Inspection on 20/05/04 for Stratfield Lodge Residential Home

Care Home For Older PeopleStratfield Lodge Residential Home63 Wellington Road Bournemouth Dorset BH8 8JLUnannounced Inspection14th & 20th May 2004 Commission for Social Care InspectionLaunched in April 2004, the Commission for Social Care Inspection (CSCI) is the single inspectorate for social care in England. The Commission combines the work formerly done by the Social Services Inspectorate (SSI), the SSI/Audit Commission Joint Review Team and the National Care Standards Commission. The role of CSCI is to: · Promote improvement in social care · Inspect all social care - for adults and children - in the public, private and voluntary sectors · Publish annual reports to Parliament on the performance of social care and on the state of the social care market · Inspect and assess `Value for Money of council social services · Hold performance statistics on social care · Publish the `star ratings for council social services · Register and inspect services against national standards · Host the Childrens Rights Director role.Inspection Methods & FindingsSECTION B of this report summarises key findings and evidence from this inspection. The following 4-point scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase Standard met? The 4-point scale ranges from: 4 - Standard Exceeded (Commendable) 3 - Standard Met (No Shortfalls) 2 - Standard Almost Met (Minor Shortfalls) 1 - Standard Not Met (Major Shortfalls) O or blank in the Standard met? box denotes standard not assessed on this occasion. 9 in the Standard met? box denotes standard not applicable. X is used where a percentage value or numerical value is not applicable. ESTABLISHMENT INFORMATION Name of establishment Stratfield Lodge Residential Home Address 63 Wellington Road, Bournemouth, Dorset, BH8 8JL Email address Name of registered provider(s)/company (if applicable) Stratfield Lodge Ltd Name of registered manager (if applicable) Mr Ernest Lister Pickering Type of registration Care Home No. of places registered (if applicable) 14 Tel No: 01202 553596 Fax No:Category(ies) of registration, with (number of places) Old age, not falling within any other category (14) Registration number D550002003 Date first registered 3rd September 1997 Was the home registered under the Registered Homes Act 1984? Do additional conditions of registration apply ? Date of last inspectionDate of latest registration certificate 27th April 2004 YES NO 19/01/04 If Yes refer to Part CStratfield Lodge Residential HomePage 1 Date of inspection visit Time of inspection visit Name of inspector Name of inspector Name of inspector 1 2 314th May 2004 and 20th May 2004 09:30 am Judith BracewellID Code072710Name of inspector 4 Name of specialist (e.g. Interpreter/Signer) (if applicable) Name of establishment representative at the time of inspectionMr. E Pickering and Mrs. R CookStratfield Lodge Residential HomePage 2 CONTENTSIntroduction to Report and Inspection Inspection Visits Brief Description of the Services Provided Part A: Summary of Inspection Findings Inspectors Summary Statutory Requirements/Good Practice Recommendations from last Inspection Conditions of Registration Statutory Requirements/ Good Practice Recommendations from this Inspection Part B: Inspection Methods & Findings National Minimum Standards For Older People: Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management & Administration Part C: Part D: D.1. D.2. D.3. Compliance with Conditions (if applicable) Providers Response Providers Comments Action Plan Providers AgreementStratfield Lodge Residential HomePage 3 INTRODUCTION TO REPORT AND INSPECTION Every establishment that falls within the jurisdiction of the Commission for Social Care Inspection (CSCI), is subject to inspection, to establish if the establishment is meeting the National Minimum Standards relevant to that setting and the requirements of the Care Standards Act 2000. This document summarises the inspection findings of the CSCI in respect of Stratfield Lodge Residential Home. The inspection findings relate to the National Minimum Standards (NMS) for Care Homes for Older People published by the Secretary of State under the Care Standards Act 2000. The Regulations applicable to the inspected service are secondary legislation, with which a service provider must comply. Service providers are expected to comply fully with the National Minimum Standards. The National Minimum Standards will form the basis for judgements by the CSCI regarding registration, the imposition and variation of registration conditions and any enforcement action. The report follows the format of the NMS and the numbering shown in the report corresponds to that of the Standards. The report will show the following: · Inspection methods used · Key findings and evidence · Overall ratings in relation to the standards · Compliance with the Regulations · Required actions on the part of the provider · Recommended good practice · Summary of the findings · Providers response and proposed action plan to address findings This report is a public document. INSPECTION VISITS Inspections are undertaken in line with the agreed regulatory framework with additional visits as required. This is in accordance with the provisions of the Care Standards Act 2000. The report is based on the findings of the specified inspection dates.Stratfield Lodge Residential HomePage 4 BRIEF DESCRIPTION OF THE SERVICES PROVIDED. 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. Mr and Mrs Pickering, the registered owners of the home, live close by and are in charge of the day-to-day running. Over the last few years the Directors have made considerable improvement to the building. The home is registered to accommodate a maximum of 14 older people (over the age of 65) who do not require nursing other than that which can be provided by the District Nurse. All rooms are single. Bedrooms are situated on the ground floor and first floors. There is a through floor passenger lift to provide easy access to all areas of the building. The home has a comfortable lounge and dining room where service users can socialise. The house is near to a bus stop and has a well laid out area for car parking. Residents are encouraged to maintain as much independence as possible though help is always available if required. The home has on call night staff; if a resident needs attention there is a call system to summon assistance from staff who sleep on the premises. The garden is planted in a manner that reflects the seaside area of Bournemouth.Stratfield Lodge Residential HomePage 5 PART A SUMMARY OF INSPECTION FINDINGSINSPECTORS SUMMARY (This is an overview of the inspectors findings, which includes good practice, quality issues, areas to be addressed or developed and any other