CARE HOMES FOR OLDER PEOPLE
Staddon Lodge 25 Nelson Road Branksome Poole Dorset BH12 1ER Lead Inspector
Carole Payne Unannounced Inspection 18th March 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Staddon Lodge Address 25 Nelson Road Branksome Poole Dorset BH12 1ER 01202 764269 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) Mr David Roger Staddon Davis Mrs Sheena Anne Staddon Davis Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th June 2005 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 DS0000004062.V287074.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on the 18th March 2006 and took a total of 3 hours. The inspectors, Carole Payne and Maxine Martin were made to feel welcome in the home. The manager was available during the visit. This was a statutory inspection and was carried out to ensure that the residents who are living at Staddon Lodge are safe and properly cared for. Requirements and recommendations made as a result of the last inspection visit were reviewed and key standards not assessed at the last inspection. The premises were inspected and records examined. Time was spent in discussion with people living in the home, the manager and staff members on duty. Four residents were spoken with and residents were observed enjoying the communal areas and spending time in individual rooms. What the service does well:
A resident was, appropriately, taking responsibility for administering their own medication. People living at the home are treated with sensitive care and respect and their right to privacy is upheld. People living at Staddon Lodge feel that it is a ‘home from home’, which, provides a suitable lifestyle which matches residents’ expectations and choices, and satisfies their social needs. Residents are supported to maintain contact with the local community and their family and friends. The home is maintained to a good standard of cleanliness, and all areas are pleasant, homely and hygienic. Staff members demonstrated good infection control practice during the visit. The numbers and skill mix of staff satisfactorily meets service users’ needs. Residents and staff are asked about their views, making a positive contribution to the life of the home, supporting the running of the home in the best interests of people who live there. Service users’ financial interests are satisfactorily safeguarded. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 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. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 was assessed and met at the last inspection. EVIDENCE: Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Plans of care generally reflect the health, personal and social care needs of service users. Residents’ health needs are normally satisfactorily met by the home. The manager undertook to address a staff member’s failure to report a potential change to a resident’s health documented in the daily records. Medication Administration Records seen were satisfactorily maintained, demonstrating that a requirement in a previous report had been addressed. A resident was, appropriately, taking responsibility for administering his or her own medication. People living at the home are treated with sensitive care and respect and their right to privacy is upheld. EVIDENCE: Care records for two people living in the home reflected their particular personal, social and healthcare needs. The care plans had been updated monthly and included reference to consultation with residents, with regard to
Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 10 their choices and needs. There have been improvements in the producing of risk assessments to support care and protect residents. Daily records are maintained. The manager undertook to respond to a change documented within the daily records regarding the health of a resident, which had not been reported to the person in charge. Other records seen showed that the home normally monitors residents’ healthcare needs, involving external professionals as required. Issues regarding the safety of medicines raised in the last inspection report have been addressed. Medication Administration Records seen showed that staff members record the administration of all medication accurately on the MAR chart at the time it is given, or the reason medicines are not given. When staff members copy the details of prescribed medicines on to the medicine chart a second competent person checks and signs to confirm all the details are correct. Training is being implemented in the safe handling of medicines. A risk assessment for the self-administration of medicines had been carried out for a resident who was administering their own medication. Residents spoken with said that they felt well cared for. Plans to support people include reference to protecting their dignity. Staff members gave gentle, and sensitive support to people needing help moving about in the home. Staff members knocked on people’s doors before entering. A personal room visited was individualised, with personal possessions and photographs. The resident called the room ‘home from home.’ The person felt that they had privacy, yet could enjoy sharing time with other people living in the home and staff members. The manager of the home, Mrs Davis spoke respectfully to residents, and people living in the home remarked that they felt ‘its not like a care home, its like a home.’ Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, Standard 14 was assessed and met at the last inspection. People living at Staddon Lodge feel that it is a ‘home from home’, which, provides a suitable lifestyle which matches residents’ expectations and choices, and satisfies their social needs. Residents are supported to maintain contact with the local community and their family and friends. EVIDENCE: Residents’ social interests were detailed in records seen. People living in the service came down to the lounge or remained in their room during the course of the morning. At lunchtime the dining room was busy with conversation. One resident was busy helping in the dining room during the visit. She said that she very much enjoys keeping busy and being a part of the life of the home. Another resident was going out with a member of the staff team. Residents said that they enjoy spending time together. Some residents play cards. A person living in the home said that the home welcomes family members. Another resident likes to walk to the shops in Westbourne. Being close to local amenities, the home and its residents are able to enjoy the life of the local community.
Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 12 Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 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 the following standard(s): Text regarding standards 16 and 18 is included in the report of the last inspection visit to the home. Both standards were met at the last inspection. EVIDENCE: Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 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 the following standard(s): 25, 26, standard 19 was assessed and met at the last inspection. A heated towel rail in the home was too hot to touch, presenting a serious risk of scalding to residents. The home is maintained to a good standard of cleanliness, and all areas are pleasant, homely and hygienic. EVIDENCE: A heated towel rail in a first floor bathroom was too hot to touch. All areas of the home seen were clean and free from offensive odours. Staff members demonstrated good infection control practice during the visit. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 The numbers and skill mix of staff satisfactorily meets service users’ needs. Staff members starting in the home receive induction training. The manager intends to introduce the Skills for Care programme to ensure that staff members are trained and competent to do their jobs. Residents are not currently fully supported by the home’s recruitment practices. EVIDENCE: One staff member was on duty on the day of the visit. Another member of staff, who was also working in the kitchen, supported her. A member of staff, who also lives on the premises, was going out with one of the residents. The manager also came in on the morning of the visit. From feedback from residents and the staff roster, sufficient staff members are allocated to work in the home, to adequately meet residents’ needs. Three staff files contained references, including one from the last employer. However, in two instances, the member of staff had started work before a POVAFirst was received and there was no copy of proof of identity or a photograph on the files. A requirement regarding ensuring that two applicable references are obtained was made in the last inspection report issued to the home. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 16 The manager confirmed that she intends to introduce the Skills for Care new induction programme. There were records of some induction, which had taken place for new staff. She also intends to ensure that mandatory training is routinely updated. The manager confirmed that she encourages and supports staff to undertake NVQ. Copies of certificates were seen on an individual file. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 Residents and staff are asked about their views, making a positive contribution to the life of the home, supporting the running of the home in the best interests of people who live there. Service users’ financial interests are satisfactorily safeguarded. EVIDENCE: The manager confirmed that people had been asked about their views about the service, as part of the home’s quality assurance system. A staff member said that there is regular discussion and meetings as well as informal opportunities to talk with the manager on a one-to-one basis. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 18 The manager said that the home does not hold any monies for service users for safekeeping, nor does she act as an appointee for any person living in the home. Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 19 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 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x x x x x x x 1 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 20 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. 1. Standard OP25 Regulation 13(4) Requirement Risk assess and take appropriate action to make safe a heated towel rail in a first floor bathroom, to protect residents from scalding. This was issued as an immediate requirement at the time of the inspection. 2. OP29 19 New staff members must not start work in the home until a satisfactory POVAFirst check has been received. Copies of proof of identity and a photograph must be held on staff members’ files. 04/04/06 Timescale for action 18/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Staddon Lodge DS0000004062.V287074.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Poole Office 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
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