Inspection on 12/07/06 for Stockton Lodge Care Home

This inspection was carried out on 12th July 2006.

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 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

Stockton Lodge Care Home 25/06/08

Stockton Lodge Care Home 27/06/07

Stockton Lodge Care Home 14/02/06

Stockton Lodge Care Home 09/06/05

Stockton Lodge Care Home 10/01/05

Stockton Lodge Care Home 03/08/04

Similar services:

The Highlands

Turret Villa Retirement Home

Moor House

Blenheim House

1 Lanark Close

Mendip House

Beaconsfield Court Care Home

Ann Charlton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Stockton Lodge Care Home Harrowgate Lane Stockton-on-Tees TS19 8HD Lead Inspector Derek Stow Key Unannounced Inspection 12th July 2006 12-30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Stockton Lodge Care Home DS0000000208.V302162.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. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stockton Lodge Care Home Address Harrowgate Lane Stockton-on-Tees TS19 8HD Telephone number Fax number Email address er 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) 01642 617335 01642 617323 stocktonlodge@highfield-care.com Southern Cross Home Properties Limited Mrs Jay Sandra Friel Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48), Physical disability over 65 years of age (0) of places Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum number of 48 service users aged 65 years and above (OP) can be accommodated within the home. A maximum number of 10 service users aged 55 years and above with PD can be accommodated within the 48 registered places. Four named individuals who are under the registered age category of the home are able to reside in the home for as long as they require and providing that their needs can be met by the home. 14th February 2006 Date of last inspection Brief Description of the Service: Stockton Lodge Nursing Home is a purpose built facility providing personal and nursing care to 48 older people. The home is owned as part of the Highfield group. Stockton Lodge is a single storey facility with 4 lounges, a dining room and appropriate toilet and bathing facilities. 46 bedrooms are single all with ensuite facilities comprising of a WC and hand basin.1 bedroom is a double facility again with an en-suite. Externally there is a pleasant courtyard where service users and their families can sit and enjoy the wide range of plants and flowers. Cost of service at Stockton Lodge. On the date of this inspection the fees for care ranged from £327 for residential care to £450 for nursing care. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took nine hours spread over three visits with the inspector examining a number of records; speaking to five residents, three relatives the manager, the deputy (nurse in charge), three members of the Care staff and the cook. A tour of the building was carried out and requirements identified at the last inspection were re-visited. This inspection looked at only those standards, which the Commission for Social Care Inspection regard as Key standards. The details of any issues identified as requiring action together with recommendations for improvement are to be found at the back of this report. What the service does well: What has improved since the last inspection? Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 6 Since the last inspection, new induction training has been introduced to meet “Skills For Care “ requirements, new menus have been developed and are ready to implement and the Manager and staff are collecting more social information relating to residents, which will help to improve the social aspects of care planning. 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. Stockton Lodge Care Home DS0000000208.V302162.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 Stockton Lodge Care Home DS0000000208.V302162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. Quality in this outcome area is “adequate”. This judgment has been made from evidence gathered both during and before the visit to this service. Service Users have sufficient information about the service at “Stockton Lodge “to help them make a choice of where to live. Service users have their needs assessed before moving in to “Stockton lodge”, however there must be more focus on assessing social and leisure needs. EVIDENCE: The service user guide and statement of purpose were examined. These are printed in bold font 12 typing, with highlights. The service user guide is made available in each new residents room on admission along with a welcome pack of toiletries and flowers. The manager said that information is also available in other formats on request including audio cassette. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 9 Three files were examined which showed extensive collection of assessment information prior to admission but only one file looked at had a good record of personal and social information regarding a residents likes, dislikes, hobbies, interests etc. The Manager is working hard with assessing nurses to continue to develop improved collection of social information for all residents files, which will feed in to the plan of care. Stockton Lodge Care Home DS0000000208.V302162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is “poor”. This judgment has been made from evidence gathered both during and before the visit to this service. All residents have a plan of care which sets out their personal and health care needs, however not all of the residents files have good records of social and leisure interests. Registered nurses are on duty at all times to ensure health care needs are met. Although appropriate policies and procedures are in place dealing with medication, on the day of inspection practice was seen as poor. Residents at “Stockton Lodge” enjoy the privacy of their own rooms whenever they wish and feel treated with dignity and respect. EVIDENCE: Three residents files were looked at in detail and these all had evidence of personal, health and nutritional assessment, care planning and review together with a recorded key worker. