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Inspection on 27/10/05 for Teesdale Lodge Nursing Home

Also see our care home review for Teesdale Lodge Nursing Home for more information

This inspection was carried out on 27th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Teesdale Lodge is well maintained providing residents with a well-decorated, modern, spacious and attractive environment. Residents spoken to during the inspection said that they were well cared for. One resident said, "I am satisfied with the care" another said, "I am happy here" Residents spoke of many activities carried out in the home and numerous outings. One resident said, "I like to go on the outings, I have recently been to a museum and I am going shopping in Middlesbrough in November". The home is well managed with an experienced and well-trained staff team

What has improved since the last inspection?

Requirements highlighted at the last inspection have been addressed. The Manager and staff at the home have worked hard to develop the home`s care planning system, many improvements were noted.

What the care home could do better:

The homes adult protection training needs to be structured and carried out on a regular basis. The Manager must ensure that she completes her NVQ level 4 in Management by December 2006. Water temperatures in resident`s bedrooms must be taken and recorded on a regular basis, and the broken bath panel must be replaced.

CARE HOMES FOR OLDER PEOPLE Teesdale Lodge Nursing Home Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS Lead Inspector Katherine Acheson Unannounced Inspection 27th October 2005 10:50 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 Teesdale Lodge Nursing Home DS0000000209.V261895.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. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Teesdale Lodge Nursing Home Address Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS 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) 01642-612821 Cleveden Care Limited Susan Wyer Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44) of places Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Manager (Mrs Susan Wyer) should attain a relevant Management qualification by 2005. The home are able to admit a maximum number of 10 service users with a physical disability aged 50 and above. Three named individuals who are under the age category are allowed to reside in the home. 7th July 2005 Date of last inspection Brief Description of the Service: Teesdale Lodge is registered to provide personal and nursing care to forty-four residents aged sixty-five and above. The home has a variation to registration that allows them to admit a maximum number of ten residents aged fifty and above within the forty-four registered beds. Teesdale Lodge is a single storey, purpose built facility providing accommodation to residents in the form of forty-four single bedrooms. All bedrooms have ensuite facilities, which comprise of a toilet and hand washbasin, all bedrooms meet the required amount of space. The home provides three lounge areas and a separate dining room. Each bedroom has television and telephone points, however pay phone access is available. The home is set in accessible grounds and provides car parking facilities for visitors to the home. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 10:50am and lasted for just over four hours. Six residents, one relative and the Manager were spoken to during the inspection. Staff were spoken to informally. Numerous records including medication, policies/procedures, menus, and staff recruitment and training records were examined. A tour of the home was carried out. Requirements highlighted at the last inspection in July 2005 were re-visited What the service does well: What has improved since the last inspection? Requirements highlighted at the last inspection have been addressed. The Manager and staff at the home have worked hard to develop the home’s care planning system, many improvements were noted. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 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. Teesdale Lodge Nursing Home DS0000000209.V261895.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 Teesdale Lodge Nursing Home DS0000000209.V261895.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): EVIDENCE: The above standards were not inspected. Teesdale Lodge Nursing Home DS0000000209.V261895.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): 9 The home’s medication policy/procedure ensures that there are safe practices in place for dealing with medication. EVIDENCE: The home’s system for storing, administering and recording medication was seen to be effective, storage is safe and complies with the relevant regulations and records of medication received at the home and given to residents were seen to be accurate. An appropriate system for disposal of medication is in operation. A record of controlled drugs is maintained. The Manager said that those residents who are able are encouraged to self medicate, a risk assessment is carried out on the resident to determine ability and safety, and lockable storage for medication is provided. It was highlighted at the last inspection in July 2005 that care plans required further development and that the Manager must develop a system for residents and relatives to sign when reviewing the plan of care, both areas had been addressed. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 10 Six residents and one relative were spoken to during the inspection. One resident said, “The staff are very good”, another said, “I like to go out on the outings, we went to the museum recently” another said, “We went to the Little Theatre yesterday to see Flannigan and Allen, Down Memory Lane, it was lovely”. Teesdale Lodge Nursing Home DS0000000209.V261895.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): 15 The home provides a wholesome, varied and appetizing menu that ensures dietary needs of residents are met. EVIDENCE: The home offers a four-week menu with an alternative choice available at each mealtime. Menus examined were wholesome and showed variety. Records were available to confirm that appropriate temperature checks are carried out on fridge, freezers and food. Records of food provided were available for inspection. One resident spoken to during the inspection said, “The food is good, this year we have done well for new potatoes”, another said, “I’m not fussed on the food” another said, “The food is fine”. Mealtime was observed to be pleasant and relaxed. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 12 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): 18 The home’s adult protection policy helps protect residents from abuse, however a structured and regular plan of adult protection training for staff would further enhance this. EVIDENCE: The home has an adult protection policy/procedure in place which details action that staff must follow if abuse is suspected. Staff demonstrated awareness of action to take if abuse is suspected. The Manager says that all staff receive adult protection training on induction and throughout their employment, however she said that there was no structured programme for doing so. Documentary evidence was not available on staff files sampled to confirm training had been carried out. Residents spoken to during the inspection said that they felt safe. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26 The standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. EVIDENCE: A tour of the premises found the home to be well maintained internally and externally. The home is modern, spacious and welcoming. Suitable communal space is provided for residents and these areas are decorated in a homely and comfortable manner, as are the home’s toilet and bathroom areas, which provide any aids needed by residents. Bathroom 5 was observed to have a broken bath panel, this must be replaced. A number of communal areas within the home environment had benefited from re-decoration and the purchase of new carpets. Resident’s bedrooms are homely and personalised with personal possessions being evident. Residents bedrooms visited were well decorated and furnished. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 14 The Manager said that all baths, showers and sinks in the home environment are temperature regulated. Records were available to confirm that the water temperature in communal bathroom and shower areas were taken and recorded on a regular basis, however, water temperatures in residents bedrooms were not recorded. At the time of this unannounced visit the home was commendably clean and hygienic with good facilities and procedures for handling laundry and preventing odours or the spread of infection. The home has a total of five hoists, many pressure relieving mattresses and other specialist equipment to assist residents and maximise their independence. Teesdale Lodge Nursing Home DS0000000209.V261895.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, 29, 30 The homes recruitment and selection process is robust and as such ensures that residents are protected. Appropriate and regular training is provided for staff to ensure the care needs of the residents are met, however, the Manager must ensure that appropriate numbers of staff receive are trained to NVQ level 2 in care. EVIDENCE: Duty rotas examined during the inspection confirmed that the home is working with the appropriate number of staff on duty. The Manager said that staffing levels fluctuate depending on dependency and resident numbers. The Manager said that 30 of care staff are trained to NVQ level 2 in care or equivalent with a further three staff registered and working towards their NVQ level 2 in care. Two staff files were examined at random during this inspection. Files examined contained a photograph, two references, one being from the last employer, proof of identity and appropriate POVA/Criminal Record Bureau checks. Both files examined confirmed that a thorough recruitment procedure had been followed. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 16 Both files examined were those of staff who had been recently appointed and contained evidence to confirm that induction training had commenced and was ongoing. A discussion took place with the Manager regarding the new induction standards that are to come into force in September of next year. Records were also available to confirm that a rolling programme of training is provided for staff working at the home. Teesdale Lodge Nursing Home DS0000000209.V261895.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): 31, 35 The Manager is working extremely hard to ensure the effective and efficient running of the home. The home ensures that the financial wellbeing of residents is safeguarded and protected. EVIDENCE: The Manager, Susan Wyer is a first level Registered Nurse who has worked in the nursing and social care environment for many years. Due to work commitments and personal reasons the Manager has been unable to complete her NVQ level 4 in Management, however has re-registered and is to commence the course in January 2006. Residents and the one relative spoken to during the inspection spoke highly of the Manager, staff team and care that is provided. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 18 The home operates an effective system in which they look after the personal allowance of a number of residents. Accurate records of transactions and receipts were available for examination. It was highlighted at the last inspection that the results of residents and relatives surveys must be published and made available for inspection, this was observed to have been addressed. Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 3 2 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X X Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 20 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 YA18 Regulation 13, 18 Requirement The Manager must provide a structured programme of adult protection training to all staff on a regular basis. Documentary evidence must be available to confirm course content and that training has been provided. • Water temperatures in residents bedrooms must be taken and recorded on a regular basis • The broken bath panel in bathroom 5 must be replaced The Manager must achieve an NVQ level 4 in Management by December 2006 Timescale for action 30/11/05 2 OP21 13 30/11/05 3 OP31 18 30/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 21 1 OP28 The Manager should continue to work towards achieving 50 of care staff trained to NVQ level 2 in care or equivalent by 2005 Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Teesdale Lodge Nursing Home DS0000000209.V261895.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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