Inspection on 06/10/05 for The Lodge

This inspection was carried out on 6th October 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 29/10/07

The Lodge 01/11/06

The Lodge 16/02/06

The Lodge 21/01/05

The Lodge 14/10/04

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

CARE HOMES FOR OLDER PEOPLE The Lodge Copdock Ipswich Suffolk IP8 3JD Lead Inspector Mike Usher Announced Inspection 6th October 2005 10:00 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 DS0000024437.V258607.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Lodge Address Copdock Ipswich Suffolk IP8 3JD 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) 01473 730245 01473 730245 Gemini Care Limited Mr Michael Bailey Care Home 29 Category(ies) of Dementia (29) registration, with number of places The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st January 2005 Brief Description of the Service: There has been a residential home caring for older people in the present building for many years. The current owner, Gemini Care Homes Ltd (a company owned wholly by Mr Abbas), was registered in December 1997. The Home is a large country house set in its own mature gardens, situated on the main road running through the village of Copdock. The County Town of Ipswich is a few miles to the north and the home is near to the main A12 road from London. The ground floor accommodation comprises; kitchen, 2 double bedrooms (one with en suite WC), 4 single rooms (one en suite WC and one with en suite WC and short bath), dining room and ‘quiet’ room with further seating, large lounge, one bathroom with WC, shower room with WC, single WC, hairdressing room, access to shaft lift and stair case with stair lift. On the second floor there are a further 11 single rooms (10 with en suite WC) and 2 double rooms with en suite WC, bathroom with specialist assisted bath (and WC), shower room with WC, separate WC and sluice. The laundry and food stores are located in outbuildings. There is a large, wellkept mature garden surrounding the house, with level access throughout for residents’ use. The perimeter of the grounds has been made secure to allow residents to move freely within the boundaries safely. An extensive refurbishment of the accommodation carried out in 1998 encompassed a new kitchen, bathrooms and WC’s, and a complete redecoration and re-carpeting of all areas of the home. During the work it was possible to greatly reduce the changes in floor level which had affected much of the first floor. The adjoining Coach House has been converted to provide accommodation for a further 6 residents. Subsequently the home changed its registration to offer care wholly for people with dementia. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection focused primarily on the work currently being undertaken to provide a major extension to the home, but also considered progress regarding previous requirements and recommendations, other significant developments, and management and staffing issues. The inspection used observation, examination of records and other documents, discussions with management, staff, and residents, and made use of information provided by the home prior to the inspection visit. The service has consistently improved over the last two years, and the home has now achieved a very good standard of care. The new extension and accompanying plans indicate a continuing commitment to providing a quality, specialised service, caring for people with dementia. What the service does well: What has improved since the last inspection? A major enlargement of the home is underway and this is designed specifically to meet the needs of older people with dementia. As well as the new building work, the opportunity is being taken to refurbish much of the existing home, with particular emphasis on creating a greater choice of communal areas to enable care to be provided on a smaller, more domestic scale. Staff training and development has continued to focus on the specialist nature of the care provided, and the growing skills and experience of staff and management have ensured that the quality of care provided continue to improve. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 6 The management team now has a more structured organisation, and the turnover of staff has dropped to a low level. The retention of staff is an important factor in providing continuity of care to people with dementia. 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 DS0000024437.V258607.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This area will be examined in more detail in future inspections. These standards have been previously assessed as well met, and during the inspection no concerns were raised or noted. EVIDENCE: N/A The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 Health and personal care is provided in an individual and well planned manner. EVIDENCE: Mr Bailey confirmed that staff guidance on completing medication records has been reinforced and he is now satisfied that the standard is met fully. This aspect will be examined during the next inspection, which will be unannounced. Mr Bailey also confirmed that, in keeping with the person-centred approach now adopted by the home, all care is provided on a personal basis, which has reduced the institutional aspects that often affect care homes, (and highlighted in previous reports) and actively promotes dignity and individuality. The interaction between staff and service users was very positive and inclusive, and supportive of service users’ dignity. The observed approach taken by staff avoided overtly directive assistance, and was not patronising. Service users were treated in a kind and friendly manner that was both informal and respectful. Service users appeared relaxed and confident, and were appropriately dressed. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 10 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 Daily life is relaxed and a therapeutic approach is taken to activities. EVIDENCE: The Assistant Care Manager also acts as the Activities Co-ordinator and has developed a well-structured activities programme. A pictorial record is kept of many of the activities and social events, such as the recent celebrations of a service user’s 100th birthday. There is usually an organised activity each afternoon, and these are specifically designed to be therapeutic for people with dementia. In the case of the afternoon of the inspection it was a reminiscence session in the main lounge. Specialist training for staff in caring for people with dementia has helped to create a positive and inclusive approach to activities, and this includes carers working with service users around everyday tasks for individuals, as well as more formalised group activities. