Inspection on 30/05/06 for Stonedale Lodge

This inspection was carried out on 30th May 2006.

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

Stonedale Lodge 17/01/06

Stonedale Lodge 25/10/05

Stonedale Lodge 22/11/04

Stonedale Lodge 25/06/04

Stonedale Lodge 11/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Stonedale Lodge 200 Stonedale Crescent Liverpool Merseyside L11 9DJ Lead Inspector Andrea Morris & Julie King Key Unannounced Inspection 30th May 2006 08:00 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 Stonedale Lodge DS0000025178.V292620.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. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonedale Lodge Address 200 Stonedale Crescent Liverpool Merseyside L11 9DJ 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) 0151 549 2020 www.bupa.com BUPA Care Homes (CFHCare) Limited Judith Aileen Howells Care Home 180 Category(ies) of Dementia - over 65 years of age (90), Old age, registration, with number not falling within any other category (90) of places Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 27 OP (N incl 5 palliative care - Blundell) 3 named females under 65 years of age (N - Blundell) 29 OP (N - Townley) and 1 named male under 65 years 30 DE/E (N -Dalton) includes one named female under 65 years of age 30 DE/E (N- Clifton) 29 DE/E (PC - Anderton) and 1 named female under the age of 65 years with dementia (DE) 29 OP (PC - Sherbourne) and 1 named male under 65 years of age (PC - Sherbourne) 17th January 2006 Date of last inspection Brief Description of the Service: Stonedale Lodge offers personal and nursing care to 180 residents, and is situated in the Croxteth area of Liverpool. Local amenities are a short walk away, as are numerous bus routes and shops. Stonedale Lodge comprises six separate houses, each with 30 beds. Five of the houses offer nursing and personal care and one offers EMI nursing care. The houses are set in the large landscaped garden, with conservatories and patios, there is also a sensory garden for all to enjoy. All the rooms are single and have an assistance alarm fitted. Stonedale benefits from having in-house activities organisers, who arrange entertainment and regular trips out. A hairdressing salon is also on site. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by two inspectors, and took place over nine hours. During this time all units were examined, including a selection of service user’s care plans, staff records, management records, kitchen and laundry areas; and some required Health & Safety documentation. What the service does well: 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. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 6 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 Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 7 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, 2, 3, 4, 5, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes Statement of Purpose and Service User Guide now provides enough information for prospective service users so they can be clear about the services the home provides to meet their care needs. Residents only enter the home following a full assessment of their needs, thus promoting resident safety. EVIDENCE: The home has an adequate Statement of Purpose and service user guide, it contains all necessary information relating to potential residents’ and their families to enable them to make an informed choice. Each resident who enters the home is issued with a written contract; this contains all the details relating to terms and conditions of residency. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 8 All residents’ prior to entering the home are assessed by either the manager or a designated qualified staff member. No one enters the home without the assessment being completed to ensure all residents’ needs can be met. The documentation in use evidenced a holistic individualised approach which includes aspects of risk assessment and family involvement. The subsequent care plan was then based on these assessments, and specialist needs of the service users are identified during this process. The home accesses specialist support from other healthcare professionals, including Social Workers, chiropodist, GP, specialist nurses such as Community Psychiatric Nurse (CPN). All visits are recorded in each resident file as appropriate. Potential residents and their families are able to visit the home prior to making any decision to move in. A potential resident can stay for a few hours or a meal if they choose at no extra cost. The home does not provide intermediate care. Stonedale Lodge DS0000025178.V292620.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments are created to promote residents safety and maintain independence and identify the individual needs of each resident. Medication management was not satisfactory, thus potentially placing people at risk. EVIDENCE: A selection of care files were examined on each unit, all residents on entering the home have a completed care file that contains up to date care plans and risk assessments. Staff were noted to evaluate care files on an at least monthly basis, this helps to ensure care delivered is relevant and resident safety is promoted. Residents who were spoken to stated they were happy with the home, and staff treated them well. Residents also confirmed that the care they received was good. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 10 Residents identified that they were encouraged to make decisions on how to spend their day, and relating to the care they received, they stated that staff members respected any decision made. Residents’ also identified that they were able to receive their visitors in private, and staff respected their wish to privacy. The home has an adequate policy relating to the care of the dying resident. Staff have received training in care of the dying and some trained staff hold the ENB 931 Care of the Dying Client certificate. The medications were examined in all units, with the findings as follows: Anderton Room & fridge temperatures recorded British National Formulary (BNF) September 2005 Returns secure and signed for MAR sheets satisfactory No CD’s Some transcriptions not signed (same person each occasion)– manager and unit manager aware and will deal with person concerned Sherbourne Room & fridge temperatures are being recorded All returns stored correctly in designated unit Returns book double signed Controlled drug(CD) count correct & CD register completed Required blood medication levels being monitored regularly Medication Administration Records (MARs) completed correctly Townley Big improvement in medication documentation since previous inspection Blood monitoring levels checked regularly Fridge & room temperatures checked daily CD’s correct, including register Oxygen stored securely with adequate signage Recommendation – Labels to be on bottles / eye-drops as well as on outer box/container Returns stored in secure area and counter-signed Dalton MARs being recorded correctly Returns managed appropriately Room & Fridge temperatures being monitored No out of date stock Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 11 Clifton MARs being recorded correctly Returns managed appropriately Room & Fridge temperatures being monitored No out of date stock Regular medication blood monitoring Blundell Weekly Nomad system in use, monthly re-stocking for liquid preparations, no out of date stock Blood medication levels being regularly monitored Correct use of MAR sheets, including use of ‘key’ system for not required drugs Oxygen stored correctly, secured and adequate signage on treatment room door CD’s – Morphine Sulphate 10mg/5mls, 35.5mls recorded in register, actual measured amount = 9mls. Manager to conduct investigation immediately and produce findings to CSCI within 14 days. Stonedale Lodge DS0000025178.V292620.