Inspection on 26/09/06 for Stratfield Lodge Residential Home

This inspection was carried out on 26th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Stratfield Lodge Residential Home 17/10/05

Stratfield Lodge Residential Home 20/04/05

Stratfield Lodge Residential Home 06/12/04

Stratfield Lodge Residential Home 20/05/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Stratfield Lodge Residential Home 63 Wellington Road Bournemouth Dorset BH8 8JL Lead Inspector Martin Bayne Key Unannounced Inspection 08:50 26 September 2006 th 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 DS0000061000.V313891.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. DS0000061000.V313891.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stratfield Lodge Residential Home Address 63 Wellington Road Bournemouth Dorset BH8 8JL 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) 01202 553596 ernestpickering@aol.com Stratfield Lodge Ltd Mr Ernest Lister Pickering Care Home 14 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Old age, not falling within of places any other category (14) DS0000061000.V313891.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Not more than 8 service users to be admitted in the LD and LD(E) categories and service users must have needs that are compatible with the care provided to service users in the OP category. Service users in the LD category must be over the age of 40 years. Date of last inspection 17th October 2005 Brief Description of the Service: Stratfield Lodge is registered to provide personal care and accommodation for up to 14 people in the category of frailty of old age and up to eight people in the category of learning disability. The home is situated close to shops and amenities of Charminster and Bournemouth town centre. The home provides single bedrooms, which are situated on the ground and first floor. The first floor of the home is accessed by means of stairs or a passenger lift. Residents of the home share communal areas of a dining room and a lounge that leads to well maintained gardens. To the front of the home there is an area for parking. DS0000061000.V313891.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key inspection of Stratfield Lodge was carried out between 8:50am and 1:20pm. The aim of the inspection was to evaluate the home against the core standards for both older people and for younger adults. Since the time of the last inspection the home has been granted a variation to accommodate up to eight people in the categories of learning disability under and over the age of 65. The home has a strategic plan to become a specialist service catering to the needs of people with a learning disability with premature aging. A variation has been granted to accommodate up to eight people within these needs. At the time of inspection there were 14 people accommodated at the home with two of these falling within the learning disability category. The inspector was assisted throughout the inspection by Mr Pickering, the registered provider and registered manager, and also by the deputy manager. Eight of the residents were spoken with and comment cards from service users, health and social care professionals and relatives were also used to form the judgements contained within the report. The fees for the home range from £500 – £650 (as of the date of this report) for people in the older persons category and fees for people with a learning disability start at £600 and vary on the assessed needs of the individual. Information in respect of fees can be found at: www.oft.gov.uk A copy of inspection reports are obtainable from the Registered Manager. What the service does well: What has improved since the last inspection? At the last inspection the manager informed that the care plans were to be developed to provide a summary for the staff on service user key needs. It was found that a summary of the care plan had been completed for each service user. The new service user within the learning disability category had been successfully introduced to the home and was settling in well. DS0000061000.V313891.R01.S.doc Version 5.2 Page 6 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. DS0000061000.V313891.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000061000.V313891.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have their needs assessed prior to a place being offered at the home to ensure that these can be met. EVIDENCE: A sample of three service users files for people who had been admitted to the home since the time of the last inspection were used to track the required paperwork that the home must maintain concerning the care of service users. It was found that for all three residents a pre-admission assessment had been carried out to ensure that the home could meet these people’s needs. It was reported that in the case of older people the deputy manager and a senior member of staff would carry out the assessment. In the case of a referral for a person with a learning disability, one of the staff who has NVQ level 3 centred on caring for people with a learning disability carries out the assessment. The home also obtains a copy of the care management assessment for those people funded through Social Services. In this way the home ensures that they can meet the needs of service users admitted to the home. The home does not provide an intermediate care service. DS0000061000.V313891.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 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans set out the personal care needs of the residents. The health needs of the residents are met at the home. Medication is administered safely and the dignity and privacy of residents is respected at the home. EVIDENCE: Care plans are developed from the detailed assessment record. The care plans were found to detail the care needs for the three residents tracked through the inspection. In addition as agreed at the last inspection a precise of the person’s care needs has been developed to provide a quick overview of the person’s care needs for the staff. It was agreed that these would be most useful if kept within the file containing the daily recording notes instead of the service user’s main file. The inspector was informed that the home was to develop care plans for the people with a learning disability in line with person centred planning. This will be followed up at the next inspection. It was found that additional monitoring sheets and processes were put in place for people with specific needs, such as one service users who requires turning and fluid intake monitoring. DS0000061000.V313891.R01.S.doc Version 5.2 Page 10 For each resident risk assessments were found to have been carried out and recorded, identifying and particular risks of harm and how these may be reduced. There was evidence from discussions about the care needs of service users with the staff and from speaking to the service users that their health needs were met at the home. On the day of inspection the optician was visiting the home. Within the care files were details of how dental, chiropody and hearing needs were being addressed. One resident told of how the district nurse was calling to dress injuries she had sustained after a fall. This person had also been referred to the ‘falls’ clinic to address this particular problem. It was reported that the home was developing good links with the community learning disability team. The residents spoken with all informed that the staff were hard working, polite and courteous. They also said that their privacy and dignity were respected. The home has a policy and procedure for the safe administration of medicines within the home. The home has recently been given advice from a pharmacist from the PCT and the policy and procedure were in the process of being revised in line with this advice. Each service users has a small locked metal medication cabinet within their room for the storage of their medication. At the time of inspection there were no service users who managed their medication. Should a person be assessed as being able to manage their medicines on their own they would be given a key to their cabinet. The medication administration records for each resident are kept with their medicines within their cabinet. The records and the cabinet for one resident were checked. It was found that their medicines were being stored correctly and the records were complete with no gaps within the records. Only the senior staff who have been given training administer medication. The home also has a main medication cabinet in the utility room where medicines are stored when they are delivered to the home and those waiting to be returned to the pharmacist. The records allow for an audit of all medicines brought into the home. DS0000061000.V313891.