concerns.) The inspector found it a joy to visit this home. The premises are beautifully maintained, full of scented flowers and prettily decorated. Most of all the service users expressed their pleasure at living in Stratfield Lodge and particularly mentioned the kindness of the owners and staff. Despite the fact that the timing of the visit was inconvenient, the Directors made the Inspector welcome and enabled the inspection to go ahead. There was however a second visit to discuss some aspects with the Administrator who had not been available initially. Some of the standards were not inspected on this occasion; the text from the previous inspection has been incorporated into the report for information. Choice of Home (Standards 1-6) 2 of the 2 standards assessed were met. The statement of purpose was not examined on this occasion. Service users all receive a copy of the contract of residence. Prospective service users are invited to visit the home prior to admission if they are able to; a representative from the home visits them at home or in hospital to carry out an assessment before any decision is made to move into the home. Health and Personal Care (Standards 7-11) 4 of the 4 standards assessed were met. All service users have a clear and comprehensive care plan, which they are invited to contribute to and to sign. Access to NHS services is facilitated and a system for assessing tissue viability is in place. Medication is securely stored and records kept. Staff have undertaken training in Handling Medication. Service users confirm that they are treated with respect and that privacy and dignity is always maintained. Daily Life and Social Activities (Standards 12-15) 1 of the 1 standards assessed was met. Service users are encouraged to remain as independent as possible and are able to come and go as they wish. Subject to risk assessment service users are able to retain control over their own medication and finances. Service users own furniture and decorative items may be brought to the home.Complaints and Protection (Standards 16-18) Stratfield Lodge Residential Home Page 6 3 of the 3 standards assessed were met. The home has a satisfactory complaints policy. There have not been any complaints since the last inspection; there have been a number of compliments. All service users are entered on the electoral register and assistance provided to take people to polling stations if they wish. The home has an Adult Protection policy and a Whistle Blowing policy. A copy of the Department of Health document No Secrets is available in the office. Environment (Standards 19-26) 8 of the 8 standards assessed were met. The standard of accommodation is high and attention is given to detail throughout the building. The home has been assessed by a qualified Occupational Therapist. Most rooms have ensuite facilities. Risk assessments have been carried out and action is being taken to minimise any risks identified. Staffing (Standards 27-30) 1 of the 4 standards assessed was met. The home has a staffing roster which demonstrates who is on duty at any time. Staff were seen to be smartly dressed and competently carrying out their tasks. Service users reported that the staff were very kind. The home has not yet reached the target of 50 of care staff qualified to NVQ2 by 2005 but with two more staff beginning training the home is well on the way to achieving that target. New staff are provided with induction training but not yet foundation training. Management and Administration (Standards 31-38) 6 of the 6 standards assessed were met. The management of the home are well experienced and suitably qualified. A commendation is given for several staff attaining the Registered Managers award Service users and staff confirm that there is an open and inclusive atmosphere within the home. Staff are adequately supervised. The Directors are able to demonstrate the homes financial viability. The home is committed to ensuring that Health and Safety is given priority.Stratfield Lodge Residential HomePage 7 Requirements from last Inspection visit fully actioned? If No please list belowNOSTATUTORY REQUIREMENTS Identified below are areas not addressed from the last inspection report which indicate a non-compliance with the Care Standards Act 2000 and accompanying Regulations. The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Regulation Standard Required actions Timescale for action Effective quality assurance and quality monitoring systems, based on seeking the views of service users, must be put in place to measure success in meeting the aims, objectives and statement of purpose of the home. 19/01/04 Work has been undertaken in this area but the standard is not yet fully met. Previous timescale 31/12/03124OP3331.7.04Action is being taken by the Commission for Social Care Inspection to ensure compliance in regard to the above requirements.Stratfield Lodge Residential HomePage 8 RECOMMENDATIONS Identified below are recommendations from the last inspection that have not been implemented No. Refer to Good Practice Recommendations StandardCONDITIONS OF REGISTRATION THAT APPLY (OTHER THAN NUMBERS AND CATEGORY OF SERVICE USERS).Met (Yes / No)Stratfield Lodge Residential HomePage 9 STATUTORY REQUIREMENTS IDENTIFIED DURING THE INSPECTION Action Plan: The Registered Person is requested to provide the Commission with an Action Plan, which indicates how requirements are to be addressed with the time scale within which such actions will be taken. This action plan will be made available on request to the Area Office.STATUTORY REQUIREMENTS Identified below are areas addressed in the main body of the report, which indicate noncompliance with the Care Standards Act 2000, and accompanying Regulations 2001 and the National Minimum Standards. The Registered Provider(s) is/are required to comply within the given time scales. The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Regulation Standard * Requirement Timescale for action 1 19(5) OP28 A minimum of 50 of care staff must be trained to NVQ2 or equivalent in care by 2005. The home most hold on record a recent photograph of each member of staff in line with schedule 2 of the Regulations. The home must have a training programme which meets National Training Organisation targets, most particularly Foundation training. Effective quality assurance and quality monitoring systems, based on seeking the views of service users, must be put in place to measure success in meeting the aims, objectives and statement of purpose of the home. 19/01/04 Work has been undertaken in this area but the standard is not yet fully met. Previous timescale 31/12/03 31.3.05219(2)OP2930.11.04318OP3030.11.04424OP3330.11.04Stratfield Lodge Residential HomePage 10 RECOMMENDATIONS Identified below are areas addressed in