Inspection on 31/08/05 for St Lawrence`s Lodge

This inspection was carried out on 31st August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Lawrence`s Lodge 12/09/07

St Lawrence`s Lodge 27/11/06

St Lawrence`s Lodge 26/01/06

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 Lawrencess Lodge 275 Stockport Road Denton Tameside M34 6AX Lead Inspector Janet Ranson Unnannounced 31st August 2005 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 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 Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Lawrences Lodge Address 275 Stockport Road, Denton, Tameside, M34 6AX 0161 336 2783 0161 336 2783 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Janet Elvin Chestnut Farm, Grayingham Cliff, Grayingham, Lincolnshire, DN21 4HL Miss Helen Goodman CRH Care Home 20 Category(ies) of DE(E) Dementia - over 65 - 20 registration, with number OP Old Age - 20 of places PD(E) Physical Disability - over 65 - 7 SI(E) Sensory Impairment over 65 - 1 St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include up to 20 OP, up to 20 DE (E), up to 7 PD (E) and up to 1 SI (E). Date of last inspection 6th January 2005 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 and/or a physical disability. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over nine and a half hours. St. Lawrence Lodge provides personal care for up to 20 people over 65 years of age. It is privately owned. The manager is registered with the Commission for Social Care Inspection. In addition to teams of carers the home employs domestic, catering and maintenance personnel. Individual case files and care plans of four residents were examined as part of the inspection process. They concerned people who had lived at the home for a long time, were newly admitted and whose needs were changing. Wherever possible the residents were invited to talk to the inspector of their experiences and expectations. Two key workers were interviewed in addition to a visiting relative. Comment cards were left for residents and relatives to complete. Certain records were examined and observations of staff practice were also carried out. What the service does well: St Lawrence Lodge provides a good service for vulnerable residents in a pleasant and secure environment. The home cares for the resident’s families and encourages them to remain involved in their relative’s care. There is a stable enthusiastic work force that works well as a team. The carers are respectful towards the residents, their families and also towards each other. The manager is committed to the National Vocational Qualification system. The majority of carers have achieved level two and seniors level three. The home has achieved the Investors in People award. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 6 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 Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 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 standard(s) 1,2 & 3 The home’s statement of purpose provides the information to enable prospective residents to make an informed choice. Some details on the contract of residency need to be improved. Systems are in place to ensure the assessed needs of the resident’s can be fully met at the home. EVIDENCE: Amendments to the statement of purpose identified during the previous inspection have now been completed. It is important that this document is now made freely available within the home. At the previous inspection it was noted that details contained within the contract and concerning the complaints procedure were incorrect and as such were misleading to the reader. This situation remains unchanged. Initial assessments were contained within the four care files examined; having been completed by social workers or healthcare professionals. In addition the St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 9 home has devised a system of assessment that is also carried out by a senior member of staff. By completing their own assessment the home identifies the individual needs and can reassure the prospective resident that the home would be suitable for them. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 & 10 Resident’s care needs are clearly identified within the care plan, and fully met by healthcare professionals. Systems are in place to safely handle medication. The resident’s and their families are treated with respect. EVIDENCE: The manager was in the process of changing the care-planning format. Four care plans were examined they clearly documented the resident’s assessed needs. The details were well documented and observed. The key workers are responsible for reviewing the plans at regular intervals and for inviting comments and observations from the resident’s family. Where identified the residents healthcare needs are met by the appropriate personnel. Two doctors were in attendance during the inspection and the home works closely with the district nursing service and mental health team. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 11 The home has a medication policy and procedure. The medication administration records were examined and found to be completed in the approved manner. All senior carers who are responsible for the administration of medication have received the appropriate training. The contracting pharmacist carries out regular audits of medications and associated paperwork. The interviewed staff demonstrated respect towards the residents, and understanding of the need for privacy and dignity. They also recognised the uniqueness and acceptance of individual personalities. The staff were observed to knock and wait for a response before entering residents rooms. The resident’s representatives confirmed that their privacy was respected at all times. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 & 15 The resident’s individual lifestyles are respected and promoted by the actions of the carers. Visitors are welcomed and encouraged to remain in contact with the residents. Meal times are flexible and relaxed. The residents are consulted on the choice available on the menu. EVIDENCE: The individual care plans briefly document the resident’s social history. It was apparent at the time of the inspection that some resident’s had chosen to remain in their rooms and this was respected by the carers. A the time of the inspection a resident had been admitted to the home in an emergency. The staff were making valiant attempts to obtain information concerning this person’s background and previous lifestyle. They had consulted with relatives and friends and the resident themselves in order that they could better understand his reactions and behaviour. Visitors were to be seen during the inspection. They were greeted at the door in a friendly relaxed manner. A resident’s relative visits most days. She St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 13 confirmed she was informed of any changes and remained involved in her relatives care. The daily choice of menu was displayed on a board close to the dining room. The main meal of the day had recently been changed to the evening, lunch being a snack type meal. The residents still enjoy a full cooked breakfast. The content of the menu was not examined at this time but the cook was interviewed. She stated that the recent changes continued to be monitored and adjusted according to the resident’s comments. