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Inspection on 25/06/08 for Stockton Lodge Care Home

Also see our care home review for Stockton Lodge Care Home for more information

This inspection was carried out on 25th June 2008.

CSCI found this care home to be providing an Adequate 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

A good standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. Comments received were very positive about the care. One relative said, "The staff at Stockton Lodge work very hard and take very good care of all of the people who live there". There were written care plans in place for each person. This helps staff make sure that each person gets the support and assistance that is needed for them to live safely and comfortably. People living at the home were comfortable and well cared for and all of them said that the food was good. The environment was in the main nicely decorated and well maintained. Staff were motivated and enthusiastic about their work.

What has improved since the last inspection?

Care plans now contain evidence of resident and relative involvement where possible, as required in the last inspection report. Social profiles are also now included. The last inspection report contained several requirements with regard to the environment. The deputy manager confirmed that the following had been addressed. The uneven paving to the rear of the courtyard garden has been levelled. New bath panels have been fitted where required and the door between the kitchen and dining room has been repaired. Several staff have now been trained and the deputy said that a first aider now covers all of the shifts. The deputy manager said that all staff now receive the required amount of formal supervision. Staff confirmed this to be the case.

CARE HOMES FOR OLDER PEOPLE Stockton Lodge Care Home Harrowgate Lane Stockton-on-Tees TS19 8HD Lead Inspector Sue Lowther Key Unannounced Inspection 25th June 2008 09:00 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 DS0000000208.V368012.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. DS0000000208.V368012.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 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) 01642 617335 01642 617323 stocktonlodge@highfield-care.com www.southerncrosshealthcare.co.uk 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 (48) of places DS0000000208.V368012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 48 2. Physical disability - Code PD, maximum number of places: 48 The maximum number of service users who can be accommodated is: 48 27th June 2007 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 Southern Cross 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 en-suite facilities comprising of a WC and hand basin. There is one double bedroom which is also 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. On the date of this inspection the fees for care ranged from £370 for residential care to £465 for nursing care. The cost of hairdressing, chiropody, personal toiletries and personal newspapers is not included. DS0000000208.V368012.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 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection of Stockton Lodge took place on the 25th June 2008. Records were examined and a tour of the building took place. Time was spent talking to people living at the home, staff and visitors. The deputy manager supplied some information on a form called an AQAA. This is an annual quality assurance assessment for home’s to provide information about their service. The inspection focussed on key standard outcomes for people living at the home. We also checked whether requirements from the previous report had been met. What the service does well: What has improved since the last inspection? Care plans now contain evidence of resident and relative involvement where possible, as required in the last inspection report. Social profiles are also now included. The last inspection report contained several requirements with regard to the environment. The deputy manager confirmed that the following had been DS0000000208.V368012.R01.S.doc Version 5.2 Page 6 addressed. The uneven paving to the rear of the courtyard garden has been levelled. New bath panels have been fitted where required and the door between the kitchen and dining room has been repaired. Several staff have now been trained and the deputy said that a first aider now covers all of the shifts. The deputy manager said that all staff now receive the required amount of formal supervision. Staff confirmed this to be the case. 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. DS0000000208.V368012.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 DS0000000208.V368012.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. People who use the service experience good quality outcomes in this area. Assessment procedures are in place to ensure that the home can meet the needs of the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is usually the manager. This is to make sure that the home can meet the care needs of the people who go to live there. The family of one person who had recently gone to live in the home confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. All of the people who responded to the survey said that they had received enough information about the home before they went to live there. DS0000000208.V368012.R01.S.doc Version 5.2 Page 9 The home does not admit people for intermediate care therefore assessment of standard 6 is not required. DS0000000208.V368012.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. People who use the service experience good quality outcomes in this area. People’s health care needs are well managed by the home. Systems to administer medication are safe and people living at the home say that they are treated well and that the standard of care is good. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The deputy manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Four were examined during the inspection. These contained individual plans of care, which are evaluated on a monthly basis. They also contained evidence of resident and relative involvement where possible, as required in the last inspection report. Social profiles are also now included. People spoken to during the inspection said that they are happy with the care received and the level of information given. All of the people who returned the DS0000000208.V368012.R01.S.doc Version 5.2 Page 11 survey indicated that they are happy with the care and usually get the care that they need. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. One relative said, “The staff look after my relative very well and the nurses look after his illness. Another said, “The staff give good help and assistance to us and our relative.” One health care professional said on a survey, “My clients appear well looked after, they are relaxed in the presence of the carers. I have no concerns about the care provided. Any problems are brought to my attention. Medication is administered by qualified nurses or carers who have been trained. The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. People spoken to said that staff always treat them with dignity and respect. One of the relatives said “ The staff are really good, they are lovely and speak to people nicely”. A health care professional responded on a survey, “The carers are mindful of their clients dignity and treat them with respect”. DS0000000208.V368012.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 & 15. People who use the service experience good quality outcomes in this area. The activities are varied and provide recreation for some of the people who live in the home. Family and friends can visit at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and people are given a choice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Activities are tailored to individual need as far as possible. Comments about the activities being provided were generally good. Everyone spoken to at the time of the inspection said that they were appropriate. Some people said that they did not wish to join in and that staff accepted this. Activities include bingo, sing a longs, quizzes and trips out. People also said that they were able to sit outside when the weather was nice. One person said, “I like to get out and about and am encouraged to do so”. People were asked about visiting arrangements, which are flexible. One of the comments from a visitor included, “We are made welcome to the home, its DS0000000208.V368012.R01.S.doc Version 5.2 Page 13 lovely”. Visitors can see people in their own rooms or in any of the communal areas available throughout the home. Comments about the food were good. The looked appetising and people said that it was tasty. Specialist diets are catered for and include menus for diabetics and soft menus. Staff supported those who needed help during mealtimes in a sensitive manner. One person said, “The food is good, no complaints”. DS0000000208.V368012.