the main body of the report, which relate to National Minimum Standards and are seen as good practice issues which should be considered for implementation by the registered Provider(s). The code in Standard is a cross-reference to the Standards described in full in the section Inspection Findings. No. Refer to Good Practice Recommendations Standard ** Note: You may refer to the relevant standard in the remainder of the report by omitting the 2-letter prefix e.g. OP10 refers to Standard 10.Stratfield Lodge Residential HomePage 11 PART BINSPECTION METHODS & FINDINGSThe following inspection methods have been used in the production of this report Direct observation Indirect observation Sampling · Pre-inspection questionnaire · Records · Care plans / Care pathways · Meals · Activities · Other (Specify) `Tracking care and support Group discussion with service users Individual discussion with service users Group discussion with staff Individual discussion with staff Discussion with management Service user survey Relatives/significant others survey/feedback Visiting professionals survey / feedback Tour of premises Formal interviews Document reading Additional inspection information: Number of service users spoken to at time of inspection Number of relatives/significant others the inspectors had contact with Number of letters received in respect of the service CRB check for the responsible individual seen CRB check for the manager seen Certificate of registration was displayed at the time of the inspection Certificate of registration accurately reflected the situation in the service at the time of inspection Total number of care staff employed (excluding managers) Total number of staff with nursing qualifications employed Date of inspection Time of inspection Duration of inspection (hrs) YES YES NO YES YES NO NO NO YES YES YES NO YES YES NO NO NO YES NO NO 7 0 0 YES NA YES YES 6 0 14/05/04 10:00 4.5Stratfield Lodge Residential HomePage 12 The following pages summarise the key findings and evidence from this inspection, together with the CSCI assessment of the extent to which the National Minimum Standards for Care homes for older people have been met. The following scale is used to indicate the extent to which standards have been met or not met by placing the assessed level alongside the phrase Standard met? The scale ranges from: 4 - Standard Exceeded 3 - Standard Met 2 - Standard Almost Met 1 - Standard Not Met (Commendable) (No shortfalls) (Minor shortfalls) (Major shortfalls)0 or blank in the Standard met? box denotes standard not assessed on this occasion. 9 in the Standard met? box denotes standard not applicable. X is used where a percentage value or numerical value is not applicable.Stratfield Lodge Residential HomePage 13 Choice of HomeThe intended outcomes for the following set of standards are: · · · · · · 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.Standard 1 (1.1 ­ 1.3) The registered person produces and makes available to service users an up to date statement of purpose setting out the aims, objectives, philosophy of care, services and facilities, and terms and conditions of the home; and provides a service users guide to the home for current and prospective residents. The statement of purpose clearly sets out the physical environmental standards met by a home in relation to standards 20.1, 20.4, 21.3, 21.4, 22.2, 22.5, 23.3 and 23.10: a summary of this information appears in the homes service users guide. Range of fees charged From (£) 375 To (£) 450Any charges for extrasYESHAIRDRESSING, CHIROPODY If yes, please state what the extras are: 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; the text has been carried over for information. The home has fully met this standard for some time. However, both Mr Pickering and Mrs Cook have identified areas that they feel can be further improved and advised the Inspector that they intend to make further alterations to the document. They advised the Inspector that this would include a Charter of Residents Rights. The home is commended for taking such a positive view towards this document.Stratfield Lodge Residential HomePage 14 Standard 2 (2.1 ­ 2.2) Each service user is provided with a statement of terms and conditions at the point of moving into the home (or contract if purchasing their care privately). 3 Key findings/Evidence Standard met? The home issues all service users with a copy of the contract of terms and conditions of residency. The contract is clear and informative and includes the number of the room to be occupied. Contracts are signed by the management and by the service users or their representatives.Standard 3 (3.1 ­ 3.5) New service users are admitted only on the basis of a full assessment undertaken by people trained to do so, and to which the prospective service user, his/her representatives (if any) and relevant professionals have been party. 3 Key findings/Evidence Standard met? Pre admission assessments are carried out and the names of those participating in the assessment are included. The Care Manager undertook to ensure that the assessments are signed where possible. The Inspector observed that the assessments provide sound information on which to base the care plans. Anyone admitted via the Local Authority would be required to have the Local Authority assessment and care plan before being admitted. Standard 4 (4.1 - 4.4) The registered person is able to demonstrate the homes capacity to meet the assessed needs (including specialist needs) of individuals admitted to the home. 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; the text has been carried over for information. The home aims to provide care to people with the general needs of old age and does not set out to provide specialist care for those with dementia, major disabilities or a learning disability. Mr Pickering advised the Inspector that much the best method of training for their staff is with the use of accredited training videos. Since the last inspection, as a result of requirements for this standard, they have purchased videos on topics such as dementia awareness and continence management. They are also trying to collate a resource library for staff to use which provides information on certain conditions and good practice care issues and are also looking for other training sources.Stratfield Lodge Residential HomePage 15 Standard 5 (5.1 ­ 5.3) The registered person ensures that prospective service users are invited to visit the home and to move in on a trial basis, before they and / or their representatives make a decision to stay; unplanned admissions are avoided where possible. 