Inspection on 08/04/08 for Staddon Lodge

This inspection was carried out on 8th April 2008.

CSCI found this care home to be providing an Good service.

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

Staddon Lodge 12/05/09

Staddon Lodge 29/08/06

Staddon Lodge 18/03/06

Staddon Lodge 14/06/05

Staddon Lodge 23/11/04

Staddon Lodge 17/05/04

Staddon Lodge 04/02/04

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Fairfields Country Rest Home

Poldhu

Queensmount

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Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Staddon Lodge 25 Nelson Road Branksome Poole Dorset BH12 1ER Lead Inspector Martin Bayne Unannounced Inspection 8th April 2008 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.V362443.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. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 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.V362443.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th August 2006 Brief Description of the Service: Staddon Lodge is registered with the Commission 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 that has a secluded and well-maintained garden. All of the bedrooms are offered for single occupancy with six of these being sited on the ground floor. Bedrooms on the ground floor have ensuite toilet facilities. The remaining bedrooms are sited on the first floor with two of these having ensuite toilet facilities. Access to the first floor is by means of the stairwell or stair lift. On the ground floor there is a lounge with a separate dining room for residents’ use. Mrs Davis, one of the registered providers is responsible for the day-to-day management of the home. One member of staff lives on the premises. Weekly fee rates for the home range from £422 to £575 per week. Information about additional charges is detailed within the homes Terms and Conditions of Residence. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We, the Commission, carried out a key inspection of the home between 9:30am and 1:45pm. The aim was to evaluate the home against the key National Minimum Standards for older people and to follow up on the one requirement and one recommendation made at the last key inspection of 29th of August 2006. Mrs Davis, the Registered Provider, as well as members of staff assisted throughout the inspection. They provided information and documentation to evidence how healthcare needs of residents were met in the care home. Information gathered in this report also came from discussions with six of the residents living at the home, the returned Annual Quality Assurance Assessment (AQAA), returned comment cards that had been sent to the home in February 2008 and conversations with two members of staff. A tour of the premises was also made. What the service does well: Residents needs are assessed before being offered a place at the home to ensure that their needs are met. Residents health needs are met through care plans being developed with their involvement. Medication is administered safely and residents are treated with respect and dignity. Residents enjoy freedom to make their own lifestyle choices and there are activities both communal and individual to provide stimulation. The standard of food provided is good. The home has a well-publicised complaints procedure and staff are trained in adult protection. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 6 The staffing levels meet the needs of the residents and the staff team are well trained. The home recruits staff in line with the Standards and good practice. The home is well maintained and provides a ‘homely’ environment. The home is run in the interests of the residents. 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. The summary of this inspection report can be made available in other formats on request. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from their needs being assessed prior to their being offered a place at the home. EVIDENCE: Mrs Davis told us that following a telephone enquiry, an appointment would be made for her to visit the prospective resident, or preferably, for them to visit the home. At this time, a pre-admission assessment of the person’s needs is carried out to ensure that these can be met at the home. Mrs Davis told us that where are person is referred through care management arrangements, a Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 9 copy of the care management care plan and assessment is obtained from the local Council. Throughout the inspection we tracked the records and paperwork that the home is required to keep up to date concerning two residents. We found that Mrs Davis had carried out a pre-admission assessment of their needs prior to their being offered a place at the home. In the case of one resident, Mrs Davis could only produce notes for the assessment and we recommend that she uses a form that covers all of the topics of need as detailed within Standard 3.3 of the National Minimum Standards. The residents we spoke with confirmed that their needs were being met at the home and that they or that relatives had been active in choosing Staddon Lodge as a suitable home. The home does not provide an intermediate care service. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from their health needs being met through development of an individual care plan and through medication being administered in line with best practice. EVIDENCE: We looked at the personal files of the two residents tracked through the inspection. Care plans had been developed from the assessment process that also detailed risks and how the risk of harm was to be minimised when carrying out the care plan. The care plans were found to cover the areas of a need identified in the assessments. We found that photographs of these two residents had yet to be taken and put on their files. We did see that photos were on the front of care plans for other residents who had been the home for Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 11 a longer period. A requirement was made that photographs are taken of each resident, so that new members of staff can easily identify them. There was evidence that residents or their relatives were involved in developing care plans by their signing the care plan. The plans were dated with a sheet providing evidence of monthly reviews as required under the Standards. We also saw daily recording notes and these provided evidence that health needs of residents were being met. One resident we spoke with, who had problems with their legs, told us that visits had been arranged with doctors and district nurse through the staff at the home. Another resident informed us that the staff had made appointments concerning hearing difficulties. Within care plans we found a record of visits from outside healthcare professionals. These included visits for dentistry, GP and district nurses and chiropodists. When we arrived at the home, Mrs Davis was liaising with a GP surgery to arrange a visit on a half of one resident. The residents we spoke with told us that the staff treated them with respect and that their right to privacy was upheld. We saw the medication administration records for all of the residents. We found that these had been completed correctly with no gaps in the record. Mrs Davis told us that all of the staff who administer medication to residents had had training in safe administering administration of medicines. We saw the medication cabinet and saw that medications were being stored correctly. Comments we received: ‘I am well looked after.’ ‘The carers liaise well with the district nurses and GP service in relation to the direct care of and advise regarding the client’s health and well being.’ Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 154 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from maintaining their lifestyle choices, being able to maintain contact with friends and families and through being provided with a good standard of food. EVIDENCE: We saw a list of activities for the week ahead in the dining room. During the inspection we spoke with five residents gathered in the lounge and also with one resident within their bedroom. One person we spoke with told how they had enjoyed the recent entertainer who had visited the home. Another resident told how they had a newspaper delivered each day and how they liked to complete the crossword with friends that they had made in the home. In general the residents we spoke with said that they were happy with the level of activities that were provided in the home. They also told us that there were no Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 13 restrictions placed upon them and that they were free to get up and go to bed when they wished. We noted that peoples’ assessment of need identified spiritual or cultural needs. Mrs Davis told us that currently there was a monthly Church of England service held in the home, which met the needs of the current resident group. The residents we spoke with said that their visitors were made welcome at the home and there were no restrictions on visiting times. The residents we spoke with told us that the standard of food home was good. Residents can choose what they would like for breakfast and this is served on a tray in their room. The main meal of the day is at lunchtime and this is served in the dining room, although residents can have meals in their room should they request. On the day of our visit there was a choice of a curry or chicken casserole and residents confirmed that they had asked what option they would like. We spoke with the cook who said that they knew what residents liked to eat and that alternative choices would be found for people if it was known that they did not like the main choice. A choice of evening meal is also provided. A sample of menus was seen and these reflected that there was a balanced and nutritious menu on offer to residents. Comments received: ‘The staff I meet on my visits are great, always cheerful and helpful’. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-publicised complaints procedure and the staff having been trained in adult protection. EVIDENCE: The residents we spoke with said that the staff and Mrs Davis were very approachable and that they could go to them if they had any concerns or complaints. The formal complaints procedure is detailed within the Service User Guide and also within the Terms and Conditions of Residence. Relatives and residents receive a copy of the Service User Guide when they are admitted to the home so that they are fully informed of how to complain. It was noted that there was also a ‘Comments, Complaints and Suggestions box’ located in the front reception area. We saw the complaints log for the home, in which one complaint had been recorded since the last key inspection and this being responded to appropriately. There have been no concerns or complaints brought to the attention of the Commission. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 15 The home has appropriate policies and procedures to respond to suspicions of abuse or neglect. Records showed that the care staff had received training in the protection of vulnerable adults. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-maintained, clean environment but some radiators in the home pose some risks due to their high surface temperature. EVIDENCE: As part of the inspection we carried out a tour of the premises. We found the home to be clean, in good decorative order, furnishings and fittings in a good state of repair and there being no unpleasant odours. We also saw the residents are able to personalise their rooms with their own furniture and possessions. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 17 Since the last key inspection in August 2006, a new carpet has been laid in the lounge, hallway and dining room. A new shower room has also been provided on the ground floor. Residents have access to an attractive, well-maintained and enclosed garden. At the last inspection a requirement was made, as it was found that one of the downstairs corridor radiators posed a potential burning risk to residents and that appropriate action should be taken. We found at this inspection that a cover had been put over this radiator and a cover fitted to the radiator in Room 6. However, the majority of radiators in the home are uncovered and the ones that we felt were very hot to touch. Mrs Davis showed us that risk assessments of radiators had been carried out and that it was her intention to have more covered to reduce the risk of harm to residents. It was agreed that by the end of June 2008 Mrs Davies would submit a plan to the Commission to inform what steps would be taken to reduce the risk from these radiators. Thermostatic mixer valves have been fitted to hot water outlets of showers and baths to protect residents from scalding water. Concerning infection-control, we saw that soap dispensers and paper towels were available in all bathrooms and that alcohol gel dispensers were positioned in the home. Staff are provided with protective clothing such as gloves and aprons. The home has sluicing area the cleaning of commodes. The home has a laundry room and we were told that this met the laundry needs of the home. The laundry room is sited away from food preparation and storage areas. Comments received: ‘The standards of hygiene is excellent. They provided a homely atmosphere’. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the home being adequately staffed, through the staff being subject to good recruitment procedures and being well trained. EVIDENCE: We were told that between 8am and 9pm there were two care staff on duty at all times excluding the manager. Between 8am and 11am there is also a cook on duty. The home employs domestic staff for approximately 27 hours per week. Care staff manage the laundry needs of the home, as part of their duties. During the nighttime period there is one awake member of staff and one member of staff who carries out a sleep-in duty. We saw duty rosters that confirmed the above levels of staffing. From speaking with residents and with Mrs Davis there was evidence that this level of staffing met the needs of the current residents. The home has a staff complement to 15 carers with about 70 of the staff trained to NVQ level 2 or above. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 19 We looked at staff recruitment files for two members of staff employed since the last inspection in August 2006. We found that all the necessary checks and requirements of Schedule 2 of the Regulations have been complied with. We recommend however, that the staff application form be changed to request a reference from the applicant’s last place of work involving children or vulnerable adults of not less than three months and also that a full employment history is requested, not just one covering the last 10 years. Concerning training we found a new care staff have an induction programme that meets Skills for Care induction standards. All the staff receive core training in areas such as moving and handling, first aid, infection control, health and safety, fire safety and basic food hygiene. Comments received: ‘In the past I have had many residents in Staddon Lodge, both for respite and long term care. I have always found Mrs Davis helpful and respectful to residents, their families and professionals. Care staff are pleasant, approachable and committed to giving a high standard of care to residents’. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well managed home that is run in the interests of the residents. EVIDENCE: Mrs Davis is responsible for the management of the home; she is trained as a Registered General Nurse and has achieved NVQ level 4 in social care and management. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 21 At the last inspection it was recommended that an annual development plan the developed. We found that this inspection that this had been done. We found that the home was run in the interests of the residents. A weekly residents meeting is held so that residents can have an input into the running of the home. We found that necessary servicing and monitoring of equipment in terms of health and safety were being carried out. Portable electrical equipment wiring was being tested, the lift being serviced twice yearly and an annual gas check had been carried out. Mrs Davis safe keeps a small float of money on behalf of one resident. We checked the records of the money held and the balance tallied with the money held. Full detailed records were in place. The home has carried out a fire workplace risk assessment. Tests and inspections of the fire safety system were being carried out and requirements of COSHH, (control of substances harmful to health) were being complied with. With the exception of the potential risk of some radiators, there were no other health and safety hazards identified during the inspection. Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 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 3 X 3 X X 3 Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation Schedule 3 (2) Requirement You are required to have a photograph of each resident accommodated in the home. Timescale for action 19/05/08 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 OP3 Good Practice Recommendations It is recommended that to record the outcome of the preadmission assessment of need, the home should use a form uses the headings of need detailed within the National Minimum Standards for Older People. It is recommended that the staff application form be changed to request a reference from the applicant’s last place of work involving children or vulnerable adults of not less than three months and also that a full employment history is requested, not just one covering the last 10 years. 2. OP29 Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Staddon Lodge DS0000004062.V362443.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!