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. People who use the service experience good quality outcomes in this area. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and sufficient safeguards are in place to protect them from abuse. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. One person said, “If I had a problem I would tell the staff”. One relative said, “I would approach any member of staff at any time”. However one person who lives in the home said that they did not know how to complain. The home had received six complaints since the last inspection. These were recorded along with the action taken. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the regional manager, or make a referral themselves if this was more appropriate. Evidence was seen during the inspection to confirm that referrals are made to the local authority where appropriate. Training is DS0000000208.V368012.R01.S.doc Version 5.2 Page 15 provided for all staff in adult protection. One member of staff said, “I would have no hesitation in reporting any concern. I am here for the residents”. Another wrote on a survey, “We always put residents first”. DS0000000208.V368012.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. People who use the service experience good quality outcomes in this area. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The communal areas were bright and nicely decorated. The last inspection report contained several requirements with regard to the environment. The deputy manager confirmed that the following had been addressed. The uneven paving to the rear of the courtyard garden has been levelled. New bath panels have been fitted where required and the door between the kitchen and dining room has been repaired. However the home have been unable to obtain the rubber bungs required to make one shower chair safe. The deputy manager said that the home may need to purchase a new chair. DS0000000208.V368012.R01.S.doc Version 5.2 Page 17 Many of the rooms are decorated to the person’s own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. There was a range of equipment seen around the home to support people with bathing and mobility. During the tour of the building, the inspector found the building to be clean, tidy and free from offensive odours. DS0000000208.V368012.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. People who use the service experience adequate quality outcomes in this area. People are generally satisfied with the care they receive. However they said that they sometimes have to wait for the attention and support of staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The people who live in the home said that there are not always sufficient staff on duty to meet their needs. One person said, “There are insufficient carers especially at rising times and retiring to bed times. They are therefore often rushed and cannot offer enough time to each person”. “As with minimal carers, there appear to be a shortage of housekeeping staff”. Some of the staff spoken to also felt that they do not always have enough time to meet all of the needs of the people who live in the home. They told the inspector that sometimes care staff have to also help with catering and domestic duties, which can detract from care hours. The person in charge must ensure that appropriate protective clothing is used when a member of staff undertakes different duties. This is to reduce the risk of cross infection. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment DS0000000208.V368012.R01.S.doc Version 5.2 Page 19 processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. Generally there is a commitment at the home for care staff to be trained at NVQ level 2 or above. Although training is provided, at the time of this inspection a large proportion of staff required an update with regard to fire training. The deputy manager told the inspector that training for all staff was to take place shortly. The last inspection report required that some staff be trained in first aid. Several staff have now been trained and the deputy said that a first aider now covers all of the shifts. DS0000000208.V368012.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, 36 & 38. People who use the service experience adequate quality outcomes in this area. The deputy manager is currently in charge of the home and is providing leadership to staff. Some training with regard to safe working practices was out of date. This potentially places people at risk. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The previous registered manager has left the home. The deputy manager told the inspector that the company have appointed an acting manager. However she is on extended leave. The deputy is allowed management time of 2-3 days a week. The CSCI have not been advised in writing about these arrangements. Staff told the inspector that although they are aware of the temporary DS0000000208.V368012.R01.S.doc Version 5.2 Page 21 management arrangements, they do not always feel able to approach the deputy with problems because she is often very busy and is the qualified nurse on duty. One person who lives in the home said that since the previous mangaer had left, should would not know who to approach with any problems. The home has an annual plan for quality assurance which includes meetings staff. These are held monthly and information from these are included in quality monitoring. Relatives and the people who live in the home can approach the staff at any time. The area manager completes a regulation 26 visit monthly. This is an audit which covers all aspects of the environment and the care delivered. The area manager said that during this audit she speaks to staff, the people who live in the home and visitors about their views. Any suggestions made are considered and improvements made where possible. Personal finances are kept in the home for people who request this. Two signatures are obtained and receipts are kept to ensure peoples’ financial interests are safeguarded. The deputy manager said that all staff now receive the required amount of formal supervision. Staff confirmed this to be the case. Health and safety systems were looked at. Safe working practices are not always maintained in line with current regulations. As previously stated, several staff have not received a recent update with regard to fire training. This potentially places people at risk. All safety checks for maintenance are carried out by external contracters as designated by law. All accidents are recorded and reported appropriately. DS0000000208.V368012.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 3 x 2 DS0000000208.V368012.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 OP30 Regulation 23(4)(d)& (e) Requirement Timescale for action 31/08/08 2. OP30 16(2)(j) The registered person must ensure that all of the people working in the care home receive fire training at suitable intervals. This is to ensure the health and safety of staff, the people who live in the home and visitors. The person in charge must 31/08/08 ensure that appropriate protective clothing is used when a member of staff undertakes different duties. This is to reduce the risk of cross infection. The registered person must advise the CSCI in writing about the current management arrangements within the home. 31/08/08 3. OP31 38(b) DS0000000208.V368012.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. 2. 3. 4. Refer to Standard OP16 OP19 OP27 OP31 Good Practice Recommendations The deputy manager should confirm at meetings that all of the people who live in the home know how to make a complaint. The home should consider the purchase of a new shower chair if rubber bungs cannot be obtained. Staffing levels should remain under constant review to make sure that they are in adequate numbers to meet the dependency levels of the people who live in the home. The current management arrangements should remain under constant review to make sure they are suitable. DS0000000208.V368012.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000000208.V368012.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. 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. 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