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; the text has been carried over for information. Since the first inspection under the National Minimum Standards, the home has always met this standard. During discussions with staff and service users it was evident to the Inspector that the home continues to offer service users the opportunity to visit the home for meals, day visits and short stays before making the decision to move into the home. Standard 6 (6.1 - 6.5) Where service users are admitted only for intermediate care, dedicated accommodation is provided together with specialised facilities, equipment and staff, to deliver short term intensive rehabilitation and enable service users to return home. 9 Key findings/Evidence Standard met? The home does not provide an intermediate care service.Stratfield Lodge Residential HomePage 16 Health and Personal CareThe intended outcomes for the following set of standards are: · · · · · The service users health, personal and social care needs are set out in an individual plan of care. Service users make decisions about their lives with assistance as needed. Service users, where appropriate, are responsible for their own medication, and are protected by the homes 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.Standard 7 (7.1 ­ 7.6) A service user plan of care generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered. 3 Key findings/Evidence Standard met? The Inspector examined forty per cent of care plans and found them to be neat, comprehensive and clear. Service users had signed to show that they had been involved in completing the plans and there was evidence that these were being reviewed. Risk assessments were carried out and included with the care plans. A skin vulnerability assessment has recently been included with the documentation. Daily notes regarding the service users wellbeing are written and anything of a medical nature is recorded.Stratfield Lodge Residential HomePage 17 Standard 8 (8.1 ­ 8.13) The registered person promotes and maintains service users health and ensures access to health care services to meet assessed needs. No. of incidents where service users have been taken to Accident and Emergency during last 12 months No. of service users with pressure sores at time of inspection (from information taken from care notes) 0 03 Key findings/Evidence Standard met? Records show that service users have access to NHS services. District Nurses visit as required and continence advice and assessment is available from them if needed. Equipment, such as special mattresses or cushions, is made available where tissue vulnerability is identified. Waterlow assessment forms are used to identify those at risk of skin breakdown. Service users may choose their own General Practitioners. Chiropodists visit the home regularly. Arrangements for service users eye and hearing tests are facilitated by the home. Standard 9 (9.1 ­ 9.11) The registered person ensures that there is a policy and staff adhere to the procedures for the receipt, recording, storage, handling administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. 3 Key findings/Evidence Standard Met? All rooms contain a locked cupboard for individuals medication. The Medication Administration Record Sheets are kept with the drugs so that they can be completed at the time of administration. It was noted that all Senior staff have recently taken part in accredited training in Handling Medication. Members of staff told the inspector that the training had been very helpful and informative. A drugs information file has been set up so that staff can update themselves on the purpose of the medication and any possible side effects. Risk assessments are carried out and recorded with regard to service users ability to self medicate.Stratfield Lodge Residential HomePage 18 Standard 10 (10.1 ­ 10.7) The arrangements for health and personal care ensure that service users privacy and dignity are respected at all times, and with particular regard to: personal care giving, including nursing, bathing, washing, using the toilet or commode, consultation with, and examination by, health and social care professionals, consultation with legal and financial advisors, maintaining social contacts with relatives and friends, entering bedrooms, toilets and bathrooms, and following death. 3 Key findings/Evidence Standard met? Discussion with service users confirmed that their privacy and dignity is respected at all times. The Inspector was advised that staff ensure that service users use their bedrooms for all personal care as well as for matters such as consulting legal and financial advisors and receiving other visitors. The home has a cordless telephone that can be taken to service users rooms and they may also have a private line installed in their rooms if they take financial responsibility for this. It was confirmed that service users are consulted as to their preferred form of address and this was also recorded on the service users files. All rooms are singly occupied. Standard 11 (11.1 ­ 11.12). Care and comfort are given to service users who are dying, their death is handled with dignity and propriety, and their spiritual needs, rites and functions observed. 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; the text has been carried over for information. Through discussion with Mr Pickering, the staff and observation of the file of a recently deceased service user, the Inspector was able to confirm that much of this standard is met. During discussions it was very evident to the Inspector how caring the home is. One relative had sent the home a letter of thanks following the death of a service user. Part of this letter read You often went the second mile in your care of her and I do appreciate all that you did for her. It was noted that funeral preferences were now included in care plans.(20/5/04)Stratfield Lodge Residential HomePage 19 Daily Life and Social ActivitiesThe intended outcomes for the following set of standards are: · · · · 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.Standard 12 (12.1 ­ 12.4) The routines of daily living and activities made available are flexible and varied to suit service users expectations, preferences and capacities. 