CARE HOMES FOR OLDER PEOPLE
Stratfield Lodge Residential Home 63 Wellington Road Bournemouth Dorset BH8 8JL Lead Inspector
Judith Bracewell Unannounced 20th April 2005 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. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service Stratfield Lodge Residential Home Address 63 Wellington Road Bournemouth Dorset BH8 8JL 01202 553596 01202 553396 ernestpickering@aol.com Stratfield Lodge Ltd 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) Mr Ernest Pickering CRH - Care Home Only 14 Category(ies) of OP - Old Age (14) registration, with number of places Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 6th December 2004 Brief Description of the Service: Stratfield lodge is an attractive House set on the level in its own grounds. The home is close to the shops and amenities of Charminster and Bournemouth Town Centre. The home is owned by Stratfiled Lodge Limited, the Directors live close by and spend much time on the premises. They are assisted by an Administrator and a competent staff team. The registration allows for the accommodation of a maximum of 14 older people who do not have nursing needs other than can be met by the District Nurse. All rooms are single and are situated on the ground or first floor, which may be accessed by means of a passenger lift or stairs. Communal space is available in a dining room or lounge or outside in the secure back garden. The gardens are well planted with interesting shrubs and flowering plants. Residents are encouraged to remain as independant as possible, though help is always available if required. There are sleep in on call staff at night and a call alarm system to alert staff if attention is needed. The home is near to a bus stop and there is an area for car parking available at the front of the home. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day and comprised a tour of the premises, examination of records and discussion with staff and Residents. Five Residents spoke at some length to the Inspector and others in passing. 30 of the National Minimum Standards were inspected and all were met. What the service does well:
Prospective Residents are invited to visit the home along with their relatives or are visited by the home’s staff before they decide if they will stay. A full assessment of needs is carried out and after the home has assessed that they can meet those needs, Residents are admitted for a trial period. The latest Residents to come into the home said that they had been made to feel very welcome. Full and clear care plans are compiled with all interested parties contributing to the content. The home gives help where needed but will encourage Residents to retain as much independence as possible, providing equipment to aid daily living as necessary. Assistance is provided with medication and Residents are treated with dignity and respect in life and at the end of their life. Visitors come and go at the home and said that they can visit their relatives in private and are always welcomed by staff. All the Residents who commented said that they have lovely food; the variety was noted in the daily record book. The premises are maintained to a very high standard with homely comfortable rooms to which, Residents can add items of their own. Visitors remarked on how clean the home is. All but two rooms have ensuite facilities; those, which do not, are adjacent to bathrooms. Residents are afforded privacy within their own rooms. There is a no smoking policy within the home. All laundry is carried out on the premises and clothing is labelled to ensure each person has their own after washing. A well-trained workforce staffs the home. All the Management have appropriate qualifications and experience and create an open, positive and inclusive atmosphere for staff and Residents. A new member of staff remarked how kind everyone is. Health and Safety is taken very seriously with regular servicing of equipment taking place and appropriate safeguards such as thermostatic controls being fitted. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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 Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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) 3 and 5 Residents are admitted to the home on the basis of a full assessment of their needs and for a trial period to ensure that the needs can be fully met and that the Residents are comfortable with the home. Prospective Residents are invited to visit the home with their relatives or representatives before any decision to move in is made. EVIDENCE: The records for the three newest Residents were examined. It was found that full assessments had been carried out and risk assessments completed. The Administrator said that where the Local Authority have responsibility for funding then Local Authority assessments were obtained prior to admission; these assessments were noted on file. Conversation with the new Residents confirmed that they had either been visited at home or had visited Stratfield Lodge prior to admission and they had been involved in their own assessments. The residents said that they had been made welcome and were already feeling at home. The terms and conditions of residency clearly state that admission is for a trial period initially
Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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 standard(s) 7,8,9,10,11 The home produces excellent clear, well-written care plans with input from the Residents or their representatives to make sure that care needs are met. Residents are well looked after in respect of their health and personal care. The system for the administration of medication is simple, straightforward and carried out with safety in mind for the well being and protection of the Residents. Personal care is carried out in such a way that dignity and privacy are respected. Death is handled with sensitivity and kindness giving comfort to all those involved. EVIDENCE: Care plans are very comprehensive, clearly written and are signed by the Residents to show their agreement. Good daily notes are maintained and the home has completed forms to provide important information in the event of a Resident being admitted to hospital. Notes show the involvement of health care professionals and demonstrate that Residents have access to NHS services. During the inspection a dentist telephoned to arrange to see a resident at the home. Equipment for the
Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 10 promotion of skin viability is provided where a need has been assessed, specific items were seen to be in use. Many Residents are able to go out for short walks and the home are contemplating reinstating flexercise classes, which were discontinued but there are several new Residents who may like to participate now. Administration of medication was seen and is considered to be carried out in a safe manner. Each Resident has a locked cabinet where their own medication and the Medication Administration Record are kept. This enables staff to give medication individually in Residents’ own rooms. Staff were observed to treat Residents with the utmost courtesy and dignity, speaking quietly to individuals and knocking on room doors prior to entry. The administrator said that staff receive regular training in this area. Most rooms have a telephone point and a telephone is available in the hall. Visitors were observed coming and going with their relatives or friends who they were able to see in their own rooms. The Inspector observed that a dying Resident was treated with gentleness and kindness and that following death time was allowed for people to pay their respects. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,15 Friends and relatives of Residents are encouraged to visit and to provide continuity in relationships. The home is operated in such a way as to maintain as much independence as possible for Residents. A varied and nutritious diet, matched to individual requirements is provided to enable Residents to stay healthy and enjoy their meals. EVIDENCE: Visitors were observed coming and going, they were greeted warmly by staff. Residents said they could see their visitors in private whenever they liked. The statement of purpose refers to visitors continuing involvement. The home encourages Residents to look after their own affairs if they are able, otherwise relatives or advocates act on their behalf. New Residents can bring their own possessions with them subject to room and safety, detailed lists of these items were seen on record. All the Residents who spoke with the inspector said that they have lovely food. The daily diary shows that a wholesome, varied and nutritious diet is provided. Decisions as to what will be served are based on Residents’ likes and dislikes at lunchtime and there is a wide choice available for supper.
Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 12 Drinks and snacks are available at any time a water cooler is supplied for anyone to use. At the time of inspection diabetic meals were being appropriately prepared. The lunch looked delicious and filled the dining room with an enticing aroma. Breakfast is served in bedrooms; all other meals are served in the dining room or rooms on request. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 There is a complaints procedure to allow anyone who may wish to make a complaint to do so with confidence that it will be dealt with appropriately. Residents are enabled to exercise their legal rights and to participate in elections. The home has a robust Adult Protection procedure to ensure that Residents are safeguarded from abuse. EVIDENCE: There have been no complaints since the last inspection, either to the home or to Commission for Social Care Inspection. The home provides information on Advocacy services. All Residents are entered on the electoral register and have postal votes. There is a satisfactory Adult Protection policy and procedure. Further training for staff in this area is scheduled to take place soon. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,26 The property is well maintained kept very clean and has been assessed by an Occupational Therapist, resulting in a safer and pleasant environment for Residents and staff. The communal areas are nicely furnished as a consequence they are well used by Residents. Residents have their own beautifully decorated and furnished rooms, mostly with ensuite facilities, allowing privacy, comfort and security. EVIDENCE: A tour of the property showed that the home was immaculately clean, well furnished and decorated. There is an ongoing maintenance programme and much refurbishment has taken place in recent times. Only two rooms do not have ensuite facilities but these are located in close proximity to bathrooms. The bathrooms are very clean and there is equipment to aid bathing. One bathroom contains a shower. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 15 The home has been fully assessed by an Occupational Therapist and action has been taken on the recommendations made. The entrance to the home has been made easier to access and a striking front door added. Residents’ bedrooms are homely and well furnished varying in shape and size, which makes each room individual. Residents are able to add their own possessions to their rooms. All laundry is carried out on the premises in a well-equipped laundry room where washing machines meet the Water Fittings Regulations 1999. The member of staff responsible for cleanliness and hygiene in the home takes great pride in her work and is completing a recognised qualification in building cleaning. Visitors commented as to how clean the house is. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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 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) 27,28,29,30 Staff at the home are well trained and employed in sufficient numbers to meet the Residents’ needs. The home has a thorough recruitment procedure, backed up by written policies, that ensure Residents are in the hands of competent people EVIDENCE: The staffing roster showed that there are at least two care staff on duty at all times in addition to Management and ancillary workers. The home does not have wakeful night staff but there are always two people sleeping on the premises on call throughout the night. One member of the care staff holds an appropriate National Vocational Qualification the other care staff hold overseas nursing qualifications. One relatively new member of staff commented as to how kind everyone was to her. Staff records were examined and on the whole were satisfactory. The source of a reference needed checking as it was not on headed note paper. The home operates in line with its equal opportunities policy. New staff are expected to undertake an approved induction course and all staff receive training in foundation studies. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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 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) 31,32,33,35,36,38 Residents benefit from a very well qualified and experienced management team who create an open, safe, positive and inclusive atmosphere within the home. Residents are consulted and an annual quality assurance report demonstrates that their views are sought on matters relating to the home. Staff communicate well with each other and the Managers who supervise them ensuring that all understand what is expected of them and how Residents needs will be met. EVIDENCE: The Director and two other members of staff hold the Registered Manager and NVQ4 care awards. The Administrator has completed her course work and is awaiting confirmation that she too has the management award. The whole management team are very well experienced and demonstrate a supportive regime. Staff and Residents said that they can approach the managers on any matter.
Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 18 Regular staff meetings take place, these incorporate training sessions and discussion. The home is quite small so consultation with Residents takes place on an individual basis. Staff are given copies of the code of conduct of the General Social Care Council. The home carries out an annual quality assurance project including consultation with Residents and visitors. Evidence for the next year’s quality assurance report is already being collated. The home are not involved in the management of any Residents’ financial affairs. Regular written supervision of care staff is practiced. The records of this were available for inspection. Staff receive regular training in Health and Safety matters. Much of the training is provided by means of video and testing procedures. Those working in the kitchen go to external providers for Basic Food Hygiene training. Fire records were up to date and a fire drill had just taken place. Thermostatic control valves protect all baths and sinks. Most doors are fitted with swing free closers that close automatically in the event of a fire alarm going off. A risk assessment of radiators has been done. Electrical testing is scheduled to be carried out in May. The home keep records of any accidents that occur. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 4 3 3 3 3 3 x 4 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 Standard No 16 17 18 Score 3 3 3 4 3 3 x 3 3 x 3 Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 20 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard 27 Good Practice Recommendations The home should assure themselves of the validity of references if they are not provided on headed note paper or bearing a company stamp. Stratfield Lodge Residential Home D55 S61000 STRATFIELD LODGE V220440 200405 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection Unit 4 New Fields Business Park Stinsford Road Poole, Dorset BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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