Inspection on 14/07/05 for Terrington Lodge

This inspection was carried out on 14th 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.

Other inspections for this house

Terrington Lodge 17/03/09

Terrington Lodge 20/02/07

Terrington Lodge 19/05/05

Terrington Lodge 14/12/04

Terrington Lodge 08/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Terrington Lodge Lynn Road Terrington St Clements Norfolk PE34 4JX Lead Inspector Chris Handley Announced 14 July 2005 9.30am 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. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Terrington Lodge Address Lynn Road Terrington St Clements Norfolk PE34 4JX 01553 829605 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) Mr Jaswant Singh Beeharry Mrs Isabel Beeharry Miss Lisa Farr Care Home 25 Category(ies) of Old Age (25) registration, with number of places Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home may admit one service user who is under 65 years of age, who will be named in the Commissions records, until 28th February 2006. The home can accommodate up to 25 older people. Date of last inspection 19 May 2005 Brief Description of the Service: Terrington Lodge is a residential care home registered to provide care for 25 elderly people. The home is a detached building of traditional design, which has had a large wing added. There are 19 single rooms, and 3 double rooms. There is a large lawn at the rear of the home, and a car park at the front. There is an ornamental fountain in the front garden and a number of large mature trees. The Registered Proprietors are Mr & Mrs Beharry, and the Registered Manager is Miss L Farr. The home situated in the village of Terrington St Clements, which is approximately is ten miles from Kings Lynn. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out as part of the annual inspection programme. Preparatory work had been previously undertaken. A total of 7 comments cards have been received. On the morning of the inspection there were 24 residents in the home, 6 of whom were interviewed by the Inspector. A total of 9 staff, plus the Manager, Deputy Manager, and Proprietors were on duty during the process of the inspection, 5 members of staff were interviewed, by the Inspector. A wide range of records, polices, procedures and care plans were seen and examined. The Proprietors Mr and Mrs Beeharry, the Manager, and Deputy Manager, were present during the Inspection. The Deputy Manager accompanied the Inspector on a tour of the home. What the service does well: *Provides detailed information to prospective residents and relatives , which gives them a comprehensive picture of the home, and the services provided *Detailed preadmission assessments are undertaken which ensures that the home can meet the needs of the prospective residents. *All residents have a detailed care plan, so that care needs can be assessed, planned, implemented and reviewed. *The medication system of the home is effective and safe. *The home provides a good catering service, with variety and choice to meet the residents’ needs. *Staff provide a high quality of individual care. *The home has good staffing levels. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 6 *Residents spoke highly of their rooms which are of a high standard, they are individually furnished to meet the residents’ needs and wishes. *The home provides a well managed supervision programme which sets the training needs of staff in progress. What has improved since the last inspection? 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. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 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 Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 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) 1 & 3 The home provides all prospective residents/relatives copies of the home’s Statement of Purpose, and Service Users Guide. A pre-admission assessment is carried out on all prospective residents to ensure that the home can meet their needs. EVIDENCE: A copy of the Statement of Purpose, and Service Users Guide were seen by the Inspector. The document is clearly set out, and is now in a larger print, following a recommendation made at the last inspection. This step will assist those residents who may have poor sight to read the document. The Manager is making a small number of additions to the documents as part of the development of Quality Assurance in the home. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 9 Pre-admission assessments are carried out by the Manager. The document seeks a wide range of information which when completed would then enable the Manager to make a decision as to whether or not the home can meet the prospective residents’ needs. As part of the mental health assessment element the Inspector recommends that Depression be added, as this can be common in old age.. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 10 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) 7,9 &11 All residents have an individual care plan, and they and their relatives are positively part of the care planning process. The medicines system in the home works is safe and effective. Residents are treated with sensitivity and respect at all times, but especially at the time of their death. EVIDENCE: The Inspector read three of the care plans. The documents are clearly labelled “ Private and Confidential”. The Personal details are followed by a full care plan, assessment, plan, implementation and review. Risk assessment is undertaken. A detailed Daily Record is maintained. Nutritional screening takes place. Residents and relatives are involved in reviews of care and the home has the good practice of writing to relatives to inform them of when the reviews take place, some attend others choose not to,’ the Manager said. This written contact with relatives on the part of the home, demonstrates a positive drive to involve residents and relatives in the care of residents. