Inspection on 21/12/05 for The Lodge

This inspection was carried out on 21st December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Lodge 09/11/07

The Lodge 12/09/06

The Lodge 26/04/05

The Lodge 02/11/04

The Lodge 20/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Lodge 8 Lower Road Bedhampton Havant Hampshire PO9 3LH Lead Inspector Eamonn Kelly Unannounced Inspection 21st December 2005 10:30 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 The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 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. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Lodge Address 8 Lower Road Bedhampton Havant Hampshire PO9 3LH 023 9245 2644 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) The Manor Trust (Bedhampton) Vacant Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: “The Lodge” residential home is part of an integrated scheme [run by a trust (Manor Trust) as a registered charity] in the area for the care and accommodation of older people. Accommodation is provided at other locations (The Manor House, The Elms and The Waterloo Room) for people who are more active and not in need of personal care (but who receive companionship and support). The Lodge came into being in 1981 to meet the needs of people who were becoming too frail to live independently at the Manor House/Elms. The home provides accommodation on the ground and first floors. Local amenities, bus and rail links are within easy reach. The home is surrounded by landscaped gardens and is situated in a quiet, scenic area. It has 14 single bedrooms (8 of which have en-suite facilities) and good communal areas. Twenty-four hour care is provided with 2 members of staff (awake) on duty at night. The Trust operates a complex fee structure (covering the full scheme) that is explained in its pre-admission documents (made available to all prospective service users and their supporters). The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection (unannounced, between circa 10.30 am and 03.30 pm) consisted of meeting with the acting manager [Mrs Maureen Gill (a former manager of the home)], members of staff, visitors (including a district nurse) and service users. Some of the homes records were seen (care plan records, medication records, risk assessments). All bedrooms and communal areas were visited. The focus of the inspection was on meeting all residents of the home. A visit was also made to the other premises that are part of the integrated care and accommodation scheme: • • • The Manor House, Edward gardens, Old Bedhampton. The Elms, 2 Lower Rd., Old Bedhampton and The Waterloo Room (attached to The Elms). What the service does well: What has improved since the last inspection? The previous inspection report contained some recommendations that have since been considered by the previous manager and acting manager. It The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 6 indicated that continuous improvements to the premises are carried out. There has been an increase in social activities for service users. Training needs have been addressed but the implementation of training plans has been delayed by the resignation of the previous manager (a new manager, Mrs Janette Waller, is taking up her appointment in January 2006 with an application to the Commission as registered manager pending). 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. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 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 The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 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): 1, 2, 6. Prospective service users and their supporters receive good information about the home’s services and facilities on which to base their decision about taking up residence. However, this information should be presented specifically for the home rather than as part of information about supported living arrangements in other parts of the scheme. EVIDENCE: An informative booklet and supporting information pack (including an outline service user’s contract) is provided to prospective service users and their supporters. The complex fee structure relating to the home and supported living units is outlined. Whilst these provide useful information, a Service User’s Guide to the home should be compiled that applies specifically to the home (rather than generically to the other parts of the service which are not registered with the Commission and are not directly part of the registered home). There may, if necessary, be reference in the new Service User’s Guide to these premises and services but it is likely that the existing brochure adequately covers their relationship with the home from a service user’s point of view. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 9 This process will mean that a new service user’s contract will also be needed (as stipulations in the current information document are deemed part of the contract). The personal contract must be a complete statement of the rights and responsibilities of both parties (the residential home and the new/prospective service user). The Commission (if requested) will provide advice on the draft Service User’s Guide and personal contract. The home does not admit service users for recuperative care, those with nursing care needs or people with dementia or mental disorder. As well as information on this, the revised service user’s guide will contain information on the care needs that can be properly met by the home (in keeping with its current registration and admission criteria). The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 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 the following standard(s): 7, 8. Service users personal and healthcare needs are met. EVIDENCE: All service users at the home were met and most provided a thorough description of the way their care needs are being met. The care plan records seen indicated that service user’s care needs were identified, members of staff knew how each need should be addressed and progress or deterioration was reviewed constantly. The previous inspection report indicated that, whilst the system of care plan recording was in place, there were significant gaps in the information when checked against service user’s disposition at the time (ie. specific problems/care needs were identified but how these were being addressed was not shown). It was agreed with the acting manager that care plan records would be reviewed by the new manager and updated as necessary. A visiting district nurse outlined how GP and district nursing services are available at all times to service users. The acting manager outlined how other The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 11 health services are also provided (including access to an NHS chiropodist). All such contacts and their outcome were recorded in care plan records. Medication is stored securely [locked room and dispensed via a Boots system with MAR (medication administration record) sheets maintained up-to-date]. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 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 the following standard(s): 12, 14. Service users have a range of opportunities to spend their time as they wish (with support and encouragement from staff and visitors). EVIDENCE: All service users were met on this occasion. They provided an outline of how they spend their time at the home and of the opportunities available for mental and physical development. Particularly good and understated decorations for Christmas were in place. There are shared events with the occupants of nearby supported living premises (Elms & Manor House): coffee mornings, outings, garden parties, barbeques. Bingo, passive exercises, birthday celebrations, craft sessions are part of regular activities. Some residents stated that they wish to observe only as they had been retired for many years and wished for a quiet life. Lunch was a very relaxed event: service users spoke highly of their enjoyment of food and meals provided. Visitors take residents out often. Bedrooms contained many personal and private possessions that were definite links with service user’s former lives and occupations. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 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): x These Standards were not assessed on this occasion. EVIDENCE: Whilst these Standards were not assessed, the previous inspection report recommended that appropriate information about AP (adult protection) procedures be made available to all members of staff. This would include the need for staff to be aware of how to identify and report suspected incidences of abuse. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. The premises are suitable for the care and accommodation of frail older people. EVIDENCE: All service users have single bedrooms (8 of which have an en-suite facility). Residents have the use of a telephone and some have their own phones. Call bells have extension leads fitted where necessary. There are comfortable communal facilities. Surrounding landscaped gardens are suitable for use by frail older people. There is plenty of parking available. A stair lift connects service user accommodation on the ground and first floors. Bedrooms were personalised with service user’s possessions. All residents spoke highly of the comfort of the home. There are alcohol-based gels available in holders at some locations (of particular importance near the door of a toilet which has no wash-basin). The premises were clean and tidy and free from odours. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 15 The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Members of staff carried out the work of supporting frail older people in a competent way. However, they need to be supported by opportunities for additional training in specific skills and knowledge. EVIDENCE: As the focus of the inspection was on meeting service users and discussing their views of life at the home, these Standards (apart from observations that confirmed Standard 30 as being met) were not fully assessed. The previous inspection report indicated that there were some shortfalls in staffing arrangements that could have an impact on the safety and security of residents. There were: • Possible low staffing numbers that, on the day, did not meet the needs of people with severe aging problems (ie. there were simultaneous calls for assistance and members of staff had to prioritise which calls to respond to first). There were problems with procedures for recruitment of new members of staff. • The acting manager agreed that these issues had been identified and that the new manager would make any changes necessary to ensure that staffing levels would be proportionate to the assessed needs of service users.. On this occasion, there were 3 care assistants at the home during the morning period and 2 in the afternoon. Two members of staff are on duty (awake) at The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 17 night. In addition to care staff, there was a domestic worker, gardener and chef on duty. The cook’s role is shared with another over 7-day cycles. The acting manager works at the home for 3 days a week. The previous inspection report stated that 13 of the 26 members of staff have an NVQ Level 2/3 in Care. Four others are undertaking this qualification. The report also stated that ten members of staff needed training updates in moving and handling of frail older people and that some needed training in food hygiene, care planning, AP (adult protection) procedures and health & safety (including knowledge of fire safety procedures). The acting manager agreed on the need for the new manager to carry out an assessment and provide the range of training needed. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 Service users live in a home that is well run. EVIDENCE: The acting manager works at the home for 3 days a week. This has benefited residents in the critical period before the appointment of a full-time permanent manager (who will start in January 2006). Service users have continued to be effectively supported. The premises were in a good state of repair. Systems and procedures have continued to be maintained. The Commission has received reports from the home each month (regulation 26) and incidents affecting the safety and well being of service users have been reported (regulation 37). The acting manager stated that the new manager is likely to review issues discussed at previous inspections and those arising on this The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 19 occasion because the home is committed to addressing quality assurance issues. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 20 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 2 2 x x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 x 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x x x x x The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 21 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 OP1OP1 Regulation 4&5 Requirement “The registered person shall produce a written guide which shall include..”. Each service user (and prospective service user) must be given a copy of a Service User’s Guide (that contains a statement of purpose as outlined in Schedule 1 (Care Home Regulations). This pack should include a copy of a personal contract (amended) and revised complaints procedure. Timescale for action 01/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP30OP30 Good Practice Recommendations Whilst this Standard has been assessed as met, in view of the home’s stated commitment to quality assurance measures for the continuing care and safety of residents it DS0000011643.V274456.R01.S.doc Version 5.1 Page 22 The Lodge 2 OP2OP2 is recommended that the new manager assesses the need for provision of any additional training opportunities for members of staff. The progress by members of staff in acquiring the NVQ Level 2/3 in Care qualification is acknowledged. The areas that may need specific attention are: training updates in moving and handling of frail older people, food hygiene, care planning, AP (adult protection) procedures and health & safety (including knowledge of fire safety procedures). A recommendation is also made that staffing levels be re-assessed to ensure that sufficient numbers of trained and experienced members of staff are in place to meet the needs of very frail older people. The current personal contract should be revised and updated so that it describes the rights and responsibilities of both parties. This is important in view of the need for a service user’s guide that relates specifically to the residential home. The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 The Lodge DS0000011643.V274456.R01.S.doc Version 5.1 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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