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 11 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): This area will be examined in more detail in future inspections. These standards have been previously assessed as well met, and during the inspection no concerns were raised or noted. EVIDENCE: N/A The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 12 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 home provides a good standard of accommodation that is well maintained. Current work in progress will significantly improve then environment. EVIDENCE: On the day of the inspection, the existing building (including the Coach House) was clean, tidy and in good order, with no odour. Refurbishment work already carried out on this part of the home includes redecoration and re-carpeting of the dining room, with work continuing on the ground floor corridors. The new extensions represent a considerable investment in the home. As well as two new ground floor wings, providing bedrooms with en suites, the communal facilities will be greatly extended to provide a number of communal rooms for service users. This will enable care to be provided in a more flexible environment, and on a smaller scale, which is more conducive to caring for people with dementia. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 13 The new bedrooms are all at least 12m2 and have en suite WC’s. The windows are large, with low sills to allow service users to sit comfortably and enjoy the view. Underfloor heating has been provided throughout which provides a more uniform heat that is comfortable right down to floor level. This also eliminates the need for hot piping and radiators, which also allows full use of wall space. The heating has separate controls in each room to provide for individual needs and preferences. The building work is being carried out most carefully with regard to minimising the disturbance to service users, and keeping working areas secure. The work will include a new perimeter fence and garden, new laundry, and other improvements. There is some staff accommodation in the grounds, and also nearby, which provides a good level of support to the home in emergencies. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Staffing levels are satisfactory. There is a good training programme, and recruitment processes are satisfactory although care is needed to ensure that all checks are carried out promptly. EVIDENCE: On the morning of the inspection there were 5 carers on duty with the same number on in the afternoon but with the addition of an Activities Co-ordinator. At night there are 3 waking care staff. It is planned to appoint a Night Manager to ensure greater consistency of care throughout the night, as appropriate to the needs of individual service users. This is an exemplary approach to providing 24 hour care. Like many other care homes, the Lodge has recently been recruiting care staff from abroad. The owners have employed a specialist agency to assist with this, and an examination of employment records confirmed that proper documentation is kept, including police checks in country of origin, proof of identity (including a photograph), and a Criminal Records Bureau check. However, it was noted that in some cases the required POVAfirst check is not obtained before the carer starts work. It is essential that all staff receive a satisfactory POVAfirst check prior to being employed, even if it is assumed that they have not previously worked in Great Britain. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 15 As part of the recruitment process for foreign workers, the management test applicants regarding language and communication skills to ensure that they are able to communicate effectively with service users. It was noted during the inspection that the turnover of staff has dropped consistently in recent months and is now very low. This provides a consistency of care that is important in caring for older people with dementia, and a good level of retention also reflects positively on the management of the home. Staff have recently completed training in Fire Safety, Moving & Handling, and First Aid. A new programme of training in caring for people with dementia will start in November. In addition, training has also been provided by the supplying pharmacy regarding medication administration, and the local community nurses have provided sessions for staff on Infection Control and Diabetes. Future training has been arranged with the local health service dietician. Nine carers have now achieved the National Vocational Qualification at Level 2, which is widely recognised as the most suitable basic qualification for care staff. The current qualification level represents 40 of the care force. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 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 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, 32, 37, 38 The home is well managed and run in the best interests of the service users. EVIDENCE: The management team has been strengthened recently with the appointment of a Care Manager, and the creation of an Assistant Care Manager post, in addition to the Senior Carer posts already in place. In addition, the manager, Mr Bailey, has recently completed the NVQ 4 Care Managers’ Award and continues to strengthen his experience and knowledge of managing services for people with dementia. Records and documents examined on the day of the inspection were in good order. The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A 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 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X x 3 3 The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19 Requirement All staff employed in the home must be in receipt of a satisfactory POVAfirst check before they can be employed. Timescale for action 06/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Lodge DS0000024437.V258607.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 DS0000024437.V258607.R01.S.doc Version 5.0 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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