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; the text has been carried over for information. Mr Pickering informed the Inspector that for the most part service users tend to prefer to avoid organised activities, possibly as many of them are relatively independent and still prefer to organise their own entertainment. Some still go out for walks etc on their own and most receive regular visitors. Over the Christmas period more activities were organised such as a childrens group from a local church and the home also had a fireworks party in November. Families and friends as well as other local groups with whom the home has contact are invited to such occasions. For the most part, however, Mr Pickering stated, they have amended the homes routines to reflect service users wishes and Mrs Pickering in particular, tries to arrange one-to-one sessions with each service user as often as possible. These trips take the form of shopping trips, visits to the coast and other local beauty spots. During the course of the inspection the Inspector ascertained from service users that they have a variety of newspapers and magazines delivered, some enjoy doing crosswords with each other and others have made new friends since moving to the home and enjoy spending tie in one anothers rooms. A local minister provides a regular communion service and the library service also visits regularly.Stratfield Lodge Residential HomePage 20 Standard 13 (13.1 ­ 13.6) Service users are able to have visitors at any reasonable time and links with the local community are developed and/or maintained in accordance with service users preferences. 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; the text has been carried over for information. As stated in the previous standard, there are various activities both at the home and in the local community that are designed to enable service users to maintain contact with family and friends and the local community itself. Discussions also confirmed that staff are careful to ensure that service users wish to see their visitors and that no restrictions upon visiting are made upon service users. Mrs Cook stated that family and friends are advised of visiting arrangements when the service user is admitted to the home, they are also actively encouraged to remain involved with the service user, indeed a number of families visited the home on Christmas day to join in the festivities. Standard 14 (14.1 ­ 14.5) The registered person conducts the home so as to maximise service users capacity to exercise personal autonomy and choice. 3 Key findings/Evidence Standard met? The whole ethos of the home is one of encouraging service users to remain in control of their lives as much as possible. Service users are enabled where possible to look after their own finances and subject to risk assessment, look after their own medication. The home had leaflets available re advocacy services should any service users require these. Visits to some of the rooms confirmed that service users may bring their own possessions with them when they are admitted to the home; an inventory of these items is kept. Service users may access their own records by arrangement should they wish to do so.Stratfield Lodge Residential HomePage 21 Standard 15 (15.1 ­ 15.9) The registered person ensures that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual, assessed and recorded requirements, and that meals are taken in a congenial setting and at flexible times. 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; some of the text has been carried over for information. Examination of menus and discussion with residents confirmed that there is an appetising and varied selection of meals, which they enjoy. Breakfast is served in residents rooms and they have a choice, some enjoy a cooked breakfast. The main meal is served at 12.30p.m.and although there is no choice this was not an issue for residents as there is a varied menu and as the home is small the chef knows about individual preferences and will alter a meal accordingly. Lunch on the day of the inspection was Gammon with mustard sauce, swede, carrots, cabbage and boiled potatoes followed by a homemade rice pudding. Supper is served at 6.00p.m. and residents choose between various sandwiches, soups etc. Further drinks, Horlicks etc. are served between 19.30 and 21.30 and a snack or biscuits provided on request. There is a four weekly menu and particular favourites are included more frequently. The chef obviously takes pride in his work. At present one of the service users is diabetic and the Inspector was pleased to note that a separate rice pudding was made for this person rather than relying on the usual standbys of fresh fruit or yoghurt. Those service users having pureed meals expressed a wish to have all the food blended together.Stratfield Lodge Residential HomePage 22 Complaints and ProtectionThe intended outcomes for the following set of standards are: · · · 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.Standard 16 (16.1 ­ 16.4) The registered person ensures that there is a simple, clear and accessible complaints procedure which includes the stages and time-scales for the process, and that complaints are dealt with promptly and effectively. No. of complaints made to the home during last 12 months No. of these complaints fully substantiated No. of these complaints partly substantiated No. of these complaints not substantiated No. of these complaints not yet resolved No. of complaints sent direct to CSCI Percentage of complaints responded to within 28 days 0 0 0 0 0 0 100 3 Key findings/Evidence Standard met? There have been no complaints either to the home or the Commission since the last inspection. The home has a complaints policy that is part of the statement of purpose. All service users and their representatives have access to a copy of the complaints policy. A compliments file is kept; the inspector read some of the letters and noted the numerous expressions of gratitude with regard to care in the home.Stratfield Lodge Residential HomePage 23 Standard 17 (17.1 ­ 17.3) Service users have their legal rights protected, are enabled to exercise their legal rights directly and participate in the civic process if they wish. 3 Key findings/Evidence Standard met? The electoral register is updated annually. Transport is made available on election days and assistance is also given to those wishing to vote by post. Any concerns with regard to service users legal rights are referred to either Mrs Cook or Mr Pickering. Service users are able to see their own legal representatives as they wish. Standard 18 (18.1 ­ 18.6) The registered person ensures that service users are safeguarded from physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance, in accordance with written policies. The home has an Adult Protection procedure (including Whistle Blowing) which complies with the Public Disclosure Act 1998 and the Department of Health Guidance No Secrets No. of staff referred for inclusion on POVA lists YES 03 Key findings/Evidence Standard met? The home has a Whistle Blowing policy in line with the Public Disclosure Act 1998. A copy of the Department of Health guidance No Secrets has been obtained and staff have received training in the prevention of abuse. The Care Manager pointed out that they avoid rigid routines so as not to introduce institutionalisation into the home.Stratfield Lodge Residential HomePage 24 EnvironmentThe intended outcomes for the following set of standards are: · · · · · · · · 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.Standard 19 (19.1 ­ 19.6) The location and layout of the home is suitable for its stated purpose; it is accessible, safe and well maintained; meets service users individual and collective needs in a comfortable and homely way and has been designed with reference to relevant guidance. 