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 11 The writing in these documents is legible, dated, and signed. The care planning documents are kept secure. The Deputy Manager showed the Inspector the medicines system. The home uses a Monitored Dosage System (Boots). When the home first started to use this system there were some teething problems but these have been resolved, and the system works very well . The medicines are kept in a locked trolley, which in turn is kept locked to the wall. Neatly completed records of administration were seen. An ice free drug fridge was seen. All staff who administer medicines have been trained to do so. There are Controlled Drugs in the home , one of which was counted and found to be correct. The records in the “ Controlled Drugs “ register, need to be neater and the Manager is recommended to monitor the entries to ensure that this takes place. There are no residents who self medicate the Inspector was informed. The medicines are reviewed on a regular basis, the Inspector was informed. Care and comfort are provided to residents at all times but especially when they are terminally ill. Their death is handled with dignity and propriety. Their spiritual needs, and rites, are observed. Pain relief is provided in the form of oral medicine, patches, or syringe drivers administered by the District Nurse. The residents wishes with regard to terminal care are ascertained in advance from the residents or family who are very much involved in this decision making process. The religious wishes of residents are carried out. Relatives can stay overnight if they wish. The home has a well-written policy on “The Death of a Service Users,” which was seen by the Inspector. Training in this matter is provided. The residents are never left alone as some one always sits with them. Senior and experienced staff support junior and less experienced staff. Some senior staff have attended an information session at the Funeral Directors, and they found this very helpful and instructive. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 12 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 & 15 The expectations and needs of residents are fulfilled. There is good contact between the home, residents and their relatives, as well as the local community. Residents exercise a wide range of choice in their own lives. The home provides a good catering service. EVIDENCE: Some residents choose to stay in their rooms and read or do a crossword, others choose to sit in one of the communal rooms which have nice views out over the garden. Activities provided include Bingo, Cards, music, and at times entertainers visit. A list of the activities which was seen by the Inspector is pinned up on the notice board. There are trips out arranged to places of local interest. Some young students from the local high school visit the home. The Inspector recommends that training in providing activities is undertaken by a small number of staff. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 13 Visitors can come to the home at any reasonable time, and there is good contact between the residents, their relatives and the staff. Relatives/visitors can be seen in private, though some meet residents in one of the communal rooms if they wish. Late night visiting is avoided, but it can take place by arrangement. Should residents not wish to meet/see a particular visitor this wish would be respected. There is good contact between the home and the community, with visits from groups of children from the local Montessori school, the church choir visits during the year. Children and pets are very popular visitors, the Manager said. All the members of the Management group feel strongly about the positive effect of visitors on the residents. The financial affairs of residents are dealt with by the residents and /or their relatives. The home holds a small amount of personal money on behalf of one resident. This was counted and found to be correct against the record. The money is kept in a container in the safe, which is locked and the key is held by the Manager. Numbered receipts are provided when money is handed in. If families need advice they are put in touch with the “Care Aware “ help line. Residents bring personal possession in with them and a number of these were seen by the Inspector when he interviewed residents in their rooms. Residents have a right of access to their notes but none had chosen to do so, the Manager said. The catering in the home is of a high standard. The Menus were seen and they appear nutritious, varied and interesting, special diets are recorded. Advice would be obtained from the dietician if required, the Manager said. Residents are weighed on admission, and monthly after that. The Inspector was informed of a lively discussion which took place at a residents meeting, which centred around likes and dislikes of particular food, but no definite conclusions were reached. All 8-comment cards spoke well of the catering provided. Residents interviewed, spoke highly of the meals provided. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 14 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) 16,17,&18 The home deals speedily and effectively with complaints. The legal right of residents are protected. Staff are aware of the importance of preventing Abuse. EVIDENCE: The Complaints procedure is displayed in the home, and the residents interviewed knew whom to contact if they had a complaint, telling the Inspector that they would see that Manager or the Proprietors and that they would “sort it out”. The Management of the home believe in dealing speedily with any concerns in an attempt to allay residents worries in a speedy fashion. Residents are enabled to exercise their legal rights, but none chose to exercise their right to vote at the last election. The Manager would facilitate legal advise if required. Staff have had certificated training in the prevention of Adult Abuse. One of the awarded certificates was seen by the Inspector. Staff interviewed by the inspector were aware of what steps to take should they have a concern of this nature. The home has a very well printed document of advice for staff on this matter, which was seen by the Inspector. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 15 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) 19,24,& 26. The location of the home is suitable for its purpose, it is accessible, and safe and meets the needs of the residents. The residents’ rooms are furnished and decorated to a high standard and meet the residents needs. The home is neat, clean, tidy, and free from any offensive odours. EVIDENCE: The home has a programme of routine maintenance, which was seen by the Inspector. The grounds are kept neat and tidy. The car park at the front of the home is well maintained. There are well kept lawns at the rear of the home which provides a quiet sitting out area. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 16 The Inspector was taken on a of tour of the home accompanied by the Deputy Manager and most of the rooms were seen. The rooms were neat and tidy and many have personal items, photos, pictures, ornaments etc. The rooms have been personalised by the resident. Residents have been asked if they want locks on their doors and they have declined, and as the Inspector left their rooms they requested that the door be left open, so the they “could see what is going on”. All the rooms have views out over the gardens. There are window latches on all the windows on the first floor. There are screens provided in double rooms, and in the Inspection dated 19/5/05 it was recommended that they should be replaced with privacy curtains, because of the danger that they represent to the residents of falling over them, The Inspector again recommends that they be replaced, and reminds the Proprietors of the danger that they can present to the residents. The premises were clean, hygienic, and free from offensive odours. The Inspector visited the laundry accompanied by the Deputy Manager. The laundry is sited so that soiled linen is not taken through areas where there is food. There is good natural light in the laundry. There are hand washing facilities in place. The laundry floor is impermeable. There are policies and procedures for the control of infection, and the safe handling and disposal of clinical waste, dealing with spillages, and the provision of protective clothing. The washing machines which have recently been replaced have specified programme to meet disinfection standards. The services and facilities comply with the Water Supply ( Water fittings ) Regulations and the Inspector was shown documentation to this effect. Whilst in the laundry the Inspector saw a large damp area adjacent to the chimney breast, and informed the Proprietor of this at the feed back, and recommends that the Proprietor seek advice on this matter quickly in order that the cause be found and the problem solved. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 17 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) 27, 28, & 30 There are sufficient staff on duty to provided a good standard of care. The home has an NVQ training programme in place. Staff have been provided with a wide range of training. EVIDENCE: The off duty records sheet shows that there are 4 care staff, 2 domestic staff and 2 catering staff on the morning shift. There are 2 care staff plus the managerial staff on during the afternoon shift. There are two care assistants on nights, with back up being provided by the Manager. The Deputy Manager and Manager work a combined total of 80 hours a week – across shifts. In addition to these figures, the Proprietors normally work 32 hours each/days a week, making a total of 64 hours a week. The Manager would bring in additional staff if the need arose. e.g. sickness on the part of residents/staff. There is one member of staff who is under 18 but undertakes domestic duties only. The home has had a good history of providing good staffing levels to ensure that they meet the needs of residents. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 18 There are 2 members of staff who have NVQ II, and there are 7 who are under taking NVQ II. There are 2 members of staff who are in the final stages of NVQ III but this has yet to be verified. There are a total of 20 Care Assistants and when the present group have completed their training it will mean that the home has 9 members of staff that have NVQII which represent 45 of the staff. The Manager, Proprietors and staff are commended for this and are urged to encourage and support staff who are undertaking this training. The home has Induction and Foundation programmes of training in place which were seen by the Inspector. In addition, other training provided includes Food Hygiene, Safe Moving, Care Practices, Fire Prevention training, Health and Safety Training, First Aid, Preventing Infection, and Dementia Awareness. The home is developing a good training programme which meets the needs of the residents and staff safety. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 19 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) 32,33,35, &36 There is a very positive ethos in this home. The home is developing a Quality Assurance System. Residents financial interest are safe guarded. The home has a wide range of records required, which are kept secure. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 20 EVIDENCE: The ethos in this home comes over to visitors to the home. The staff are a hard working pleasant group, who work well as a team. They all share the same values for the residents “Privacy” “Dignity” and providing the best that is possible, at all times. The residents told the Inspector that they thought that staff were very good, and very helpful and that nothing was too much for them, and this was confirmed in the comment cards. The Manager is currently developing an Quality Assurance system for the home. This was seen by the Inspector and she is commended for doing this , and is urged to continue, until this process has been completed. The Manager carries out Supervision for all staff. The supervision covers care practices, philosophy in the home, and career development needs. A record of this process was seen by the Inspector. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 21 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 3 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x 3 2 x 3 3 x x Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 22 N/A 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 Regulation None Requirement Timescale for action 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. 2. 3. 4. 5. Refer to Standard 3 9 12 24 26 Good Practice Recommendations It is recommended that Depression be added to the mental health element, of the pre-adimission assessment document. It is recommended that the Manager monitor the entries in the Controlled Drug book,to ensure that they are neatly written. It is recommended that the home arrange to have a member of staff undertake Training in Activities. It is recommended that the privacy screens be replaced with privacy curtains. It is recommended that the damp patch on the laundry wall be repaired. Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 Terrington Lodge I55 S39909 Terrington Lodge V231246 140705 Stage 4.doc Version 1.30 Page 24 - 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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