Inspection on 27/07/05 for Stokeleigh Lodge

This inspection was carried out on 27th July 2005.

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

Stokeleigh Lodge 26/01/10

Stokeleigh Lodge 10/11/08

Stokeleigh Lodge 28/11/06

Stokeleigh Lodge 03/03/06

Stokeleigh Lodge 20/03/05

Stokeleigh Lodge 28/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Stokeleigh Lodge 3 Downs Park West Westbury Park Bristol BS6 7QQ Lead Inspector Sam Fox Announced 27 July 2005 09:30 th 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 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. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stokeleigh Lodge Address 3 Downs Park West Westbury Park Bristol BS6 7QQ 0117 9624065 0117 9624065 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Lyn Farrall-Miles Mrs Rosemary Anne Beck PC Care home 17 Category(ies) of OP Old age (17) registration, with number of places Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate 17 persons aged 65 years and over requiring personal care. Date of last inspection 20 March 2005 Brief Description of the Service: Stokeleigh Lodge is a privatly owned home that is registered to provide personal care and accommodation for up to 17 people who are 65 years and over. The premises are situated close to The Downs and have been extended and adapted over time to meet with the needs of the elderly. There are two storeys which are accessible via a stair lift. The house is residential in style and blends in well with the neighbouring community. It is close to many local amenities and facilities. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an annual announced inspection, the purpose of which was to check on residents welfare, ensure the premises was being well maintained and look at care planning systems within the home. In addition to this key health and safety records were spot-checked. Evidence was gathered from a variety of sources including discussion with the manager and owner, discussions with residents, observation and examination of records. In addition to the above eleven comment cards were received from relatives and friends, one from a district nurse and six from residents. This was an excellent response and comments made (the majority of which were positive) will be included in the body of the report. What the service does well: What has improved since the last inspection? The dining room has been redecorated which has considerably improved the ambience of this area. The manager continues to work hard to ensure that an open atmosphere is fostered within the home and has developed a leaflet which informs residents of some of their rights and how they can make a complaint. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 6 Residents continue to speak positively about the quality and quantity of food provided. They benefit from a varied and nutritious diet that is well presented and tasty. 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. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 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 standard(s) 1,2, 3,5 Residents are supported to have trial visits which enable them to take a more considered approach about their future care. Improvements need to be made to recording initial assessments so that the home can more clearly demonstrate it will be able to meet individual needs. EVIDENCE: The home has an old brochure which has recently been supplemented by a short information guide for residents and families. This highlights activities, visiting arrangements and the complaints procedure. The manager said these are given to prospective new residents. Discussion took place about how this information could be consolidated and expanded and it is recommended that this be a focus in the forthcoming months. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 9 Opportunity was taken to view four personal files, one of which related to residents who had recently moved in. There was some basic information about them and it was apparent from discussion with the manager that she carries out an initial assessment to ensure that the home will be able to meet their needs. Records available in relation to this, however, were limited and should be expanded so that the home can more clearly demonstrate they are meeting with the requirements of the legislation. National Minimum Standard 3.3 gives further guidance on this. Residents said they, or their relatives, were able to visit the home prior to making a decision to move there. It was apparent that the home has a good reputation within the local community and many had heard of Stokeleigh through word of mouth. It was noted that residents are issued with a contract which details some of the conditions of residence, fees and arrangements in relation insurance. These were relatively easy to understand and included information required by the legislation. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 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 standard(s) 7,8,9,10,11 Residents can be assured that they will be supported in a sensitive and prompt manner with their personal and health care needs. Action needs to be taken to improve practices in relation to the administration of medication - this will make the system safer. EVIDENCE: Four personal files were looked at in detail. These included personal information and care plans. It was noted that these did not always reflect the actual care that is provided and information was limited in some instances. Also some residents had little information about their emotional and social needs – the current format does not lend itself to including detailed information. Examples of how this could be improved were discussed with the manager. It would also be expected that residents sign their agreement to the care plan and were offered a copy. These comments should not be seen as a reflection of poor practice within the home but as a means through which the home can more easily demonstrate the actual good practice that takes place on a daily basis. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 11 It was apparent from discussions that residents are supported to see the relevant health care professionals. The manager was advised to more clearly record these visits. One comment card was received from a district nurse who visits the home regularly. This stated that “Staff are responsive to suggestion, act promptly and appropriately when seeking advice, and are always grateful”. They had no concerns about the running of the home and felt that communication was good. The manager has devised a pro forma to be used about residents’ wishes in the event of their death. It is recommended that these be filled out more consistently so that residents’ rights and needs are dealt with in a sensitive and respectful manner at the end of their lives. The home operates a monitored dosage system for the administration of medication that is supplied at regular intervals by the local pharmacist. The majority of records held in relation to this were found to be well maintained. Tablets are booked on the premises and regular stock checks are made of tablets held on an as and when basis. It was noted, however, that there were several instances when tablets were missing from the dosage system. Discussion with staff indicated that this was because tablets had been lost by residents over some months and had led to an accrued shortfall. Action must be taken to improve this, tablets should not be taken from a different part of the system unless in an extreme emergency. The manager was asked to: • • Write guidelines about staff training in medication, to include what is expected from them – this would more clearly enable the home to demonstrate that they have received the appropriate training. Check all staff competencies to give out medication. The manager was advised that if staff continue to make mistakes then this should be linked to the home’s disciplinary procedures. There were detailed and clear instructions about the use of oxygen for one resident. This is being stored in an appropriate manner. Residents spoke positively about the support they receive from staff and they were observed being sensitively and discreetly assisted with their personal care needs. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 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 standard(s) 13,15 Staff ensure that visitors to the home are made welcome at all times, this means that families can be confident that they will be told of any changes or issues of concern. EVIDENCE: Eleven residents\visitors to the home filled out comment cards about the home. This is a high response rate and indicates that the home is well regarded. The majority of comments were positive about the service provided and praised the staff. They included the following: • • • • “it is like home from home” “Warm and affectionate care” “My uncle thinks Stokeleigh Lodge is an excellent home and so do I. All the staff are a pleasure to meet and have the best interests of the residents at heart.” “The food is good and the welcome to visitors and provision of tea or coffee at all times is impressive” It was apparent that visitors and friend are made to feel welcome at any time, are offered refreshments and that residents are encouraged to maintain friendships and outside links that are important to them. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 13 Residents said there was plenty to do and that there were opportunities to go out if they wished to do so. Some residents spoken with stated that they would like to restart the gardening club. Residents have access to, appreciate and use, a range of books in large format print so that they can continue to read. Opportunity was taken to join residents with their lunchtime meal. This was served in an unhurried and sensitive manner. The food was appetising and residents commented on how lovely it was. They also confirmed that they are given a choice the day before. Records of menus further evidenced that residents do have a choice and that meals are varied, nutritious and wholesome. The cook is aware of the two diabetics within the home, which is controlled through their diet. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 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 standard(s) 16,18 Staff create a homely and open atmosphere so residents can feel confident that they will be listened to. EVIDENCE: Stokeleigh Lodge has a complaints procedure and all residents have been reminded of this recently through the distribution of an information leaflet. Periodic meetings take place during which time residents are invited to make comment on the service they receive. The majority of residents’ visitors forms stated that they had not had cause to make a complaint. It was apparent, however, that the felt able to do so if they wished. The home has a protection of vulnerable adults procedure. It was recommended that a few minor alterations be made to this so that it is clearer for staff if they have to use it. It was noted that no staff had received protection of vulnerable adult training and the manager was advised that this is now considered part of mandatory statutory training and that she should begin a rolling programme of training. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 15 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 standard(s) 19,20,21,23,24,25,26 Residents benefit from a homely, clean and comfortable environment – they can be confident that the premises will be kept well maintained and safe. EVIDENCE: Stokeleigh Lodge is residential in style and blends in well with the local community. It continues to be well maintained, homely and comfortably furnished. It was observed that the majority of radiators in shared space had guards, there were, however, some areas, such as in the dining room when these were not in situ. The manager must demonstrate, via risk assessment, that these pose no threat to residents. All bedrooms should have radiator guards as a matter of course. Opportunity was taken to view a number of bedrooms. These were found to be personalised and to reflect individual tastes. Residents confirmed that they were able to bring in small items of furniture, which made it feel more homely. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 16 The dining room and bathrooms have recently been redecorated. The home is awaiting the bathroom floors to be replaced and pictures on the walls in the dining room to make it look more homely. The house was found to be cleaned to a good standard and there were no unpleasant smells. Some of the less mobile residents are unable to use the main area of the garden due to the three steps down to the garden but can use the furbished patio area with table and chairs which they enjoy. The Stanner stair lift is still in good working use but appears to be old and well-used as it was fitted in 1950. The maintenance file is well organised and the equipment and health and safety testing was up-to-date, except the hoist which needs servicing. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 Action needs to be taken to improve the recruitment procedure so that the home can demonstrate that it is in place for the protection of vulnerable adults. EVIDENCE: Staffing rotas indicated that there are two care assistants on duty throughout the waking day, reducing to one staff who stays awake during the night and one who sleeps but can be woken in an emergency. In addition to this there are ancillary staff including a cook and care co-ordinator. The manager’s hours are not included and the owner visits on a daily basis. At present these levels are sufficient to meet with the needs of those residents currently accommodated. They should be reviewed, however, if dependency levels increase. Opportunity was taken to view two staff personal files. The information in these was erratic and there were some references missing. In addition to this different application forms had been used. The manager must review the current recruitment procedure to ensure that it is more robust. They must have the following: • • • Two completed references, one of which should be from the most recent employer POVA first check and CRB check Completed application form giving full employment history. D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 18 Stokeleigh Lodge It was noted that the home are waiting for a CRB check for the newest member of staff – they have however received a “pova first” check – the home must ensure that this person works under supervision until a full check is received. The manager has developed a staff information book, which includes essential information about residents’ needs and key policies and procedures. This is written to good detail and provides a clear reference guide for all staff. The whistleblowing policy needs further development including phone numbers of relevant organisations to help staff further if an incident arose. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,38, The manager and owner are well respected and are committed to providing good standards – the home is therefore run in the best interests of the residents. EVIDENCE: The fire logbook evidenced that tests and checks of the system are taking place at the appropriate intervals. As an additional mark of good practice each resident is listed with special consideration that may need to be taken into account in event of evacuation, and there is a separate night procedure. The hoist had been serviced on 15\12\04 The gas central heating system had been serviced on 22\7\05 Fridge and freezer temperatures are regularly maintained. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 20 The nurse call system needs to be updated. Some of the residents said that they would prefer a mobile call button to wear around their necks for their personal safety. The provider is already researching the possibilities. It was noted that the manager has received training to instruct staff on manual handling. This is good practice and will enable her to ensure that all staff receive the appropriate instruction. There were manual handling risk assessments on file although these were not looked at in detail during this visit. There were assessments on file which included task related to domestic risks – this meets with requirements of health and safety legislation. The owner visits the home almost daily and it was apparent that she is highly regarded both by residents and the staff team. She was advised that she needs to compile a small report of her findings at monthly intervals and send copies to the CSCI. Residents spoken with said that they look after their finances themselves or a family member does. This standard will be further inspected at the next inspection. Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 2 x 3 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 x 13 4 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 x 3 3 3 2 STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 3 x x x x x Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? 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. 2. 3. 4. 5. 6. 7. 8. Standard 3 7 8 9 9 18 29 33 Regulation 14 15 12(1)(b) 13(2) 13(2) 13(6) 19 26 Requirement Conduct initial assessments prior to admission and fully record findings Review and expand care plans Review and improve recording systems in relation to health care Ensure that guidelines are written about medication training Ensure all staff are checked for their competency to give out medication Ensure all staff receive protection of vulnerable adult training Review recruitment procedure and ensure it meets with current standards Owner to care out monthly visists and send reports of findings to CSCI Timescale for action 26\07 \05 30\11\05 30\09\05 30\09\06 30\08\05 30\12\05 30\08\05 26\08\05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Version 1.30 Page 23 Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc 1. 2. 3. 1 11 18 Review and expand brochure Ensure all residents are consulted with about their wishes in event of their death Make ammendments to the protection of vulnerable adults procedure Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 Page 24 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Stokeleigh Lodge D56_D05_S26503_StokeleighLodge_V230614_270705_Stage4.doc Version 1.30 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!