Inspection on 09/10/08 for The Lodge

This inspection was carried out on 9th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Lodge 18/10/07

The Lodge 08/05/07

The Lodge 12/07/06

Similar services:

Abbey The

Snydale Care Home

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Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Lodge 29 Bargate Grimsby North East Lincs. DN34 4SN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Theresa Bryson     Date: 0 9 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Lodge 29 Bargate Grimsby North East Lincs. DN34 4SN 01472357774 Telephone number: Fax number: Email address: Provider web address: nicolamcdonagh@bluecroftestates.co.uk Name of registered provider(s): Rabindranath Rommel Selliah,Ramesh Dalton Murugupillai Name of registered manager (if applicable) Miss Nicola Josephine McDonagh Type of registration: Number of places registered: care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Lodge is a 29-bedded care home set near the centre of the town of Grimsby. The building is Victorian in style and retains many of its original features, but has a modern extension and large gardens. The home is equipped to provide care for those with dementia and problems of old age. It will also take up to 4-day care places. The home has a variety of sitting rooms and a dining area. The residents, who are able, can wander freely in the home as there is a digital locking system, for which the code is available, to ensure those less able do not leave the building unescorted, due to the very busy main road, through to Grimsby town centre. The home has bathroom and toilets on all floors and also a shower. The first floor is reached via a chair lift. Fees are Care Homes for Older People Page 4 of 26 Over 65 29 29 0 0 Brief description of the care home reviewed annually. Additional charges include hairdressing and chiropody. A statement of purpose and services users guide is available on request to ensure prospective service users are aware of the services the home can provide. Copies of the last inspection reports can be obtained from the manager on request and is available at all times in the main office. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The site visit took place over one day in October 2008. Prior to this we tracked the evidence we had gathered since the last inspecting and sent out surveys to people who use the service, relatives, staff and other health care professionals. There was a poor response from people who use the service and relatives, but a good response from staff and other health professionals. Whilst on site we looked at a variety of documents and records to support our findings. The home had also sent us their Annual Quality Assessment Audit in good time for us to look at the evidence they had included and decide whether we needed to see other evidence during our visit. Care Homes for Older People Page 6 of 26 The manager was present through out the site visit and both owners near the end. We have reviewed our practice when making requirements, to improve national consistence. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information is available about the home to ensure people can make informed choices about using the services the home provides, prior to going to stay and each person is assessed fully prior to admission. Evidence: Information was available in the form of the Statement of Purpose and Service users guide which detailed the services the home can provide. this was seen in a normal print layout and large print. The manager informed us that it can also be made available in audio form for those who cannot read or understand the written word. it was on display near the main entrance and is given to each person prior to admission which enables people to make informed choices about using the home. Relatives spoken to stated it had helped them make informed decisions about the home and their experience were that the information given reflected their care given. Care Homes for Older People Page 10 of 26 Evidence: Prior to admission the manager or the deputy manager assessed each person individually to ensure the home could meet their needs and to clarify any questions each person or their relative/advocate may have to ask. Documentation was tracked in the most recent admissions care plans and was well written and looked at each person in an holistic way. this was then used as a basis for developing the care plan ,once staff had got to know each person better. the home does not provide intermediate care and therefore Standard 6 is not applicable. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care is evaluated regally to ensure peoples needs are being met and staff understand their expectations and problems and respond in a caring and sympathetic way. Evidence: Prior to the visit to the home surveys were sent out but there was a poor response from relatives, but a good response from staff. Many positive comments were made about the support the home is receiving from the management team and owners. People made such comments about staff as staff know about me, what I want and make me feel wanted. And another says they are ever so good to me. When observing staff during the day they approached and assisted people, with a variety of tasks, in a relaxed and calm manner, taking into consideration their individual needs. The atmosphere in the home was one of calm, with people being allowed to be as independent as they could be, but supported by staff. 