CARE HOMES FOR OLDER PEOPLE
Staddon Lodge 25 Nelson Road Branksome Poole BH12 1ER Lead Inspector
Gill Kennedy Unannounced 14 & 15 June 2005 10:00 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. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Staddon Lodge Address 25 Nelson Road, Branksome, Poole, Dorset, BH12 1ER 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) 01202 764269 Mr David Roger Staddon Davis Mrs Sheena Anne Staddon Davis Care Home only 12 Category(ies) of OP - 12 registration, with number of places Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23 November 2004 Brief Description of the Service: Staddon Lodge is registered with the Commission for Social Care Inspection to accommodate a maximum of 12 older people. The home is situated in a residential area within walking distance of Westbourne shopping area and Bournemouth upper gardens. The home is an older style property with a secluded private garden. All the rooms are single and six en-suite rooms are on the ground floor. The remaining bedrooms are on the first floor; two have en-suite facilities. These rooms can be accessed via a stair lift. On the ground floor there is a lounge and a separate dining room for service users. Mrs Davis, one of the proprietors, is responsible for the day-to-day management of the home and a member of staff lives on the premises. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection had been conducted as part of the normal inspection process legally required. During the inspection Mrs Davis the proprietor, was available on the first day to provide information and answer questions and on the second visit Mrs Pam Rippon a Senior Carer was on duty, both were helpful and co-operative. The files of four residents were read during this inspection. Five residents were spoken privately to discuss their views about life in the home and the services provided. Two staff were also seen in private. One visitor was spoken during this inspection. A selection of residents’ rooms were seen along with the communal areas and the kitchen. The time taken on this inspection was 8 hours and 11 standards were considered. CSCI comment cards were left at the home for residents, relatives and professionals to complete to ascertain their views about the services provided at the home. Six replies from residents have been received. The terms resident and service user used in this report are interchangeable. What the service does well:
Mrs Davis aims to provide an informal homely environment for residents, and it is clear from talking to them that she does this for the most part successfully. All the residents spoken to expressed satisfaction with the home and felt that their independence was encouraged, but help was available when needed. One resident who had been at the home for a number of years said this is ‘My home and a I love it’. A newer resident said he/she ‘Couldn’t fault it’. However, whilst the majority who replied to comment cards said they liked living at the home one person said they did ‘sometimes’ and another person said they did not. One resident added additional information on the comment card, saying ‘Sheena (proprietor) and her staff are very good, have helped me especially when I came here first and feeling hopeless’. There is a core of committed long-standing staff who know the service users well and provide a caring and sensitive environment and new staff have been integrated into this team. One new staff member said that she enjoyed
Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 6 working in the home and it was noted that staff treated residents in a caring and respectful way. Residents expressed satisfaction with the quality of the food provided and felt that it was in plentiful supply. This was also re-enforced in the comment card replies with five respondents saying they liked the food and one person saying they did not. There are robust procedures in place to deal with complaints and ensure the protection of residents. Mrs Davis has demonstrated that she will take the appropriate steps when areas of concern come to light. All residents bar one said in the comment cards that they felt safe in the home. The home is clean and well maintained, bedrooms are comfortable and personalised to suit residents’ needs. There are no unpleasant odours. 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.
Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 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 Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 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) 3 There are systems in place to assess residents prior to admission and they are informed that the home is able to meet their needs. EVIDENCE: The files of two residents who had recently been admitted were seen. One person who had been transferred from another area was accepted without a social service care plan being supplied until after his/her admission and Mrs Davis was advised not to accept residents who had a Community Care Assessment until this was made available to her. However, she had obtained information about the prospective resident by speaking with the family, social worker and former care home, so felt confident she would be able to meet the prospective resident’s care needs and had confirmed this in writing, a copy of the letter being available on file. Another new resident had visited the home with his/her family and discussions had taken place with them and the proprietor said she had verbally assured them that the home would be able to meet the needs she had highlighted in the assessment.
Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 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 standard(s) 7,8 and 9 A lot of effort has been put into improving care-planning documentation, but records are not always reviewed regularly and changed to reflect residents’ current needs and this could lead to inappropriate care being provided. Service users health care needs are promoted and maintained in line with their care plan. Systems for the administration of medicines need some adjustments to prevent mistakes being made. EVIDENCE: The files of four residents were read. There has been a considerable effort to improve care-planning documentation including more detailed risk assessments. Daily records are generally good, providing detailed information about the ongoing care provided. A variety of different forms are used and it was sometimes difficult to track an audit trail to clarify if a problem area had been addressed. Monthly reviews were sometimes out of date and in the case of one resident bore no reflection of his/her current capabilities.
Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 10 Evidence seen on files, talking to residents and to Mrs Davis, indicates that service users access appropriate medical and ancillary care. Mrs Davis had developed at a glance checklists that she was now using to indicate when service users had accessed various specialist healthcare services. A retired member of staff now comes in weekly and does stretching exercises as agreed with a professional physiotherapist. Four staff have received accredited drugs training from Weymouth College, but two staff who give out medication have only received some in house training from Mrs Davis. There was no list available indicating who gives medicines with a copy of their signature and initials, but Mrs Davis subsequently supplied this explaining it was kept in a separate place to the MAR sheets. One member of staff who had received the accredited training said it had been beneficial and made her more aware of medication issues. Most of the medication is supplied in the MDS and is securely stored. The records of three service users were seen. Staff were recording in the MAR chart the reasons for medication not being given, but in the case of one resident it was recorded on the MAR chart that fifteen tablets had been supplied and administered, but there were still two tablets left, they were not supplied in the MDS. Also where medication was handwritten on the MAR chart this was not always signed by two competent people. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 11 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) 14,15 Residents are encouraged to be as independent as possible and have control over their lives. A wholesome and nutritious diet is provided in a light and airy dining room. EVIDENCE: Where practical, residents manage their own affairs and are encouraged to bring their own possessions into the home. It was noted that service users rooms were personalised to suit their own needs. Residents confirmed that they felt able to do as they wished in their everyday lives. Three meals are served daily, with breakfast being provided in residents’ rooms and the main meal of the day is served at noon and supper at 5.00pm. Mrs Davis explained that some residents had lost weight when a virus had occurred at the home and she had increased their calorific intake with additional carbohydrates and made sure homemade cakes were on offer for afternoon tea, this was noted during the inspection. Whilst there is no choice for the main meal, the home is aware of residents’ likes and dislikes and will accommodate this.
Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 12 Residents seen expressed satisfaction with the food provided and said there was enough to eat. Five residents said on the comment cards that they liked the food and one person did not. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 13 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) Residents are confident that the management at the home would resolve complaints and there are robust systems in place to protect residents. EVIDENCE: Details of the complaints procedure are supplied to residents but a minor rewording is required to ensure complainants know they could contact CSCI direct at any stage of a complaint. In practice residents said they would be confident in approaching Mrs Davis if they had any concerns and feel she would address issues and put things right and this was also echoed in discussion with a relative. There had been one complaint made since the last inspection, the records demonstrating that this was fully investigated by the home and the service user written to formally. The complaint was not upheld. Some money had been taken from a resident and the home acted quickly to resolve this matter and protect all their service users. The police were involved and the member of staff was dismissed from the home. Mrs Davis liaised with this person’s second employer who was also a care home manager and made sure this was recorded on the POVA register. All residents bar one who completed comment cards said they felt safe at the home. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 14 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 Staddon Lodge is clean, comfortable and well maintained. EVIDENCE: The premises are maintained to a good standard and there is a private garden, which is well used by the residents. The maintenance book was seen and work is signed off as repairs are completed. There was also a written future plan of improvements and major maintenance for the building over the next year. The Fire Officer visited in June 2004 and the Environmental Health Officer in November 2004. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 15 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) 29 To fully protect residents the home needs to ensure that references from an applicant’s past employer are obtained prior to them starting work at the home. EVIDENCE: The files of two new staff were seen, the records held most of the information required and staff had current CRB checks. However, in the case of one member of staff there were no suitable references on her file. Mrs Davis said she would remedy this and immediately requested that the staff member provide information so that suitable references could be sought. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 16 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) 38 Training is in place that protects and promotes the welfare of residents and staff. EVIDENCE: This standard was not fully inspected, but the areas that were highlighted last time relating to staff training were addressed. Eleven staff now have a basic First Aid Certificate and the remainder of staff who do not have a Basic Food Hygiene Certificate will undertake this course within the next three months. Only two new staff do not have the manual handling certificate and Mrs Davis confirmed this would be addressed. This information was taken from training records supplied by Mrs Davis and from discussion with staff. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 17 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 x 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 3 Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 18 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 7 Regulation 15 Requirement The residents plan must be kept under review on a monthly basis and significant changes affecting their management recorded on the care plan. Staff must record the administration of all medication accurately on the MAR chart at the time it is given, or the reason medicines are not given.(timescale 31.01.05 not met.) No staff must be employed until two suitable references have been obtained including one from the last or current employer. Timescale for action 15.08.05 2. 9 13 15.08.05 3. 27 19 Schedule 2 15.08.05 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 9 9 Good Practice Recommendations When staff copy the details of prescribed medicines on to the medicine chart a second competent person should check and sign to confirm all the details are correct. All staff who handle or give medicines should have
D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 19 Staddon Lodge accredited training on medicines and their safe handling. Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 Staddon Lodge D55 S4062 Staddon Lodge V227771 140605 Stage 4.doc Version 1.30 Page 21 - 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!
