Inspection on 10/03/06 for Sycamore Lodge Care Home

This inspection was carried out on 10th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sycamore Lodge Care Home 21/08/07

Sycamore Lodge Care Home 15/08/06

Sycamore Lodge Care Home 29/11/05

Sycamore Lodge Care Home 19/01/05

Sycamore Lodge Care Home 15/06/04

Sycamore Lodge Care Home 21/05/03

Sycamore Lodge Care Home 17/06/02

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

CARE HOMES FOR OLDER PEOPLE Sycamore Lodge Care Home 2 Burringham Road Scunthorpe North Lincolnshire DN17 2BB Lead Inspector Eileen Engelmann Unannounced Inspection 10th March 2006 09:30 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 Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sycamore Lodge Care Home Address 2 Burringham Road Scunthorpe North Lincolnshire DN17 2BB 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) 01724 856963 01724 856963 sycamorelodgehome@hotmail.com Mr Sukhuinder Marjara Mrs Margaret Williams Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Terminally ill (5) of places Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: Sycamore Lodge is situated in the Ashby area of Scunthorpe, it is close to the local amenities and on a number of bus routes. The home provides care including nursing for up to 40 service users over the age of 65; five of these beds are registered for service users with palliative care needs. Accommodation is provided on two floors; there is stair and passenger lift access to the first floor. There are thirty single rooms and five shared rooms; en- suite facilities are provided in eight of the single rooms. The home has a good variety of day space; there are two lounges, a dining room and a conservatory. All rooms are decorated and furnished to a good standard. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the manager, staff and residents of Sycamore Lodge. The inspection took 2.5 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. Some of the residents were spoken with, as well as chats with staff members as they worked. The provider, manager and staff have worked hard to action the requirements and recommendations from the last report. Residents comments are much more positive on this visit and they said that life within the home has got better. All the key standards have been inspected in the past year and information on these and their outcomes can be found in the report for 29th November 2005 and this one. What the service does well: What has improved since the last inspection? Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 6 The staff recruitment policies and procedures have got better and new staff have all appropriate employment checks carried out before starting work, which keeps residents safe from harm. New and existing staff are given basic training when they start at the home, and then move onto more in-depth work based learning. This ensures residents are cared for by staff who understand their care needs. The manager has provided staff with clear instructions about how the home is to be run, what they must do to improve things and what is expected of them. Residents living at the home say that ‘things have improved over the past few months’, and that ‘the staff have made changes to the way they do things and seem happier in their work because they are getting good advice and guidance from the top’. 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. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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 Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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 arrangements for the assessment of potential residents are good, and offer individuals the assurance that their needs can be met by the home before they move in. EVIDENCE: The home continues to meet the criteria of standard 3. All residents at the home have their own personal file and one of the three looked at was for a fairly new resident. Each individual had a need assessment completed by the funding authority and the home has also completed its own needs assessment before a placement was offered to the resident. The home develops a comprehensive care plan from the assessments, identifying the individual’s problems, needs and abilities using the information gathered from the resident and family. Those residents at the home who receive nursing care have undergone an assessment by a NHS registered nurse from the Health Authority, to determine the level of nursing input required by each individual. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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, 9 and 10. The health care needs of the residents are well met, with evidence of good multi disciplinary working taking place on a regular basis. Staff have a good understanding of the resident’s support needs and offer personal care in a way that promotes the residents privacy, dignity and independence. EVIDENCE: The home continues to produce and keep clear and well-written care plans for the residents. Individual care plans are in place for all residents and the three examined set out the health, personal and social care needs identified for each person. The plans looked at have been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. Risk assessments were seen to cover pressure sores, nutrition, moving/handling and activities of daily living and the majority of the care plans have been signed by the resident or their family. Information about the resident’s social interests, likes and dislikes, spiritual needs and wishes regarding death and dying are all included within the individuals care plan. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 10 The medication policy for the home says that individuals can self-medicate if they want to and after a risk assessment has been completed and agreed. All four of the residents spoken to prefer to have staff administer their medication. Checks of the medication records and the system used showed that these are mainly up to date, accurate and well managed. There were some areas of concern that were discussed with the manager and these included ∗Transcribed (handwritten onto the sheet) medication did not have the quantities received written down or two signatures from the staff to indicate that they had both checked the information recorded initially was correct. ∗Medication already held in the home when a new delivery is receipted in is not added to the supplies on the medication record sheets. This should be done so as to ensure a running total is available at all times. ∗One resident has been admitted to hospital and a quantity of their controlled drugs went with them. This was not documented in the Controlled drug register so the stock balance was incorrect when checked by the inspector. The above practices could lead to medication errors being made and are not acceptable to the Commission. The inspector recommended that an audit of the medication system should be carried out weekly to ensure the records are kept up to date and staff are using the system correctly. At the last inspection four residents were spoken to who expressed some ‘niggles’ about the care being provided at the home. On this visit these individuals were much happier and positive comments about the care, staff and management were made. One resident said ‘the staff are lovely, they are very good at letting your family know if you are feeling down or unwell’ and another commented that ‘the staff do a good job, they answer the bells quickly and cannot do enough for us’. Everyone spoken to was satisfied that staff respected their privacy and dignity at all times, and each person was able to say how their wishes and choices were incorporated into their care. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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, 14 and 15. Residents are provided with choice and diversity in the meals and activities provided by the home. Individual wishes and needs are catered for and people have the option of where, when and how they participate in both eating and leisure activities. EVIDENCE: Since the last inspection the home has offered one of the care assistants additional hours to spend time organising the social activities and events for the residents. The four residents spoken to knew about the new arrangements and were satisfied with the activities taking place. Two individuals said they had enjoyed a game of skittles the day before and other favourite pastimes were exercising with the other residents, playing Ludo and ball games. Posters in the entrance hall give residents information about events organised for the next few weeks, and feedback from the residents indicates they are clearly much happier now there is a new activity person giving them some 1-1 attention. Three residents spoken to were well aware of their rights and said that they had family members who acted on their behalf and took care of their finances. The manager said she is aware of the advocacy groups in the community that residents can access and the contact information is on display within the home. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 12 The inspector recommended that advocacy information is also included in the Service User Guide. All the residents said that the home encouraged them to bring in small items of furniture and personal possessions to decorate their bedrooms. Discussion with the residents showed that they were aware of their care plans and were able to input to them and access them through their key workers. Food at the home is well presented at meal times and comments from the residents indicated that they are pleased and satisfied with the quality and quantity of the meals. The kitchen prepares appropriate meals for residents who are diabetic or who need a soft/pureed diet, taking care to present all the meals in an attractive way. Residents are able to take meals in their own rooms or in the dining room and those spoken to said that the staff always ask them for their choices of menu on a daily basis, and give them different options to choose from. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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. The home has a satisfactory complaints system with evidence that residents’ views are listened to and acted upon. Staff, relatives and residents are confident about reporting any concerns and the manager acts quickly on any issues raised. EVIDENCE: Checks of the complaints record shows that the home has not had any formal complaints since the last inspection. Discussion with the manager indicates she would deal with any ‘niggles or grumbles’ on a daily basis. The home has a complaints policy and procedure that is found within the statement of purpose and service user guide. It is also on display within the home. Three residents showed a clear understanding about how to make their views and opinions heard and said ‘the manager comes round every day to see us and will discuss any problems at this time. She will take immediate action, if needed, to resolve any issues brought to her attention’. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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 and 24. The standard of the environment within this home is good, providing residents with an attractive and homely place to live. EVIDENCE: The home has an ongoing programme of routine maintenance and decoration that ensures the environment is kept safe and well presented. Since the last inspection the home has fitted a new specialist bath to one bathroom, this has a ‘Jacuzzi’ feature (for residents who like bubbles with their bath) and the manager said it had proved to be very popular with the residents. Corridors and bedrooms have been repainted/decorated and all areas seen by the inspector were clean and bright, no malodours were noted. Four residents spoken to were very pleased with their individual rooms and said that they had ‘brought in a number of personal possessions to make them feel more homely’. All bedrooms are supplied with door locks and lockable storage space to ensure resident’s valuables are kept safe. The rooms are decorated to a high standard and supplied with sufficient furnishings to meet the requirements of the residents and standard 24. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 15 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 and 29. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. EVIDENCE: Inspection of the duty rota and discussion with the manager indicates that the staffing levels at the home remain the same as at the last inspection. However residents comments were much more positive at this visit about the way in which staff carry out their duties. One individual said ‘the staff are quick to respond to the call bell and nothing is too much bother’. Another resident commented that ‘there can be a wait at times, but this is only when everyone wants to get up or go to bed, and they do not take long to come to see you’. In general there are two nurses and six care staff on duty in a morning, two nurses and five care staff in the afternoon and one nurse and three care staff at night. Observation of the staff showed that the home is busy, but well organised. There is an induction and foundation course that meets National Training Organisation (NTO) specification for new members of staff, and sixteen of the twenty-two staff (73 ) of the care staff have achieved an NVQ 2 or 3, with two other staff members going through the training. Since the last inspection the manager has acted on the requirements and recommendations from the report and made improvements to the recruitment procedure. Actions taken by the manager include Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 16 ∗The two employees from overseas who did not have work permits were asked to produce these. One individual has done so, but the other could not. This employee has been ‘laid off’ until she has her work permit up dated. ∗References for three nurses have been followed up with their last employer, and this response was satisfactory. Examination of a staff file for a new employee at the home showed that the manager is following the recruitment procedure, and ensures the interview process, police/CRB checks, written references, health checks and past work history are all obtained and satisfactory before the person starts work. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 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 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): 35. Satisfactory accounting and financial systems are in place to protect and safeguard the interests of the residents. EVIDENCE: Checks of the financial records showed that residents are able to have Personal Allowance accounts in the home. These records are hand written and each person has their own account sheet, which is updated each week by the manager/administrator. Information from the manager indicates that the residents have a family member or representative who looks after their monies and these individuals make sure the Personal Allowances are sent/brought into the home. Each resident has their own wallet for their money and receipts of all transactions undertaken are kept in their file. Checks of these showed them to be accurate and up to date. The home does not keep large amounts of cash on the premises and if a person’s allowance builds up it is returned to the family/representative for ‘safe-keeping’. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 18 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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 X 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X X X X 3 X X STAFFING Standard No Score 27 3 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X X Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 17 Requirement Timescale for action 01/06/06 2 OP9 13 Staff must keep accurate records of medication received, administered and leaving the home (given timescale of 27/02/06 was not met). 01/06/06 Medicines in the custody of the home must be handled according to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society, the requirements of the Misuse of Drugs Act 1971 and Nursing staff abide by the NMC Standards for the administration of medicines (given timescale of 27/02/06 was not met). RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations Standard 1 OP9 The manager should carry out an audit of the medication system weekly, to ensure the records are kept up to date and staff are using the system correctly. 2. OP14 Advocacy information and contacts should be included in the Service User Guide. Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Sycamore Lodge Care Home DS0000002807.V264138.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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