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, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users social, cultural, religious and recreational interests and needs are being met; leading to independence and a sense of fulfilment amongst the service users. The food offered at Stonedale Lodge is good, helping to ensure a wholesome and varied diet for all service users. EVIDENCE: The home employs two activity organisers to work between the six units. Activities are provided on a daily basis. On each unit photographic evidence was seen of some of the recent activities that had been carried out. Residents are encouraged to participate as much as they want to, one resident stated they did not want to participate in activities and preferred their own company, they confirmed that the staff respected that decision. The home receives visits from the Roman Catholic Church and the Church of England for communion on a monthly basis. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 13 The home is currently developing links with the local community to promote further social interaction for residents. The home operates an open visiting policy for all visitors, residents are able to receive their visitors in private as they choose. Stonedale Lodge DS0000025178.V292620.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): 16,17,18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A complaints and adult protection policy and procedure was in place that helps ensure the safety and welfare of residents. EVIDENCE: Since the previous inspection there have been noticeable improvements in staff training in the prevention of adult abuse. The Registered Manager has provided training to most staff, including care, housekeeping and kitchen staff; and records of this training are now being kept. For all complaints received by the home audits, outcomes and action plans are produced. Relatives spoken to informed the inspectors that they would have no worries about approaching staff or management if they had any concerns, and the contact details of CSCI were readily available in all units. The home procedures which includes information on ‘whistle-blowing’, in accordance with the Department of Health ‘No Secrets’ guidelines, and some advocacy information is available as needed. There is no religious or political persuasion at Stonedale Lodge, and service users are enabled to participate in voting, etc; as they wish. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 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 the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Since the previous inspection the standard of cleanliness and décor within the home has improved, presenting in most areas as a homely and comfortable environment for service users. EVIDENCE: The home environment has much improved over the last few months. There has been re-decoration to most units since the last inspection. The gardens are maintained to an adequate standard by the home’s gardener. The maintenance person records all checks on Health and Safety to a good standard. Water temperatures are checked on a weekly basis. Each bathroom has a thermometer so bath temperatures can be checked prior to residents’ entering the bath. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 16 The home has access to specialist mobility equipment such as several ‘Stand Aid’ and ‘Oxford’ mobile hoists; plus grab rails, raised toilet seats, etc. The majority of service user’s bedrooms were personalized with their artefacts and possessions, and some evidenced relative/family involvement. New bedlinen had been obtained, with more apparently on order. Pressure relieving mattresses and cushions were seen, as were lifting and mobility aids, and specialist equipment as needed. Each resident has their own room; which they are able to personalise with their own effects and memorabilia. Residents stated having their own things around them helps them to settle in and generates a homely feeling. The home was found to be clean and hygienic, and did not have any malodour. Some areas of the kitchen environment require repair and / or replacement as follows:• Extractor fan damaged and requires repair • Store area requires painting • Floor in cold room badly damaged and presenting a tripping hazard – require replacement as soon as possible • Tiles off wall by sink require replacement Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 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 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is now a consistency of care within the home provided by permanent staff, which helps to offer safety and stability for the residents. The home operates an adequate recruitment policy, this assists in protecting residents from harm. EVIDENCE: Staff rotas were examined and all units were found to be appropriately staffed. The home does not use agency staff on a regular basis as most shifts are covered in-house, thus providing a continuity of care for the service users. The home has an adequate recruitment policy, a selection of staff personnel files were examined, including all staff that had commenced employment since the previous inspection. All were found to contain all the necessary information and checks including CRB (Criminal Records Bureau) and references. Staff receive regular training in all aspects of care. On the day of the inspection staff were receiving training in fire safety. Over 50 of care staff hold an NVQ2 in care. Some staff are awaiting to commence on the NVQ programme in the near future. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 18 The home has a training plan to ensure all staff receive the training mandatory annually; and all training that staff receive is recorded in the individual training files for each person. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 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 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, 32, 33, 34, 35, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, thus staff receive leadership to assist with promoting high standards of care. EVIDENCE: The manager is very experienced in care home management, is registered with the Commission for Social Care Inspection, and holds the RMA (Registered Managers Award). The home regularly reviews the policies and procedures to ensure care delivery remain safe and in-line with current legislation. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 20 All staff who were spoken to stated that they found the manager approachable and knowledgeable, and felt supported in their roles. The service users also told the inspector that they were happy and felt “able to talk to the staff about anything”. Relatives spoken to also expressed their increased confidence in the home’s internal management systems, and felt that overall care had improved. The home has adequate financial procedures, a selection of financial records were examined and found to be recorded correctly and a clear audit trail is available if required. Documentation is also recorded in relation to finances to support all current practices. All the home’s Health and Safety certificates were found to be in date and valid, and records of fire safety are maintained to a good standard. It was noted that not all staff receive regular supervision sessions with their line manager. A requirement has been made to address this. Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 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 3 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 3 3 3 3 2 3 3 Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 22 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 OP36 Regulation 18(2) Requirement The registered person shall ensure that persons working in the care home are appropriately supervised. The registered person must ensure that all medications received into the care home are appropriately managed and recorded at all times. The registered person must ensure that the care home is kept in a good state of repair at all times – refer to kitchen findings in main body of report. Timescale for action 30/07/06 2. OP9 13 (2) 25/07/06 3. OP19 16 23 31/08/06 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 Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Stonedale Lodge DS0000025178.V292620.R01.S.doc Version 5.2 Page 24 - 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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