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 17 The resident’s were confident that their complaints would be addressed. The absence of formal training in the Protection of Vulnerable Adults could result in a resident being put at risk. EVIDENCE: The complaints procedure was available in the service users guide. As previously documented in this report, amendments are required to ensure the content is correct. The resident’s and their representative who spoke with the inspector were unable to recall having seen the complaints procedure but were able to tell the inspector how and to whom they would voice their concerns, either to family members or staff. The home has a policy and procedure to respond to allegations of abuse. The manager and a senior member of staff is to attend a recognised training course Protection of Vulnerable Adults (POVA) that when completed will enable them to cascade the learning to the remaining staff. Until then the staff are dependent on an intuitive reaction which may not provide the desired protection. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 15 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 standard(s) 19, 25 & 26 St Lawrence Lodge provides a warm, clean, safe and well maintained environment with an improved standard of furnishings and fittings. The home is clean with a good standard of hygiene. The laundry has been improved and the equipment replaced with commercial washers and dryers. EVIDENCE: A maintenance man is employed to provide day to day repairs and redecoration. The residents and their representatives who spoke with the inspector voiced their satisfaction with their accommodation. It was noted that some rooms had been redecorated and refurnished to good effect. Many of the bedrooms were nicely personalised and all the doors are lockable. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 16 The registered provider has totally replaced the laundry equipment to commercial standard and has improved the standards in the laundry room. The resident’s and their representatives stated they were satisfied with their washing and ironing. Two bedrooms had a smell of stale urine. This was discussed with the manager and alternative floor coverings suggested in an attempt to overcome the problem. The remainder of the home was fresh smelling and welcoming. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The home fails to employ staff in numbers to meet the assessed needs of the residents. The residents receive care from enthusiastic and well-trained staff who respond in a respectful manner. The organisations recruitment policy and procedure provides protection to the residents from potential abuse. EVIDENCE: The staffing rota was available, but not examined during this inspection. At previous inspections there has been a recommendation that the registered provider considered increasing the cooks hours into the evening. The practice has been that the senior on duty is responsible for cooking and presenting the evening meal. The recent changes to the meals providing the main meal of the day at 5 pm involves greater time spent in the kitchen for the senior staff who are also responsible for the administration of medications at this time. This is no longer acceptable and the manager is required to review the cooks’ hours to provide cover for all meal times. From observation the carers were attentive and responded to the residents in a respectful manner. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 18 In addition to care and catering staff the home also employs a team of housekeepers. The carers are also responsible for laundry duties. It is a very stable workforce which serves to provide a continuity of care to the residents. Recruitment is carried out according to the homes written policies. The registered manager confirmed to was her practice to obtain references and CRB clearance prior to appointment. The staff files were not examined at this time. The management continues to support carers to complete the National Vocational Qualification at level two. At the previous inspection there was a ratio of 40 of carers with a level two this has now increased to 82 with the remainder enrolled at the local college. The carers have also benefited from a variety of training to meet the residents identified needs. At interview the carers mentioned the training as one of the good aspects of working at St Lawrence Lodge. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,34 & 38 The manager of the home has the skills, experience and qualifications to run the establishment. A system of accounting and financial procedures is in place to safeguard the resident’s interests. The staff benefit from a systems of formal supervision and mandatory training. The health, safety and welfare of the residents, visitors and staff are promoted and protected. EVIDENCE: The registered manager has the appropriate skills and experience to manage St Lawrence Lodge. She has recently achieved National Vocational Qualification level four (registered managers award) as required by the standard. At interview the staff state they are well supported and enjoy St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 20 working at the home. They are enabled to carry out their roles in a relaxed and informed manner. The home has purchased a quality assurance package that provides an amendment service to maintain the policies and procedures in a current state. It has not yet been put fully into service. All the care plans are reviewed after six weeks and annually thereafter or when individual needs change. A resident’s representative was fully aware of the care planning process and confirmed they had been invited to become involved. The home has achieved the Investors in People award. A business plan has been documented after the manager had received training in this aspect. The registered provider can provide audited books as evidence of sound business. The staff at all levels benefit from an established formal supervision process. The supervision takes place every eight weeks and is fully appreciated by the carers. All staff have received the mandatory training concerning health and safety, fire awareness, first aid, moving and handling and food hygiene. The registered manager should be commended for her commitment to staff training and her ability to seek it out. All appliances and equipment is maintained in safe working order under contract. St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 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 3 x x x x x 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 2 3 x 3 3 x x x 3 St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 22 yes Are there any outstanding requirements from the last inspection? 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. 1. Standard 2 & 16 Regulation 22(7)(a)( b) Requirement Timescale for action 01/10/05 2. 3. 18 27 12 (1) 18(1)(a) The registered person must ensure the information in the complaints procedure regarding contact addresses detailed within the terms and conditions is amended. (Timescales of 01/12/04 and 01/03/05 not met). The registered person must 01/01/06 ensure that all staff are trained in the prevention of abuse. The registered person must 01/12/05 ensure the cook’s hours are increased to cover the evening meal and enable the carers to provided continuity of care. 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 Good Practice Recommendations St Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton under Lyne OL7 0QD National Enquiry Line: 0845 015 0120 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 Lawrencess Lodge F54 F04 s5578 St Lawrences Ldge v246934 310805 Stage 4.doc Version 1.40 Page 24 - 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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