported that this area was to be redecorated. New specialist flooring had been installed in the dining area. This a good practical solution for the area as it can be mopped after each meal and it is also non-slip. The residents said it looked lovely and they were very pleased with the effect. The expert by experience noted: “This was not a salubrious environment by any means, but what it lacked cosmetically was by far exceeded by its atmosphere of friendliness and cosiness.” St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 19 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 well-trained staff who respond to the residents and visitors in a respectful manner. The home’s 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: This is a very stable workforce, which serves to provide a continuity of care to the residents. There had been no new staff employed since the previous inspection. The staff who responded in the comment cards wrote they felt supported by the management. Of the five surveys returned all showed they had worked at St Lawrence’s Lodge for longer than two years. From observation the carers were attentive and responded to the residents in a respectful manner. A young student on placement at the home said she had been “looked after” by the staff and working at the home had been a positive experience for her. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 20 The manager continues to support carers to complete the National Vocational Qualification at levels 2 and 3. She remains very skilful in seeking out further and specific training for all levels of staff. The expert by experience noted: “Although I did not get to meet the actual manager as she was on a course, it was obvious from the way the staff carried on their duties under the deputy, that everything was carrying on as normal and that they themselves were under no duress at work which is an idea atmosphere for any ageing service user to live in.” The carers who spoke with the inspector confirmed they had attended an induction programme and had completed all the health and safety (mandatory) training. A small number of staff files were examined. They contained the required documentation and there was evidence of references, including satisfactory checks with the Criminal Record Bureau. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 21 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. The manager of the home has the skills, experience and qualifications to run the establishment. The residents’ financial interests are safeguarded. Systems are in place to protect the residents, their visitors and the staff’s health and safety. This judgement has been made using available evidence, including a visit to this service. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager has the appropriate skills and experience to manage St Lawrence’s Lodge. There was evidence to show she continues to update her knowledge. The staff state they are well supported and enjoy working at the home. They are enabled to carry out their roles in a relaxed and informed manner. One resident continues to manage their own finances. 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 service provider visits the home at regular intervals and also carries out the requirements according to Regulation 26. There was no evidence of the manager formally seeking the resident’s views or of a quality assurance system. By using such a system the manager could be sure that the care provided to the residents is acceptable to them and the systems used to protect them are current. No hazards to health were noted during the inspection. The health, safety and welfare is further ensured by the systems in place to report accident and incidents. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 23 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 2 2 3 X X N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 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 X 3 St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 24 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 3 4 5 Refer to Standard OP1 OP2 OP16 OP19 OP33 Good Practice Recommendations The registered person should ensure prospective and current residents have access to a statement of purpose and service user guide. The registered person should ensure all the residents have a statement of terms and conditions or a contract if they are privately funded on the point of admission. The registered person should ensure all the residents have access to the formal complaints process. The registered person should ensure the bedrooms, ground floor bathroom and communal areas are redecorated. The registered person should ensure there is an effective quality assurance and monitoring system in place. St Lawrence`s Lodge DS0000005578.V319892.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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.V319892.R01.S.doc Version 5.2 Page 26 - 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!