Inspection on 05/07/05 for The Lodge

This inspection was carried out on 5th 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

The Lodge 18/08/09

The Lodge 02/12/08

The Lodge 09/01/08

The Lodge 11/04/07

The Lodge 19/04/06

The Lodge 28/04/05

The Lodge 04/10/04

The Lodge 17/05/04

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

CARE HOMES FOR OLDER PEOPLE The Lodge Watton Road Ashill Thetford IP25 7AQ Lead Inspector Chris Handley Announced 5 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. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Lodge Address Watton Road Ashill Thetford IP25 7AQ 01760 440433 01760 440043 kaz1509@hotmail.com Mr Kenneth John Squire Mrs Irene Margaret Squire Mrs Karen Syer Care Home 20 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) Category(ies) of Old Age (20) registration, with number of places The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 April 2005 Brief Description of the Service: The Lodge is a residential home registered for 20 elderly people. The home was originally a large detached family home, and it retains many of its original features. There is a large lawn at the front of the home which provides a good sitting area for residents, with smaller gardens at the side and rear.There is a car park at the front of the home. If nursing care is required it is provided by members of the District Nursing team. Any medical or specialist sevices are obtained via the GP. The home is situated on the outskirts of the village of Ashill, on the Swaffham to Watton Road (B1077). The Lodge I55 S27322 The Lodge V229576 050705 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-taking place over 6 hours, and was carried out as part of the annual inspection programme. Preparatory work had been undertaken beforehand & comment cards sent to the service users. 2 comment Cards from residents had been received. On the morning of the inspection there were 19 residents in the home. As part of the inspection 4 members of staff, the Proprietors, 5 residents and 2 professional visitors, were interviewed. The Inspector undertook a full tour of the home. A wide range of records policies and care plans were examined. A total of 18standards were inspected. Mrs Karen Sykes the Manager was present during the inspection. What the service does well: What has improved since the last inspection? * The pre admission assessment has improved since the last inspection. * Care planning has improved, it is more structured. * The upstairs environment has improved since the last inspection. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 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. The Lodge I55 S27322 The Lodge V229576 050705 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 The Lodge I55 S27322 The Lodge V229576 050705 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) 1,2, & 3 The home provides prospective residents with good quality of information about the home, and the services it provides. All residents are provided with a detailed contract/Terms and conditions, on admission to the home. A detailed pre-admission is carried out on all prospective residents. EVIDENCE: The home has a Service Users Guide, and Statement of Purpose, which were seen by the Inspector. They are detailed, well set out and in a print size which could be read by a person who may have poor sight. On the tour of the home the Inspector saw a number of these in residents rooms. One resident told the Inspector that he had been provided with some information when he first came to the home. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 9 A copy of the Terms and Conditions were seen by the Inspector. The document clearly sets out the services which will be provided. The Manager sits with the resident and/or relative and goes through this document with them explaining it carefully to them. The resident/relative is provided with a copy and a signed copy is kept in the office. A detailed pre admission assessment is undertaken on all residents prior to them coming to the home. A copy of this document was seen, it was detailed and comprehensive. This document has improved since the last inspection. When completed it will form the basis for a decision to be made as to whether or not the home can meet the prospective individuals needs. The Lodge I55 S27322 The Lodge V229576 050705 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) 7,8,9 & 10. All residents have an individual care plan. The residents health care needs are fully met. The home has a medicine system which is safe and effective. Residents are treated with respect, and privacy. EVIDENCE: All residents have an individual care plan which is kept in an A4 ring binder folder, which is marked Confidential Information. There are named dividers in the folders which provides quick and easy access to the information sought, and have improved the structure of the care plans. The care plans have the essential elements of Assessment, Action required, Progress and review. Residents and relatives are involved in reviews of care, and this is recorded. The care notes are kept secure. There is a wide range of other documentation including a risk assessment, a Daily record, and visits by medical staff, all of which are of a high standard The management of the documentation in these folders continues to improve and the Manager and staff are commended for this. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 11 The health care needs of residents are monitored on an ongoing basis. All residents have a G.P. The health care needs are met by the staff of the home or visiting professionals by staff from the local Health Centre. If needed the G.P. would make a referral for further advice or consultation. The Inspector recommends that a review of residents who have been at the home for some time who appear to becoming mentally frail is undertaken by the appropriate professionals, and if needed, then the registration category may have to be changed to reflect this. During the process of the inspection the Inspector spoke to two members of the District Nursing Team who were visiting the home to provide care to residents, and they both spoke very highly of the staff and the care they provide. The medicines are kept in a locked cupboard. Staff who administer medicines have been trained to do so. Medicines are clearly recorded. There are no residents who self medicate the Manager said. As part of the last inspection a requirement was made that the home obtain a dedicated Controlled Drug Cupboard, this has since been done and the cupboard was seen by the Inspector. There were no Controlled Drugs in the home on the day of the inspection. The home has a detailed and comprehensive procedure for the reception, storage, administration and disposal of medicines, which was seen. Staff would contact the prescribing G.P. if they had any concerns about the effects of medicine on a resident. The home has a sound working relationship with the supplying pharmacist. The medicine room is due to under go a major upgrading in early Autumn of this year, the Manager said. Privacy forms part of the induction of staff, the Manager said. Residents wear their own clothes, and are addressed by their preferred name.Any form of consultation would take place in private and there are privacy curtains in shared rooms. Both comment cards received state that their privacy is respected, and the 2 residents interviewed said that staff provide privacy when caring for them. The Lodge I55 S27322 The Lodge V229576 050705 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) 14 &15 There is a wide range of choice provided to residents in keeping with their likes, and preferences. The home provides a good catering service. EVIDENCE: The Manager outlined a number of areas in which residents have a choice, i.e. meals, time of getting up, and retiring, bath time, and other features of daily life, where if possible a choice can be provided. The hairdresser who was busy in the home on the day of the inspection, informed the Inspector that the residents choose the style that they want. In the afternoon there is a range of activities provided, including Bingo, Art & Crafts, Singing, Games, Quiz afternoons, and singers are invited to the home. whilst other residents prefer to sit in their rooms and read a paper or a book. Church services are also held in the home. It is recommended that the Manager arrange for one or two members of staff to undertake training in this providing activities, which would build on the activities already provided. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 13 The home provides a wide range of choice in regard to meals. The Menus are neatly printed appear to be nutritious varied and interesting. Special diets are provided and recorded. The Menus have been seen by a Dietician. The Cook, Mrs Squire is fully aware of the need to provide good wholesome food which the resident like, and makes every effort to meet the smallest wish of the resident in regard to food. The Comment Cards state that the residents like the food, and the five residents interviewed, spoke very well of the meals provided. The Lodge I55 S27322 The Lodge V229576 050705 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 has effective practice, and a sound procedure for dealing with complaints. The Manager takes steps to ensure that the legal rights of residents are protected. Staff are aware of the importance of preventing abuse in the home. EVIDENCE: The homes complaint procedure is posted up in the reception area of the home and it is known to staff. The Inspector was shown the homes complaint record book by the Manager, which shows that there have been no complaints since the last inspection. Both comment cards received show that residents are aware of how to make a complaint, and three of the residents interviewed also knew what steps to take if they had a complaint. The Manager believes in dealing with concerns quickly thus preventing small matters becoming matters of serious concern, and it also allays worries quickly. The Manager would facilitate legal advice if this were needed. There are 3 residents who are subject to Power of Attorney the Manager said. Residents in the home have chosen not to vote. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 15 The home has an Adult Abuse Protection procedure which was seen, and staff are aware of this. Any allegation of Abuse would be quickly investigated the Manager said .Staff interviewed knew what steps to take if they had a concern that abuse was taking place, but they were also aware that this might not be obvious at first. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 16 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 improvement work on the ground floor is progressing but is not yet completed. Resident’s rooms are of a high standard. The home is clean, pleasant, and odour free. EVIDENCE: The home is suitably located and there are pleasant grounds at the front of the home with lawns and flower beds. At present the flowers are in bloom, and present a pleasant picture. There are benches for resident to sit out. The home meets with the requirements of the local Fire Services and the Environmental Health Department. For some time the Proprietor has been undertaking a major renovation programme. This is nearly completed, but there remains some plasterwork to be done on the ground floor corridor, and the Proprietor intends to have this completed in the near future. The new carpet for this area has been purchased. Whilst this work is in progress, care is being taken to ensure the safety of residents. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 17 The home has a written plan of maintenance which was seen by the Inspector. The resident’s rooms are of a high standard, and the Inspector inspected seven of them. They were all neat, clean, tidy, and odour free. There is a variety of ornaments, pictures, and personal items. The state of decoration is good. Radiators are protected. Double rooms have privacy curtains. Some residents have chosen to have locks on their doors and appropriate locks have been fitted. All rooms have a call bell, and smoke detector. The upstairs windows are fitted with safety bars. Three residents told the Inspector how much they liked their rooms “ I come here to sit and think” said one. The premises are clean hygienic and odour free. The area where work is carried out, is frequently cleaned to ensure that there is no dust carried to other parts of the home. The home has a laundry which is sited in a manner so that soiled clothing is not carried through areas where there is food. There are hand washing facilities in place. The laundry floor is impermeable. There are procedures for the control of infection, the safe handling and disposal of clinical waste, and the provision of protective clothing, and hand washing. One of the machine has a sluicing facility the Manager said. The washing machines have specified programme to meet disinfection standards The Manager does not know if the Services and Facilities comply with the Water Supply ( Water Fittings ) Regulations, and the Inspector recommends that she make enquires about this matter. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 18 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) 28,& 30 The home provides NVQ training, and this needs to continue. The home proves a wide range of other training which develops the skills of staff. EVIDENCE: There is 1 member of staff who have NVQ level II ,and I member of staff who has NVQ level 3, making a total of .24 , which is a very low figure The Manager is aware of the need to increase the number of staff who have this training and both she and the Proprietors are advised to encourage, and support staff to undertake this training. The home has an Induction and Foundation training programmes (Mulbery House) which were seen by the Inspector. The training programmes are of a high Standard. Other training provide includes First Aid, Fire Prevention Training, Moving and Handling, Health and Safety, Boots Medication Training, Promoting Continence. Training in Adult Abuse Prevention has been arranged to take place in late July, the Manager said. It is recommended that a course in Caring for the Elderly, be arranged for a small number of senior staff. The Lodge I55 S27322 The Lodge V229576 050705 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) 32,33,36 & 37 There is a strong group ethos among the staff of this home. The home is developing documentation for a Quality Assurance System. There is a programme of staff supervision in this home. EVIDENCE: The Manager is clearly the leader of the team. She is an able and effective leader, who believes in sharing things with the team, an example of this being the development of documentation. She has innovative ability, and creativity. The staff told the Inspector that they like coming to work and enjoy the work they do. Her style of caring is also shared by the team, caring, polite, helpful, sense of humour, but knowledgeable, thorough, and conscientious. The Manager is currently collecting information required about the polices of the home as part of the process of applying for Quality Assurance recognition. Although there is considerable work involved she is progressing this matter, and firmly believes that the home will benefit when this process has been completed. The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 20 There is a programme of supervision in the home, which is recorded. The Inspector was shown a completed document used . The forms used for supervision in this home are of a high standard, and they were developed by the Manager, who is commended for this. Supervision covers aspects of practice, philosophy of care of the home and career development. There is a consistent system of monitoring the development of staff. During the process of this inspection a wide range of records were seen. Much of the documentation has been developed by the Manager, and she involves staff in this process, who have consequently that staff have got “ownership” of the documentation. Residents have access to the information held about them. The records are kept up to date and they are held secure. The Lodge I55 S27322 The Lodge V229576 050705 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 x 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x 3 x 2 STAFFING Standard No Score 27 x 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 x 4 2 x x 3 3 x The Lodge I55 S27322 The Lodge V229576 050705 Stage 4.doc Version 1.30 Page 22 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. Refer to Standard 8 Good Practice Recommendations It is recommended that the Manager arrange a reassessment of residents to establish what client group they should now be assessed as, and if there are any changes are needed, to apply for a variation of registration. it is recommended that the Manager arrange for a number of staff to undertake Training in Activities for Older People. it is recommended that the Manager make enquiries to see if the laundry services and facilitied comply with the Water Supply ( Water Fittings ) Regulations 1999. It is recommended that the Manager arrange for a number of senior staff to undertake Caring for the Elderly training, which will enhance knowledge of the elderly. 2. 3. 4. 14 26 30 The Lodge I55 S27322 The Lodge V229576 050705 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 The Lodge I55 S27322 The Lodge V229576 050705 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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