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the assessment process the home obtains a brief history for each resident with the aim of meeting their lifestyle preferences. Some group activities are arranged such as games and bingo being held in the afternoons and the occasional entertainer. Individual needs are also catered to, with evidence of one resident doing art work within their room, three attending day centres for some days during the week. All residents said they enjoyed visits from their relatives or friends who are made welcome at the home. The spiritual needs of residents are met with a Holy Communion service being held within the home each month and a visiting priest for one Roman Catholic resident. The residents spoken with said that they could get up and go to bed when they chose and there were no restrictions placed upon them within the home. The home has an open visiting policy, but residents’ guests are asked to respect mealtimes. DS0000061000.V313891.R01.S.doc Version 5.2 Page 12 All of the residents spoken with said that the food was of a good standard. One resident informed that the staff now consulted with them each day about their choice of meals. A sample of the menus provided at the home was seen and reflected a varied and balanced diet. Residents are able to eat in the main dining room or within their room if they chose. Specialist diets are catered to, with one resident having a celiac diet and another diabetic diet. DS0000061000.V313891.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-publicised complaints procedure and staff trained in adult protection. EVIDENCE: The complaints procedure is displayed on the notice board and is also detailed in the terms and conditions of residence and Statement of Purpose. The home maintains a complaints log and none have been recorded since the time of the last inspection. There have been no complaints brought to the attention of CSCI. The home has copies of policies and procedures for the protection of vulnerable adults that link to ‘No Secrets’. Staff are given training on abuse as part of their induction training. DS0000061000.V313891.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is wellmaintained and clean, however residents safety will be improved with the covering of radiators. EVIDENCE: On the day of inspection the home was found to be clean and in good decorative order throughout. There was also an absence of any unpleasant odours. The home is provided on two floors with well maintained gardens to the rear of the home and parking to the front of the property. The inspector saw some of the residents within their own rooms and these were well furnished and there was evidence that residents were able to bring their own possessions to personalise their rooms. It was noted that the majority of the radiators in the home were not covered. This was discussed with Mr Pickering who agreed that a programme would be put in place to have all the radiators covered, starting with those that constituted the highest risk. This will be followed up at the next inspection. DS0000061000.V313891.R01.S.doc Version 5.2 Page 15 The home has policies and procedures for infection control and staff receive training in this field. Gloves and protective clothing are provided for the staff. It was recommended that the home obtain a copy of Department of Health guidance for infection control in care homes. The home has a separate utility room with washing machines capable of a disinfection cycle. DS0000061000.V313891.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are put at potential risk by staff commencing work before a POVAFirst check is returned. Staff will benefit from training in person centred planning for residents with a learning disability. EVIDENCE: A sample of three staff recruitment files were seen. It was found that all of the necessary checks and records were in place for these staff. It was however found that some staff had started working at the home prior to a CRB form having been returned. A requirement was made that no staff start working with residents unsupervised until a CRB form has been returned. Staff may start working with residents under supervision if a POVAFirst check has been returned. The staffing levels remain the same as at the time of the last inspection with one awake member of staff on duty during the night time period and two staff on duty from 8am to 10pm. The residents spoken with said that although the staff were always busy their care needs were met with current staffing levels. With regards to training, the home now has a 50 level of staff who have received training to NVQ level 2. All new staff receive induction training that meets the Skills for Care induction standards. They also receive training in core topics such as first aid, infection control, moving and handling and health and safety. DS0000061000.V313891.R01.S.doc Version 5.2 Page 17 The training strategy was discussed and the inspector informed that once the home had completed work to gain the Investor’s in People award, a training plan for person centred planning and LDAF training would be put in place. This will be followed up at the next inspection. DS0000061000.V313891.R01.S.doc Version 5.2 Page 18 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, 33, 35 & 38 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home well managed and run in the interests of residents. EVIDENCE: Both Mr Pickering and the deputy manager have obtained NVQ level four in management and care and the Registered Managers Award. The home was found to be well managed with system in place for the effective management of the home. The records sampled with the exception of the staff recruitment records were up to date and accurate. Residents in the main are responsible for their own finances. Mr Pickering assists with one service user with their finances and full accountable records are maintained. Mr Pickering provided dates included in the pre-inspection questionnaire for the servicing of equipment at the home and for the testing of the fire safety system. There were no hazards identified during the inspection save the uncovered radiators. DS0000061000.V313891.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000061000.V313891.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement You are required to ensure that new staff have had a satisfactory POVAFirst check undertaken prior to their starting working at the home. Timescale for action 09/10/06 1 OP27 Schedule 2 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP26 Good Practice Recommendations It was recommended that the home obtain a copy of Department of Health guidance for infection control in care homes. DS0000061000.V313891.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000061000.V313891.R01.S.doc Version 5.2 Page 22 - 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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