3 Key findings/Evidence Standard met? The home is conveniently situated close to the Charminster area of Bournemouth. The inspector made a tour of the premises and found that the home was very well maintained both internally and externally. There was evidence of continuous upgrading of the building with attention to small details enhancing the comfort and homeliness. The gardens were well laid out and planted with plenty room at the back of the home for service users to wander or sit. The home has had recent satisfactory inspection visits from the Fire Officer and the Environmental Health Officer. Standard 20. (20.1 ­ 20.7) In all newly built homes and first time registrations the home provides sitting, recreational and dining space (referred to collectively as communal space) apart from service users private accommodation and excluding corridors and entrance hall amounting to at least 4.1 sq. metres for each service user. 3 Key findings/Evidence Standard met? The dining room is large and well furnished with a number of shared tables and can accommodate all the residents comfortably. The lounge on the other hand whilst being an attractive room would not accommodate all the service users at the same time. In view of the governments amendments to the environmental standards, this requirement no longer applies. Seven bedrooms measure well above the present standard for a single room and therefore provide additional individual sitting space.Stratfield Lodge Residential HomePage 25 Standard 21 (21.1 ­ 21.8) Toilet, washing and bathing facilities are provided to meet the needs of service users. 3 Key findings/Evidence Standard met? Eleven of the 14 rooms have ensuite toilets and wash hand basins. Those rooms without toilets are close to the communal bathrooms. There are two bathrooms on the first floor, one with an assisted bath the other having a shower. On the ground floor two communal toilets are located in close proximity to the lounge and dining room. Standard 22 (22.1 ­ 22.8) The registered person demonstrates that an assessment of the premises and facilities has been made by suitably qualified persons, including a qualified occupational therapist, with specialist knowledge of the client groups catered for, and provides evidence that the recommended disability equipment has been secured or provided and environmental adaptations made to meet the needs of service users. 3 Key findings/Evidence Standard met? The home has been assessed by a qualified Occupational Therapist and her report is awaited. The home are congratulated for carrying out this process. Individual residents and their rooms are assessed as and when required. The inspector observed that various pieces of equipment are in place throughout the home such as grab rails, handrails, ramps, stair lift and through floor passenger lift, raised toilet seats, chair and bed blocks and commodes. The home has a mobile hoist. The Inspector noted that storage areas have been provided for equipment and that a call system, which may only be cancelled at source, is installed in all rooms.Stratfield Lodge Residential HomePage 26 Standard 23 (23.1 ­ 23.11) The home provides accommodation for each service user which meets minimum space as prescribed Total number of single bedrooms with at least 10 sq.m usable space or additional compensatory space Pre-existing homes only (1 April 2003) - single bedrooms below 10 sq.m usable space or additional compensatory space Total number of wheelchair users accommodated for in rooms at least 12sq.m Total number of wheelchair users accommodated for in rooms at less than 12sq.m Total number of shared rooms at least 16 sq.m Total number shared rooms less than 16 sq.m Percentage of places within single rooms: 100 80 - 99 Less than 80 Total number of single bedrooms Total number of single rooms with en suite Total number of double rooms Total number of double rooms with en suite YES NO NO 14 11 0 0 14 00 0 0 03 Key findings/Evidence Standard met? All room sizes exceed that which was required at 31.3.02. Seven rooms exceed the current size standard of 12sqm. There are no shared rooms.Stratfield Lodge Residential HomePage 27 Standard 24 (24.1 ­ 24.8) The home provides private accommodation for each service user which is furnished and equipped to assure comfort and privacy, and meets the assessed needs of the service user. 3 Key findings/Evidence Standard met? The inspector visited several rooms and found them to be well decorated, warm, comfortably and tastefully furnished. All rooms are carpeted and provided with a 3ft. single bed and pretty bedding. All furniture is provided though service users may bring items of their own if they wish. Overhead and bedside lighting is available. Rooms may be secured if the service users wish to lock them. Service users spoken to in their own rooms consistently remarked how nice the rooms are. Standard 25 (25.1 ­ 25 8) The heating, lighting, water supply and ventilation of service users accommodation meet the relevant environmental health and safety requirements and the needs of individual service users. 3 Key findings/Evidence Standard met? All rooms have access to natural light and ventilation. Risk assessments have been carried out around the building as a result some windows have been replaced to restrict the opening width and radiators have been covered. Radiators are fitted with thermostatic controls so that service users may alter the temperature in their own rooms. Baths and wash hand basins are fitted with valves to restrict the delivery temperature of the hot water, which is stored at a temperature that inhibits Legionella. The emergency lighting is serviced regularly.Standard 26 (26.1 ­ 26.9) The premises are kept clean, hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance. 3 Key findings/Evidence Standard met? The home was seen to be clean and tidy throughout. The laundry room is well fitted out and has easily cleaned walls and flooring. Cleaning fluids are securely stored. The home has an infection control policy. The services and facilities comply with the Water Fittings Regulations 1999.Stratfield Lodge Residential HomePage 28 StaffingThe intended outcomes for the following set of standards are: · · · · 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 homes recruitment policy and practices. Staff are trained and competent to do their jobs.Standard 27 (27.1 ­ 27.7) Staffing numbers and skill mix