Inspection on 27/06/07 for Stockton Lodge Care Home

This inspection was carried out on 27th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stockton Lodge Care Home 25/06/08

Stockton Lodge Care Home 12/07/06

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 Val Daly Key Unannounced Inspection 27th June 2007 09:30 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.V344271.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.V344271.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 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.V344271.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. 12th July 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 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.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.V344271.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a key inspection and was completed by one inspector over two days. At the time of the inspection the manager had just left the home. A manager from another home in the organisation was due to take up the position, going through the registration process to become the new manager. The regional manager and staff in the home provided the information and documentation required. As a key inspection, all of the key standards were examined. Walk around the home took place, resident’s records were examined, records including accidents, complaints and menus were looked at and staff, the regional manager staff and residents were engaged in discussion about living at Stockton Lodge. The Commission for Social Care Inspection sent a number of questionnaires to the home for residents to complete. Seven were returned from residents and relatives. Comments from residents and relatives include: • • • • • • • • • The home offers excellent activities to all who wish to participate. It might be more pleasant to residents who use the lounge to have background music. There is a schedule of activities but they are hit and miss. They put up notices to say what will take place but it doesn’t always happen. Lunchtime meals seem to be okay but teatime could be more varied. Variety of teas is poor, soup and sandwiches every day. Waiting for a new manager. Paved area of the home is very uneven for residents to walk on. Sometimes restricted number of places for relatives to sit, one lounge being used for staff training, one is locked and one for smoking. One of the top homes in the area. What the service does well: Resident’s care plans are evaluated monthly and then reviewed three monthly with relatives being invited to attend and make their comments on the plans and care given. The documentation also showed placement reviews take place six monthly or every three months if the resident has any skin pressure damage. The home employs an activity co-ordinator, who organises a variety of interests and pastimes for the residents to join in with if they wish. There is a weekly programme of activities on display, offering, quizzes, crafts, dominoes, gentle keep fit, bingo, entertainment and video afternoons when residents have drinks, crisps, sweets or ice creams during the film. The home has an Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 6 enclosed courtyard garden and a number of residents enjoy being involved in the planting of shrubs in the raised flowerbeds, discussing the new plants as they are put in and also planting and growing tomatoes. 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. Stockton Lodge Care Home DS0000000208.V344271.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.V344271.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&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs assessed. EVIDENCE: Assessments are carried out prior to a resident moving into the home to ensure their needs can be met. The manager also carries out her own assessment, meeting with the prospective resident, either in his or her own home or in hospital. Four residents files were examined and they each contained the required information. Residents informed the inspector during discussion that their relatives had visited the home before they moved in. The home does not provide intermediate care. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 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. 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. The health and personal care that people receive is based on their individual needs. Staffs need to ensure signatures are on individual plans to show resident or relative involvement. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Four care files were examined and they each contained an individual plan of care. The plans were evaluated monthly and then reviewed three monthly with relatives being invited to attend and make their comments on the plans and care given. However in three out of thee four reviews examined there were no signatures in place form either the resident or their relative. The plans also contained a social profile of the resident, showing their likes and dislikes of food, hobbies and working years. Signatures were required for these plans. Whilst the social profile provided information about activities the resident may like, this was not followed through in the activities provided. The documentation also showed placement reviews take place six monthly or every Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 10 three months if the resident has any skin pressure damage. There was evidence that the resident’s health care needs were being met. Risk assessments are in place where needed. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. For residents wishing to manage their own medication a risk assessment and management process was in place. Staffs who administer medication were either qualified nurses or they had received training. This was confirmed in staff training records and during staff interviews. Residents interviewed said the staff were kind and respectful. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use services are able to make choices about their lifestyle. A variety of food is offered. EVIDENCE: The home employs an activity co-ordinator, who organises a variety of interests and pastimes for the residents to join in with if they wish. There is a weekly programme of activities on display, offering, quizzes, crafts, dominoes, gentle keep fit, bingo, entertainment and video afternoons when residents have drinks, crisps, sweets or ice creams during the film. The home has an enclosed courtyard garden and a number of residents enjoy being involved in the planting of shrubs in the raised flowerbeds, discussing the new plants as they are put in and also planting and growing tomatoes. Two residents interviewed during the inspection said they ‘loved to be in the garden area, enjoying the scent of the flowers and discussing further changes with the activity co-ordinator’. Residents may also be taken out to the local shops or the town on an individual basis. A trip out to Redcar for many of the residents had been arranged for the week following the inspection. A resident interviewed said she ‘enjoyed her one to one chats’ with staff. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 12 The activity co-ordinator completes a daily record of activities which shows who joined in, how the activity went, response and enjoyment. The regional manager said that representatives from religions visit individual residents and some residents attend church. Two residents spoken to said they ‘were not bothered about church but liked to watch a service on the television’. The menu showed that a variety of food is offered to residents and more alternatives are available, and residents are asked for their choice prior to the meal being cooked. The regional manager said a new menu was to be started the following week, which had been planned for older people and people with dementia in care homes. The menus were nutritionally analysed. One resident interviewed said she was not happy with the food offered at teatime and felt it was repetitive. She said she was looking forward to the new menu and the choices it offered. Residents are able to eat their meals in the dining rooms or in their rooms as they wish. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 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. 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. People who use the service are able to express their concerns and have access to a robust effective complaints procedure, are protected from abuse, and have their rights protected. EVIDENCE: Four residents interviewed said that they would be comfortable speaking to a member of staff if they had any concerns. The home has a complaints policy and procedure in place. This has been updated since the previous inspection and includes the Contracts and Commissioning department of the Local Authority. There had been two complaints made to the home since the previous inspection. Records showed that complaints were investigated promptly and there were written reports of action taken in place. Following the outcome of the investigation the complainant is asked if they are satisfied or not. The home has a whistle blowing policy and an adult protection policy in place. There was evidence in the staff training file to show that staff had received training in Adult Protection’. During interviews with staff they confirmed they had received training were aware of the procedure to follow in the case of suspected abuse. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a comfortable environment. Some maintenance is required both inside and outside on the building for the safety of the residents EVIDENCE: A walk around the home was carried out. Resident’s bedrooms contained personal possessions and were comfortable and homely. A bedroom where a new resident was moving in to contained toiletries and the latest news letter, which gives information about activities, hairdresser, chiropodist and items of interest relating to the home. This was to help the resident feel welcome into the home. One of the lounges had been changed into a sensory room with soft lighting and aromas for a peaceful area for the residents. In one shower chair it was noted that rubber bungs were required in the seat. In a bathroom a new bath panel was required. The door between the kitchen Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 15 and dining room needed repairing or replacing as it slipped off the bottom hinge. The regional manager said a new door had been ordered and the handy man was repairing the door until the new one was delivered. In the dining room, not all the tables were nicely set, cloths did not match and after discussion with the regional manager it was agreed that serviettes would enhance the tables. The garden area was full of colourful plants and flowers. There were different parts for the residents to sit in and whilst there was some uneven paving the regional manager said they were to be repaired. This had been highlighted in the previous inspection. Some of the residents were involved in helping growing tomatoes, which they thoroughly enjoyed. Maintenance certificates were in place and up to date. The home was clean and odour free. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 16 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. Staffs in the home are in sufficient numbers to support the people who use the service; however further training is required for some staff in order to safeguard the residents. EVIDENCE: The home has a rota in place, which is flexible for the needs of the residents and there are both male and female staff giving care to residents. There is a policy and procedure in place for the recruitment of staff. Staff records showed that the required information, references and CRB checks were in place prior to staff commencing work in the home. Since the previous inspection a new induction training programme was in place, which runs alongside ‘Skills for Care’ induction programme. The home has a training plan in place and since the previous inspection staff had undertaken training in many areas such as NVQ 2, Adult Protection, Fire Safety, Moving and Handling, Continence, care of a person who has suffered a stroke and Food Hygiene. It was noted that training is required for some of the staff in First Aid and Health and Safety. The area manager said that this training would be arranged. 50 of the carers have undertaken and completed NVQ level 2 or above. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. Staff supervision needs to be up to date and further training is required for some staff in Health and Safety in order to safeguard the residents. EVIDENCE: At the time of the inspection the manager had just left the home. A manager from another home in the organisation was due to take up the position, going through the registration process to become the new manager. The home has a ‘relatives surgery’ where the manager is available one evening a week for anyone who wishes to see her. This is to assist relatives who wish to see the manager but are unable to visit the home during the day. The regional manager carries out monthly visits and reports on many aspects of the home, Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 18 the building, care records, health and safety and also has discussion with residents and staff. Surveys are sent out annually to residents to seek their views about life in the home. Feedback from the surveys is given if the person states their name. An action plan is formulated where any issues or concerns are raised. Resident and staff meetings are held regularly and minutes are kept. Some of the staff requires an update in Health and Safety training. Records showed that formal supervision for staff was not up to date, with the deputy manager being responsible for carrying out the supervision of a large number of staff. The regional manager said that this system would change when the new manager was fully in place. Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 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 3 X X N/A 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 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 15 (1) Requirement Signatures must be obtained from the resident or relative when not possible to show resident involvement in their individual plan. Timescale for action 30/09/07 2. OP19 13(4a) The area of uneven paving to the 30/09/07 rear of the courtyard garden must be levelled for the safety of the people who use the service. In one shower chair rubber bungs were required in the seat. In a bathroom a new bath panel was required. The door between the kitchen and dining room needed repairing or replacing as it slipped off the bottom hinge. These are required to protect the health, safety and welfare of the people who use the service. Training is required for some of the staff in First Aid, to protect the health, safety and welfare of the people who use the service. Training is required for some staff in Health and Safety. All DS0000000208.V344271.R01.S.doc 3. OP19 13 (4)(a) 30/09/07 4. OP30 13 (4)(c) 30/09/07 5. OP38 18(1)(c) 30/09/07 Stockton Lodge Care Home Version 5.2 Page 21 staff must receive training in Health and Safety, to protect the health, safety and welfare of the people who use the service. 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 OP7 Good Practice Recommendations The manager should continue to work with staff to improve the collection of social profile information and then feed in to the completion of Care plan 9. in meeting social, leisure needs. Care staff should receive formal supervision at least six times a year. 2. OP36 Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Stockton Lodge Care Home DS0000000208.V344271.R01.S.doc Version 5.2 Page 23 - 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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