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 11 The Manager said that assessing nurses were working hard to include social and leisure needs in to the care plans and felt that they had achieved this in 75 of the files, but only one file had evidence of this. It was observed that for several residents bed rails were used without the support of resident/relative signatures and without the support of a risk assessment involving a professional from outside of the Home. This practice should be reviewed urgently. The administration, recording and storage of medication must be improved. There were several boxes of medications to be disposed of which were not stored securely which could lead to medicines being mishandled or stolen. It is also recommended that all disposed of medicine is witnessed and signed for by a second member of staff. The community pharmacy produced records did not print the standard British National Formulary warning/cautions upon them; this is essential medicine handling information that ensures medicines are administered at the correct time of day in relation to food. Other important information such as required storage conditions and potential side effects are also omitted. One supply of antibiotics was found where the tablets remaining did not tally with the administration record. The recording of blood checks was not up to date relating to one resident on warfarin. Fridge temperatures had not been recorded daily and the fridge was too warm. Unidentified tablets had been left in pots on top of the medicine trolley. It is recommended that regular medication audit checks are carried out and kept for inspection purposes. Many residents were seen to be enjoying the privacy of their own rooms and the four residents spoken with confirmed that they were free to come and go as they please and felt that they were treated with dignity and respect. One resident said that they chose to spend all his time in his own room with en-suite facilities; television, music and hobbies, their own supply of drinks and snacks and staff served the meals there. The resident said “ Staff are very pleasant, they have made my life very happy here”. Stockton Lodge Care Home DS0000000208.V302162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is “adequate”. This judgment has been made from evidence gathered both during and before the visit to this service. Residents on the whole find life at Stockton lodge satisfactory. There are regular activities organised during the week, a variety of trips out across the year and there is open visiting for friends and relatives. The dining room is attractive, comfortable and well decorated. New menu’s have been developed to include a clear choice of main meals but is not yet implemented. EVIDENCE: Residents were observed to be freely using their own rooms and the facilities at Stockton Lodge as they wished. One resident spoken with said that they preferred to spend all of their time in their own room with the en-suite facilities as if it were their own flat. Staff respected this and the resident had their own supply of drinks and snacks in the room and staff served all the meals in their room as they did for several other people. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 13 Notices advertising activities were clearly posted around the home and Country and Western entertainment was taking place during the unannounced inspection. Records of activities and outings should be kept up to date. One resident said “ I couldn’t find a better place, I go to bed when I want, watch television in my room till after midnight and get up at 8 o’clock, just as I like”. Another resident said that they enjoyed helping with the gardening in the very attractive enclosed quadrangle garden and on the day of inspection, which was a very hot summers day several residents were relaxing and enjoying cold drinks and ice-lollies under the shade of the trees and parasols. The dining room is very pleasant, well decorated and with flowers on each table. New improved menus have been developed but not yet implemented. These need to be displayed in large print on a daily basis and communicated with residents to inform them of the choices available. On the day of inspection, the main meal served was not what was on the menu and there was nothing written on the board in the dining room to inform residents. All changes to the menu must be fully recorded. Stockton Lodge Care Home DS0000000208.V302162.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is “good”. This judgment has been made from evidence gathered both during and before the visit to this service. Residents and relatives are confident that their views and concerns are listened to and acted upon by staff and managers and that resident are protected at Stockton Lodge. The training of staff in the protection of vulnerable adults is ongoing. EVIDENCE: A satisfactory complaints procedure is in operation at Stockton lodge and the 7 formal complaints received within the past year were dealt with appropriately by the manager. The policy and procedure should now be updated to make it clear to residents and relatives that the responsibility to receive, resolve and investigate complaints is with the management of the Home and those agencies such as Social Services and Primary Care who contract or commission services on behalf of individual residents. The Commission for Social Care Inspection is not a complaints investigation body and will no longer be involved in the complaints process. However residents, relatives and members of the public can still report any concerns about the running of a particular service to the Commission who will consider the issues and whether the service is meeting the required regulations. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 15 The protection of vulnerable adults policy and procedure is in place and Staff spoken with during the inspection all knew what to do if they suspected abuse of residents. The Manager said that staff training in the protection of vulnerable adults is on going. Stockton Lodge Care Home DS0000000208.V302162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is “adequate”. This judgment has been made from evidence gathered both during and before the visit to this service. Stockton Lodge is well maintained, comfortable and in good decorative condition. The home is generally clean, pleasant, and hygienic; however a number of issues observed in the kitchen were referred to the Evironmental Health Officer. EVIDENCE: A tour of the home took place, which confirmed that all the bedrooms examined were clean, well furnished, decorated and personalised with residents’ own possessions. All the residents spoken with were very happy with their own bedrooms with en-suite facilities and no unpleasant odours were apparent. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 17 There is a very pleasant internal courtyard garden, which is well used and has raised areas, which assist residents to participate in gardening. To the rear of this garden there is a small area of uneven paving, which requires attention. The issues identified regarding the kitchen must be addressed by following the advice and guidance of the environmental Health officer. Stockton Lodge Care Home DS0000000208.V302162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is “adequate”. This judgment has been made from evidence gathered both during and before the visit to this service. Consideration must be given to more Care staff being on duty between 5 and 8pm. Recruitment procedures are safe and robust to ensure that residents are in safe hands and a stable staff team has been established. Staff training and records of training should be improved upon. EVIDENCE: The information provided by the Home in the pre-inspection questionnaire shows that a stable staff team has been established at Stockton Lodge. Programmes of essential training take place although three staff files examined held no evidence of induction training. The manager explained that a new inhouse induction was being introduced which meets “skills for Care “ standards. 24 of the care staff have achieved NVQ 2 or above and the Manager is working hard to achieved a minimum of 50 . Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 19 Stockton Lodge provides a residential and nursing care service for up to 48 residents, many of whom have high dependency needs and require 2 staff to assist with mobility, dressing, toileting and bathing. The residents spoken with were all very positive in their praise for the staff. One resident said, “Staff can’t do enough for you – they’re great, nothing is too much trouble”. “ There is normally enough staff but they’re short at twilight”. This view was confirmed by other residents and staff and was also a theme at the previous inspection. It appears that a period of peak demand for personal care occurs after tea on an evening when several residents need assistance in bathing and getting ready for bed. At the same time other residents have said that this is the time that they have to wait too long for help with personal care. There are currently 5 care staff on duty from 1 PM to 8 PM. The Manager should review each residents individual need for assistance after teatime and review the staffing levels in line with national minimum standard 27.3 and 27.4. Staff files examined showed evidence of robust recruitment including relevant identity checks, Criminal Record Bureau checks as well as references. Stockton Lodge Care Home DS0000000208.V302162.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 36 and 38 Quality in this outcome area is “adequate”. This judgment has been made from evidence gathered both during and before the visit to this service. The registered Manager is qualified, competent and experienced to run the home. Stockton Lodge is run in the best interests of the residents and several quality assurance systems are in place although the results of resident surveys are not yet published. Appropriate procedures are in place to safeguard money held on behalf of residents at Stockton Lodge. Care staff receive formal supervision but not yet 6 X per year. The health, safety and welfare of residents and staff is promoted and protected. Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager is a registered nurse and additionally holds a diploma in nursing and the registered managers award. There are a number of quality assurance systems in place based on seeking the views of residents including reviews, resident meetings, surveys and regulation 26 visits by another manager. However, residents meetings should be held more than once or twice a year and the results of quality surveys should be published to meet the standard set out in National Minimum Standard 33.4. The manager is working to achieve formal supervision for staff at least six times a year. A number of health and safety documents and records were examined at the inspection including the accident book, the gas safety certificate, hot water temperatures and various other records. These were all found to be up to date. Stockton Lodge Care Home DS0000000208.V302162.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 3 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 3 Stockton Lodge Care Home DS0000000208.V302162.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 OP9 Regulation 13(2) Requirement The registered person must ensure all medicines are administered as prescribed and accurate and up to date records are kept. The area of uneven paving to the rear of the courtyard garden must be levelled. The manager must ensure that sufficient staff are on duty to meet the care needs of the residents at all times as set out in standard 27, and specifically between the hours of 5 & 8 PM in considering standard 27.4. Risk assessments must be in place for all residents where bed rails are used including appropriate agreements. With regard to the issues identified in the kitchen, the manager must follow the advice and guidance of the Environmental health officer relating to any requirements that they make. Timescale for action 13/07/06 2. 3. OP19 OP27 13(4a) 18(1a) 31/08/06 30/09/06 4. OP38 13(4c) 13(4c) 31/08/06 5. OP38 31/08/06 Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 24 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. OP7 Refer to Standard Good Practice Recommendations The manager should continue to work with staff to improve the collection of social profile information which can then feed in to the completion of Care plan 9. in meeting social, leisure needs. The records of activities and outings should be improved to evidence the work done. The new menus showing choice should be implemented and posted daily around the home in large print and written on the board in the dining room. The complaints procedure should be up dated to exclude the Commission for social care Inspection but inform residents/relatives of the role and contact details of the relevant Social Services and Primary Care Trusts who commission/contract for services. It may also be helpful to include this information on individual resident contracts. The manager should continue working to achieve 50 of the care staff with NVQ2 in care. The Manager should ensure that all new staff receives induction training to meet the “Skills For Care” requirements. The manager should continue to work to achieve supervision for care staff at least 6 X per year. It is recommended to hold regular meetings of residents. This will help to inform the managers regarding the quality of service user experience in the home. The results of resident / relative quality surveys should be published and made available to residents / relatives and other interested parties including CSCI. 2. 3. 4. OP12 OP15 OP16 5. 6. 7. 8. 9. OP27 OP30 OP36 OP33 OP33 Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Stockton Lodge Care Home DS0000000208.V302162.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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