of qualified/unqualified staff are appropriate to the assessed need of the service users, the size, the layout and purpose of the home, at all times. Number of staff /hours in respect of service user needs based on guidance recommended by Department of Health. Personal Nursing Care No. service users High No. staff hours 0 X X needs allocated No. service users Medium needs No. service users Low needs No. of staff hours required No. of full time equivalent first level registered nurses No. of care staff No. of ancillary staff 8 6 X No. staff hours allocated No. staff hours allocated No. of staff hours provided X X 168 X X X0 6 23 Key findings/Evidence Standard met? The staffing roster was examined and found to comply with the requirements of this standard. The home employs six care staff who cover duty from 8am to 8pm over the week. Ancillary staff are employed for cooking and housekeeping tasks. A Care Manager/ Administrator has taken on day-to-day responsibility for the home and the Directors and their family carry out various tasks as and when required, most particularly cooking and maintenance. There are no wakeful night staff but up to three persons are resident and on call at night. The Directors are aware of the need to increase staffing should the care needs of service users increase. Stratfield Lodge Residential Home Page 29 Standard 28 (28.1 ­ 28.3) A minimum ratio of 50 trained members of care staff (NVQ Level 2 or equivalent) is achieved by 2005, excluding the registered manager and/or care manager, and in care homes providing nursing, excluding those members of the care staff who are registered nurses. No. care staff (excluding registered nurses) with NVQ level 2 or equivalent of care staff with NVQ level 2 1 16 2 Key findings/Evidence Standard met? At the present time one member of the care staff has NVQ. This is a little deceptive as two staff are undertaking NVQ level 3 at the present time and 3 of the management have NVQ 4 in management and care. Once the two staff on NVQ3 have achieved their qualification then the home will have met its target, though this should not discourage other staff from undertaking the training. The home shows great commitment to having a fully trained workforce. Standard 29 (29.1 ­ 29.6) The registered person operates a thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. 2 Key findings/Evidence Standard met? Examination of staff records demonstrated that the home undertakes a thorough and rigorous recruitment procedure. References are obtained and Criminal Records Bureau checks carried out. The General Social Care Council code of practice is issued to all staff. Schedule 2 of the regulations requires that there is a recent photograph of all staff members held on file. The Care Manager undertook to accomplish this in time for the next inspection. Standard 30 (30.1 ­ 30.4) The registered person ensures that there is a staff training and development programme which meets the National Training Organisation (NTO) workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users. 2 Key findings/Evidence Standard met? The home provides induction training that complies with Topps recommendations. For the most part those staff going immediately on to NVQ training would not need to undertake foundation training. However for those staff who do not wish to be involved in NVQ then it is essential that they undertake the foundation training. Subjects covered by Foundation include effective communication and recognition of abuse, amongst others. It is important that all staff understand their responsibilities in these areas.Stratfield Lodge Residential HomePage 30 Management and AdministrationThe intended outcomes for the following set of standards are: · · · · · · · · 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 homes record keeping policies and procedures. The health, safety and welfare of service users and staff are promoted and protected.Standard 31 (31.1 ­ 31.8) The registered manager is qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives. 4 Key findings/Evidence Standard met? The Director and two other members of staff hold the NVQ 4 Registered Managers and Care awards. This is highly commendable. An Administrator has been appointed and she has also embarked on the NVQ4 Registered Managers award with a view to becoming the Registered Manager in the future. The Inspector had not visited the home since the initial registration, around seven years ago and was delighted to find that Mr. and Mrs. Pickering have improved the home almost beyond recognition. They demonstrate professionalism in their management that is appreciated by staff and service users alike. Standard 32 (32.1 ­ 32.7) The registered manager ensures that the management approach of the home creates an open, positive and inclusive atmosphere. 3 Key findings/Evidence Standard met? The inspector discussed the management style of the home with staff and service users who confirmed that the home does indeed have an open, inclusive and positive atmosphere. Staff were able to approach the Directors on any matter and felt that they were listened to and also able to offer ideas that would be acted upon. Service users spoke with great affection for the management and staff. All staff have copies of the General Social Care Council code of practice including translations for those for whom English is not the first language.Stratfield Lodge Residential HomePage 31 Standard 33 (33.1 ­ 33.10) Effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in meeting the aims, objectives and the statement of purpose of the home. 0 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was partially met at the previous inspection; the text has been carried over for information. Mr Pickering advised that he had purchased the National Care Homes Association package for quality assurance. He intends to implement this, with Mrs Cook, once she has been in post a little longer and the outstanding policies, procedures etc have been implemented. Standard 34 (34.1 ­ 34.5) Suitable accounting and financial procedures are adopted to demonstrate current financial viability and to ensure there is effective and efficient management of the business. 