4 care plans were tracked in depth, including one of the people who comes to the home for day care. these have now improved over a period of time and gave a very Care Homes for Older People Page 12 of 26 Evidence: detailed history of each person in a legible and easy read way. Full assessments had been completed on each one covering all aspects of their care needs. For example where a person had a history of falls the evaluations are completed frequently with input recorded from other health professionals such as the falls coordinator and District Nurses and auditing of the accident reports. Another care plan detailed problems with some one taking their medication and there was sufficient written evidence to show how the staff had tackled that issue and what support they had received from other health professionals.The care plans looked at each person through a twenty-four hour period and documentation was seen that covered peoples expectations at night as well as day. This has ensured that peoples current needs are being evaluated regularly and where the need arises reviews take place. With documented evidence seen that this has involved all parties and outside agencies. The manager is currently looking at individual staffs knowledge base to enable them to write fuller daily report sheets and expand the day to day detail on each persons care as it occurs. On speaking to staff they appeared to have a better understanding of how the care plans assist them in assessing peoples needs and allowing each individuals expectations to be met. When speaking to some health care professionals who visit the home they said how polite staff were to them and passed information and asked for assistance in an appropriate manner. The staff were good at following instructions and if they did not know would ask and also seek clarity by fact finding about an illness or treatment themselves. Medication records were checked and the home appeared to be using a safe system to administer them to people in the home. All records seen - such as the administration sheets,temperature records and returns to pharmacy appeared to be accurate. this ensures that people can have their medication administered correctly from health professionals instructions to enable them to keep well and be free from risk. The staff could benefit from a more updated version of their reference book on drug names to ensure they keep up to date and ensure all medication given follows the latest information produced by the pharmaceutical industry. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A variety of social activities though out the year ensure that peoples expectations can be met and this is well documented in different formats by staff on a regular basis. Meals are prepared in a safe and clean environment taking into consideration individuals needs. Evidence: The provision of social activities in the home has improved since the last inspection. There was better documented evidence - which had been evaluated - of peoples expectations and wishes. This was balanced with their current needs in the care plan documentation. The Company has now employed a person to coordinate activities each week and be assisted by other staff. The home has forged more links with the Community and there was documented evidence that a local bus service is now used to take people to local events like the Carnival and trips to events in the local park and seaside area of nearby Cleethorpes. Staff keep an individual book on each person in the home so records can be kept of Care Homes for Older People Page 14 of 26 Evidence: not only attendance at events such as entertainers in the home, reminiscence sessions or outings, but also one to one experience such as reading to them. Key worker staff also record in these books their quality time with people and what they have been doing such as talking with them and their relatives, going through photograph albums and sitting and talking. There was ample evidence in peoples rooms of how they have been able to individualize their rooms. One person had lots of ornaments they had brought from home, whilst another room was very feminine with soft toys and beauty accessories displayed. Relatives spoken to said they thought this had helped their loved ones to settle into the home as they could see familiar items around them. The Company has ensured that the signage on doors is clearer to enable people to identify their own rooms for example with a picture of their favorite dog on the door. Whilst on the site visit a number of activities were in progress through out the day. Such as an art class in the morning. One person stated how they were using that session to make Christmas presents for family and friends. And through out the session there was friendly banter among the participants. Another person, who was listening to a special recorded television pro gramme said of how the staff ensure we have fun. Through out the day, even when a couple of people showed some loud and demanding behavior staff approached them calmly, defused the situation so people were not fearful and where necessary withdrew that person to a different area to enable an activity to continue. Comments made about meals were all very positive. Such as food is really good and I get more than enough to eat. The last Environmental Health Officers report in April 2008 showed the home to be good with no requirements made. A brief tour of the kitchen showed food was prepared in a clean and safe environment. Care staff and kitchen staff had a very good knowledge base of individuals dietary needs and were seen to assist people at a meal time in an encouraging manner to ensure their dietary intake was adequate that day. There was a 4-week cycle of menus, which had just started the Autumn/Winter pro gramme. This ensures that people remain healthy and their wishes fulfilled. The Company has ensured that it has replaced equipment where necessary in the kitchen area, such as a new dishwasher and new windows. Auditing processes are in place to ensure it is a safe place to work in and safety standards are maintained to eliminate risk to each person resident in the home. Care Homes for Older People Page 15 of 26 Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A robust complaints system is in place to ensure people can raise issues in confidence. Evidence: The complaints policy for the home as now been reviewed and staff made aware of changes. The new one was on display in the main entrance and staff knew how to direct people to it. Relatives and health professionals spoken to stated that they would be happy to bring any concerns to the notice of the management team and felt confident that issues would be addressed promptly and in confidence. There was one outstanding safe guarding referral outstanding at the time of the site visit, but this had been refereed earlier in the year by the home and was being dealt with by the police. It only concerned the behavior of a relative not a staff member. A second issue had just been refereed but no decisions had been made by the local safe guarding team. