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Inspection on 07/07/05 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 7th July 2005.

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.

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

It is evident following the inspection that the Manager and staff at Teesdale Lodge provide a high standard of care to its residents. Residents spoken to during the inspection spoke highly of the staff team and care that is provided. One resident spoken to during the inspection said, "The staff are very good, they look after me extremely well". Another resident said, "Staff are very respectful they will do anything for you. Relationships with families of residents are very good and visitors are made to feel welcome at any time. One relative who spends a number of hours at the home each day said, "I feel part of the family".

What has improved since the last inspection?

Requirements identified at the last inspection have been addressed The Manager has developed a quality assurance system, questionnaires have been sent out to residents and relatives to seek views on many areas o the home and the service that is provided. Documentation in respect of risk assessments showed a marked improvement. The home continues to be well managed with staff providing a high standard of care.

CARE HOMES FOR OLDER PEOPLE Teesdale Lodge Nursing Home Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS Lead Inspector Katherine Acheson Unannounced 7 July 2005 09:15 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Teesdale Lodge Nursing Home Address Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS 01642 612821 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cleveden Care Limited Susan Wyer Care Home 44 Category(ies) of OP Old age (44) registration, with number of places Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15/09/2004 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 wash basin, 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 B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection started at 9.15am and lasted for four hours. Five residents two visitors, two staff and the Manager were spoken to during the inspection. Numerous records including care plans, policies and procedures, maintenance records, staff records and complaint records were examined. What the service does well: What has improved since the last inspection? Requirements identified at the last inspection have been addressed The Manager has developed a quality assurance system, questionnaires have been sent out to residents and relatives to seek views on many areas o the home and the service that is provided. Documentation in respect of risk assessments showed a marked improvement. The home continues to be well managed with staff providing a high standard of care. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 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 B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home is able to meet the assessed needs of residents living at the home by ensuring that a thorough pre-admission assessment is carried out. EVIDENCE: Residents are admitted to the home following an assessment that is carried out by a Social Worker or Health Care Professional. Qualified staff at the home also carry out a pre-admission assessment on all prospective residents to ensure that the home can meet the individuals assessed needs. Residents spoken to during the inspection confirmed that their care needs were met. One resident spoken to during the inspection said, “Staff are very good, they are very respectful and will do anything for you”. The home does not provide intermediate care. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 10 The home provides a high standard of care and ensures that the health, personal, and social care needs of residents are met, however further development is required in respect of care planning. EVIDENCE: Three plans of care were examined during this inspection. Care plans examined were found to be fairly comprehensive, well presented and evaluated on a regular basis. Files examined contained a record of visits carried out by chiropodists, G.P’s, opticians and other health care professionals. Records examined confirmed that the home was on occasions using core care plans, which are pre-printed plans of care for specific problems. Two of the three plans of care examined were observed to have the same plan of care in place in respect of hygiene, despite the fact that the residents were of different sex, age, and that one of the residents required complex nursing care. Care plans were not individual to the resident. A discussion took place with the Manager in respect of this. Not all care plans contained signatures of residents or their family to confirm that they had been involved in drawing up the plan of care, nor were there signatures to confirm that they had been involved in reviewing the plan of care, however copies of multi disciplinary reviews were available. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 10 The Manager carries out an effective monthly audit of the residents accident record and risk assessments are developed for those residents identified at risk. Residents spoken to said that they are treated with respect and provided with dignity. One resident said, “staff put themselves out to help”, another said, “The staff in here look after me great” Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 Resident’s daily lives are enhanced by the social activities provided by the home and the welcome it extends to residents visitors. EVIDENCE: The home employs an Activity Co-ordinator twenty-five hours a week to plan and provide a programme of activities and outings. Residents spoken to said that there were regular activities at the home. Residents spoke of quizzes, bingo, sing a longs, trips out and entertainers coming into the home. One resident spoken to during the inspection said that he had been a keen gardener and that he is continuing to enjoy this since he has moved to Teesdale Lodge, he said, “I’ve enjoyed doing the weeding and watering of plants”. One relative spoken to during the inspection said, “I like the quiz afternoons”. Residents spoke of past trips to Museums and a trip to Eden Camp that is planned for August. Residents spoke highly of the Activities Co-ordinator one resident said, “She does an excellent job”. One resident spoken to during the inspection said that he enjoyed the activities that were provided by the home, however he would like to do more. This same resident said that the home do plan activities, however activities are limited due to the lack of interest and the fact that from some residents are unable to join in due to their medical condition. The Manager said that the home support residents to practice their religion and that visits from clergy are available to the home. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 12 Two relatives spoken to said that contact with family and friend’s is encouraged and that they are made to fell welcome on their regular visits to the home. One relative said, “I feel like part of the family”. This same relative went on to say that every Sunday staff set a separate table within the main dining area of the home so that he can enjoy Sunday lunch with his wife. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has an effective complaints procedure, which enables residents to make any complaints they feel necessary. EVIDENCE: The home has a clear complaints procedure, details of which are also available in the statement of purpose and service user guide. Residents interviewed during the inspection said that the Manager and staff at the home are approachable and if they felt the need to complain then they would do so. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: The above standards were not inspected, however a recommendation highlighted at previous inspections in respect of replacing the carpet in the lounge designated for those residents who wish to smoke had been addressed. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: The above standards were not inspected. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 38 The home ensures that the health and safety of residents is safeguarded and protected. The home seeks the views of residents and their families to ensure that it is managed with their best interest. EVIDENCE: The Manager has developed a formal quality assurance system to send out to residents and relatives on an annual basis. Records were available to confirm that the home have commenced this process. A discussion took place with the Manager regarding publishing the results of the survey. It was highlighted at the last inspection that care staff should receive supervision at least six times yearly. Records were examined during this inspection to confirm that supervision was taking place. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 17 The home operates a rolling programme of servicing appliances and equipment. Records examined at random confirmed that the homes fire extinguishers, fire alarm and gas boilers are serviced on a regular basis. Mandatory training is provided to staff working at the home on a regular basis. Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x 2 x x x x 3 Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 19 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Care Plans must be individual to the resident and include capabilities and limitations. Care plans must clearly state assistance required from staff The Manager must develop a system to ensure that residents and their relatives sign when devloping or reviewing their plan of care The results of the residents and relatives survey must be published and made available Timescale for action 30th September 2005 30th September 2005 30th october 2005 2. OP7 15 3. OP33 24 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 OP28 Good Practice Recommendations The Manager should continue to work towards achieving 50 of Care Assistants trained to NVQ Level 2 in care or equivalent by 2005 Teesdale Lodge Nursing Home B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit B, 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 B51-B01 S209 Teesdale Lodge V235044 070705 Stage 4.doc Version 1.40 Page 21 - 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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