3 Key findings/Evidence Standard met? The home has recently been subject to re registration as a limited company. During this process accounts and insurance details were submitted to the Commission to demonstrate the homes financial viability. These were found to be satisfactory.Stratfield Lodge Residential HomePage 32 Standard 35 (35.1 ­ 35.6) The registered manager ensures that service users control their own money except where they state that they do not wish to or they lack capacity and that safeguards are in place to protect the interests of the service user. Number of service users subject to Power of Attorney processes Number of service users subject to Enduring Power of Attorney processes Number of service users subject to Guardianship Orders X X 00 Key findings/Evidence Standard met? Not inspected on this occasion. This standard was fully met at the previous inspection; the text has been carried over for information. Mr Pickering advised that the home tries to avoid any involvement in service users finances. He confirmed that he does not hold cash, pension books or valuables for any service users. During discussions it became evident that on occasion he will pay for shopping or other services for service users if they do not have sufficient cash to cover this. He advised that this situation is discussed with family/representative when the service user is admitted and that if this occurs he keeps the receipt and then recovers the money from the family/representative. The Inspector advised that should the situation ever arise where he is holding an amount of cash on behalf of a service user in order to cover such expenses he must ensure that the cash is held separately and that detailed accounts are kept of credits and debits together with a running balance. Standard 36 (36.1 ­ 36.5) The registered person ensures that the employment policies and procedures adopted by the home and its induction, training and supervision arrangements are put into practice. 3 Key findings/Evidence Standard met? Records confirmed that staff are receiving two monthly supervision sessions that are recorded. Appraisals are also carried out. Ancillary staff are supervised on a day-to-day basis. Staff are encouraged to familiarise themselves with the homes policies and procedures.Stratfield Lodge Residential HomePage 33 Standard 37 (37.1 ­ 37.3) Records required by regulation for the protection of service users and for the effective and efficient running of the business are maintained, up to date and accurate. 3 Key findings/Evidence Standard met? The inspector examined a number of records, which were found to be up to date and showed clarity. The records are particularly neatly kept and accessible. Service users confirm that they can see their records if they wish and signatures showed that they are involved in compiling their own care plans. Records should be stored in accordance with the Data Protection Act 1998 but if no personal and health care details relating to service users are held on the computer then the home does not need to register.Standard 38 (38.1 ­ 38.9) The registered manager ensures so far as is reasonably practicable the health, safety and welfare of service users and staff. 3 Key findings/Evidence Standard met? Stratfield Lodge shows commitment to matters relating to Health and Safety. Staff are trained in mandatory subjects relating to safety, e.g. Manual Handling, Basic Food Hygiene Health and Safety etc. The home has a clinical waste disposal contract. Water temperatures are controlled appropriately. Windows are limited or being limited at the present time. Equipment and machinery are serviced as required. The garden is well laid out and the front car park smoothly surfaced. The home has copies of relevant legislation. Fire checks and training have been carried out. All accidents are recorded and an analysis regularly takes place.Stratfield Lodge Residential HomePage 34 PART C(where applicable)COMPLIANCE WITH CONDITIONSCondition CommentsComplianceCondition CommentsComplianceCondition CommentsComplianceCondition CommentsComplianceLead Inspector Second Inspector Regulation Manager DateMrs. J. BracewellSignature Signature SignatureStratfield Lodge Residential HomePage 35 Public reports It should be noted that all CSCI inspection reports are public documents.Stratfield Lodge Residential HomePage 36 PART DD.1PROVIDERS RESPONSE TO IDENTIFIED STATUTORY REQUIREMENTSRegistered Persons comments/confirmation relating to the content and accuracy of the report for the above inspection.We would welcome comments on the content of this report relating to the Inspection conducted on 14th & 20th May 2004 and any factual inaccuracies: Please limit your comments to one side of A4 if possibleStratfield Lodge Residential HomePage 37 Action taken by the CSCI in response to provider comments: Amendments to the report were necessaryComments were received from the provider Provider comments/factual amendments were incorporated into the final inspection report Provider comments are available on file at the Area Office but have not been incorporated into the final inspection report. The inspector believes the report to be factually accurate Note: In instances where there is a major difference of view between the Inspector and the Registered Provider both views will be made available on request to the Area Office. Please provide the Commission with a written Action Plan by 30th June 2004, which indicates how requirements are to be addressed and stating a clear timescale for completion. This will be kept on file and made available on request. You will also note that the Commission has identified in the inspection report good practice recommendations and it would be useful to have some indication as to whether you intend to take any action to progress these. D.2 Status of the Providers Action Plan at time of publication of the final inspection report: Action plan was required YESAction plan was received at the point of publicationYESAction plan covers all the statutory requirements in a timely fashion Action plan did not cover all the statutory requirements and required further discussion Provider has declined to provide an action planYESOther: enter details here Stratfield Lodge Residential HomePage 38 D.3PROVIDERS AGREEMENT Registered Persons statement of agreement/comments: Please complete the relevant section that applies.D.3.1 I Mr Ernest Pickering of Stratfield Lodge confirm that the contents of this report are a fair and accurate representation of the facts relating to the inspection conducted on the above date(s) and that I agree with the requirements made and will seek to comply with these. Print Name Signature Designation Date Or D.3.2 ............................................................. am unable to confirm that the contents of this report are a fair and accurate representation of the facts relating to the inspection conducted on the above date(s) for the following reasons: ERNEST PICKERING E.Pickering DIRECTOR 16-6-04Print Name Signature Designation Date Note: In instance where there is a profound difference of view between the Inspector and the Registered Provider both views will be reported. Please attach any extra pages, as applicable.Stratfield Lodge Residential HomePage 39 - 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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