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and comfortable environment suitable for their needs. Evidence: We were able to have a tour of the home both accompanied and unaccompanied during the site visit. The Company have continued to make improvements and upheld their own maintenance programme, which was seen and had been in place from February 2008. All communal areas were seen plus all bathrooms and toilet areas and a selection of bedrooms. Each area looked fresh and bright and clean and there were obvious signs where rooms had been redecorated. There was better signage on the doors to enable people to identify different rooms. For example pictures and words showed a toilet plus the word and a desk and the word office. For peoples own bedrooms the signage depended on what they recognized. For example a favorite dogs picture on one, the color blue on another. Since the last inspection the laundry has been refurbished and made safe. All equipment was in working order. Staff spoken to stated we feel a pride in our work and aim to get clothes quickly back to rooms and fresh linen out for staff to use. The kitchen area was also clean and tidy and had benefited from new windows and a new Care Homes for Older People Page 18 of 26 Evidence: dishwasher. The last Environmental Health Officers report in April 2008 gave the kitchen a good report with no requirements in this area. The environment generally was more homely looking and comfortable and people spoken to stated how much they felt at home and relaxed living there. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are looked after by suitably qualified staff who have had safety checks to ensure they safe to work in the home. Evidence: Prior to the site visit people had expressed how at times the home is sometimes short of staff on some shifts and this was also stated during the site visit by the staff. The manager gave us a copy of the staffing matrix which had recently been reviewed and it had also been identified on the live rota. At the time of the visit there were no shortages, but the management team appeared to be addressing these issues as they arose. the home must ensure that sufficient staff are on duty at all times to meet the needs of people in their care. 4 staff personal files were tracked in depth and all records showed sufficient evidence to show the home had made suitable safety checks prior to commencement of employment to ensure they are suitable to work in the home. The training records on all staff had greatly improved and the audit trail used by the home showed the percentages of staff who had completed training in different topics. For example 92 of staff had received manual handling training and 81 training in dementia. New training manuals were seen to be in place and of the 7 staff spoken to all stated Care Homes for Older People Page 20 of 26 Evidence: how they have appreciated the training courses put in place for them and how this had enhanced they way they work and their own knowledge base. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a secure and safe environment adapted to suit their needs and are looked after be staff supervised to do their jobs. Evidence: Since the last inspection the manager has been registered with The Commission for the home and the new relevant certificate was seen to be on display. This has ensured that there is some continuity in the home from a management perspective. The home is further supported by continual help from the Registered Providers who make regular visits to the home, which was verified by seeing the Regulation 26 reports and by speaking to staff and people living in the home. They made such comments as feel supported by management team and the owners visit a lot and make sure they speak to us and residents. Records were also seen to ensure the management team make the environment safe and staff are supervised. Documentation was seen to show that all equipment is in Care Homes for Older People Page 22 of 26 Evidence: working order and certificates are in place. Regular audits are also undertaken in for example bedrooms and of the accidents to see if lessons can be learned to improve care. The home was only holding personal money for one person and this was checked and found to show accurate recording. The supervision records had much improved and were now completed on a regular basis.This enables the manager to see whether staff can do their jobs and where they may need training to ensure they are safe to deliver care to people living there. The quality assurance yearly audit was seen and was very detailed. Showing results of all the audits, giving information in easy to read bar and pie charts, as well as results of surveys from a variety of sources. Action points included ensure peoples views are sought and where necessary improvements made to the service the home gives. This has ensured that people are living in a comfortable environment suitable for their needs. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 To make links with the local community To enable them to fulfill their social, religious and cultural expectations and be a part of the local community and maintain contact with their families. 07/04/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 It would be helpful to staff to have an up to date reference book to enable them to ensure the medication they are administering is appropriate for each persons needs and is being administered correctly. It is good practice to regularly review the staffing matrix against the dependency levels of the people living there to ensure sufficient staff are on duty at all times to meet the peoples needs. 2 27 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!