Inspection on 10/11/06 for The Lodge, Exeter

This inspection was carried out on 10th November 2006.

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, Exeter 06/11/08

The Lodge, Exeter 29/12/05

The Lodge, Exeter 26/07/05

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE The Lodge, Exeter The Lodge 22 Spicer Road Exeter Devon EX1 1SY Lead Inspector Rachel Doyle Key Unannounced Inspection 10th November 2006 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, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge, Exeter Address The Lodge 22 Spicer Road Exeter Devon EX1 1SY 01392 271663 01392 431545 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) Elizabeth Finn Homes Ltd Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th December 2005 Brief Description of the Service: The Lodge, close to the centre of Exeter, retains features of what is one of the citys grander houses. It has been extended in the past to provide facilities for those requiring nursing care. Some residents are receiving residential care only and are more able. There are various garden areas, patios, an orchard area and a large courtyard directly accessible from some bedrooms and wheelchair accessible. A major re-building and refurbishment programme is just being completed to provide accommodation for up to 46 service users. A new 22 bedded wing has been built and occupied, and extensive landscaping and refurbishment to the original building. There is a new car parking area at the rear for visitors and staff. The Home is owned by the Elizabeth Finn Homes Ltd, which offers accommodation to people from a professional background on application. The average cost of care is £ 705-785 per week at the time of inspection. Additional costs, not covered in the fees, include hairdressing and personal items such as toiletries, newspapers and magazines and private chiropody and taxis. Current information about the service, including CSCI reports, which are accessible at the Home, is given to prospective residents/their representatives. The Service Users’ Guide and Statement of Purpose are available on request and a copy given to all residents on admission. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Friday 10th November 2006 from 10.00-15.30. There were 23 residents living at the Home at the time of the inspection and this will gradually increase to 46 now that the refurbishment programme is near completion. Three residents were receiving respite care, nine were ‘residential’ and therefore more able and 14 residents were receiving ‘nursing’ care. During the inspection the inspector case-tracked 3 residents, which helps us to understand the experiences of people using the service. A number of other residents were met and spoken with during the course of the day and one relative briefly. The inspector also spent time observing the care and attention given to residents by staff. Staff were spoken with during the inspection, including care staff, ancillary staff and the clinical manager. The general manager was on annual leave. Prior to the inspection a pre-inspection questionnaire was sent to the Home, which was returned in good time by the manager. The inspector also sent surveys in order to obtain their views of the service provided, to relatives, health care professionals, residents and staff. However, relatives and residents contact information was not received until after inspection and responses had not been returned in time for this report. Responses were received from 10 staff. The inspectors toured the premises freely, including all shared areas and the majority of residents’ accommodation. A sample number of records were inspected which included care plans, medication records/procedures, staff recruitment files, service and maintenance certificates and fire safety records. The inspector appreciated the time taken by the clinical manager and administrator to assist with this inspection and the inspector found all staff very helpful on the day, especially as the new refurbished areas were being completed and there was lots of change occurring. What the service does well: All residents spoken with praised the care they received from the staff and said that they were very happy living at the Home. The manager and staff are keen to ensure the well-being and comfort of residents and were seen to treat them with great respect and kindness. Many staff have worked at the Home for many years and provide continuity of care. The environment is purpose built and very homely. Each resident has a doorknocker on their rooms to give them a feel of being in their own homes, with their possessions arranged, as they like around them. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 6 Privacy and dignity is well maintained and residents confirmed that they were treated with respect at all times, commenting that they could live as they wished at the Home. The Hotel Services Department provides an excellent service delivering high quality meals following consultation and regular review with residents. Special needs and diets are catered for sensitively and nothing is too much trouble. The management and staff provide open communication between residents and staff to ensure that residents are involved in the quality assurance process and kept informed and involved with the running of the Home through newsletters, regular residents’ meetings and questionnaires. Care plans included good recording of any short-term health or personal care goals and actions and staff use them as working documents with records reflecting each residents’ needs during the inspection. The complaints procedure ensures that residents are able to be confident that their concerns are heard and acted upon. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from good admission and assessment practice which ensures that the Home can meet their needs. EVIDENCE: The Home brochure and Statement of Purpose both re-iterate that the Home encourages service users to retain as much independence and mobility as possible. Staff spoken to and practice observed during the inspection confirmed this ethos allowing time for residents to maintain independence. Service users spoken to felt that staff were able to meet their needs and that they had the Service Users’ Guide in their rooms. Records were meticulously kept both on paper and using the computer system. There are detailed admission records covering activities of daily living and any residents’ preferences. Admission is by application to Elizabeth Finn Homes Ltd and Home committee. The manager/clinical manager conducts a thorough home or The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 9 hospital assessment and makes a final decision ensuring that the Home can meet the person’s needs in line with existing residents. An emergency admission was being facilitated during the inspection from the hospital and the clinical manager was ensuring that adequate details were obtained over the telephone and that staff on duty were aware and preparing a room accordingly. The Home does not provide intermediate care. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ health needs are well met and evidenced with good multidisciplinary working taking place on a regular basis. Staff offer care in a way that maintains and promotes residents’ privacy, dignity and independence. The medication at this home is well managed promoting good health EVIDENCE: Three care plans were looked at on the computer and their corresponding hard copies. Care plans were excellent and short-term goals and actions were clear. One resident had very detailed records about their hearing problems and how these were being addressed. There were detailed records about any medical tests, preferences relating to life-saving treatment, changes and reasons for increased needs and general health care and risk assessments. Care plans were individualised and staff said that they were used as working documents. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 11 When the inspector met with the three residents who were part of the casetracking process they presented as described in the care plan and all three said that they were aware of the contents of their plans. Two others said that their key workers had gone through their plans with them. All care plans were well reviewed on a monthly basis and involved the resident and/or representative. The GP does a weekly round at the Home and there were excellent records about health care professional visits to the Home and follow up. Plans included residents’ preferences, what they can do and what they need assistance with, dressings, social histories and regular progress graphs relating to dependency levels. During the inspection staff were seen to be very attentive to residents’ needs ensuring that new staff used residents’ preferred names and that residents were encouraged to do as much as they could. Staff knocked on residents’ doors prior to entering and also acknowledged and greeted everyone they met around the Home. The clinical manager and staff were showing particularly sensitive and gentle care to one resident and their family. One resident said that they like to make their own dentist appointments and 3 others said that their every health need was very well met by lovely staff. They said that they enjoyed the company of staff of different ages and that all staff were respectful and added to the homely and friendly atmosphere. One resident said that their GP had praised the Home and that they agreed that ‘it couldn’t be better’, they were very thankful to have got a place after a long wait. The medication system was looked at. Medication is kept securely in designated clinical rooms. All medication was well stored and in date including controlled drugs and fridge stored medication. Fridge temparatures were kept up to date. Medication Administration Records were correct, including correct use of codes if medication not given and staff were seen to ensure that residents took their medication prior to signing that it had been administered, other than for one resident who said they would keep the tablet for later. Medication training for staff also includes competency checks such as on the topic of controlled drugs and storage. There is a Homely Remedies policy, which has been discussed with GP surgeries. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social activities are well managed, creative and provide choice and interest for those living at the Home. Residents are able to exercise choice and control over their lives. Residents’ contact with friends and relatives is encouraged and facilitated by staff. The provision of meals in this Home is excellent, offering quality, choice and variety and catering for special dietary needs in a sensitive manner. EVIDENCE: The activity organiser is now full time and very enthusiastic and continues to consult all the residents about what activities they would like and offering suggestions. There are detailed individualised residents’ records and the November activity programme includes card games, coffee mornings, beetle drive, poetry, scrabble, Remembrance Day, craft and games afternoons, quizzes, pamper sessions, and current affairs. There are external trips weekly The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 13 and the Home tries to offer these to different residents to ensure that all residents who wish to go out are given the opportunity. The Home has keys to any public disabled toilet for use on external trips for residents. Residents spoken to said that activities were usually enough, although one would like to go on a short trip. The activity organiser will monitor this. The Home has their own minibus and driver. This month trips included a visit to Exeter Cathedral, museum trip and to a local Farm Shop complex. A new ‘Lodgical Chronicle’ newsletter has been launched and residents spoken to said that they enjoyed the fun at the Home. Records relating to relatives phone calls were clearly listed and issues relating to visits. Visiting times are open and relatives were seen popping in and out during the inspection. There is also relatives’ accommodation for those who need to stay if necessary. Resident choices are respected such as choices relating to routines and personal care and access to the grounds in relation to risk assessments. Residents had chosen the Home to subscribe to Devon Today rather than Devon Life magazine and one resident had suggested ‘whitebait’ for the menu which was being accommodated. All residents spoken to felt that they could live as they wished at the Home, one resident had just been out to meet a friend for coffee. Residents were seen to make choices such as where they wanted to eat, choosing to have a ‘day in bed’ and to go out with relatives for lunch or entertain in their rooms. One resident said that it was good to be able to choose when to spend time alone sometimes, another said that they felt part of a family. The Hotel Service at the Home caters for individual tastes and provides an excellent varied menu and delivery to a very high standard. These staff also provide all coffee and tea services moring and afternoon so that care staff are free to attend to residents. Residents dine in the new large dining room. Tables are beautifully laid out with flowers, napkins and condiments and staff offer a waitress service assisting with dishing up vegetables, which are placed on every table for residents to help themselves and offering seconds. On the day of the inspection residents were having Salmon Pie and Hollandaise sauce or they could choose from a wide range of hot or cold alternatives. There was a large selection of desserts, followed by cheese and biscuits and coffee or tea. Lunch was a jovial affair and residents spoke very highly of the food saying that it was difficult to resist such lovely food. The kitchen staff ask residents their views and suggestions for menus on a monthly basis as well as within the annual quality questionnaire. The kitchen is newly refurbished and well organised and hygenic. Relatives are welcome to order a meal with a resident for a nominal fee. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are handled well and recorded thoroughly giving residents confidence that any issues raised will be taken seriously. Residents and staff are protected from abuse by sound policies and procedures. EVIDENCE: The complaint book was seen and any issues raised by relatives or residents were seen to be logged and actioned appropriately with the residents’ needs being the focus. There is a comprehensive complaints procedure which is accessible to residents and visible. This includes ‘what do you want to achieve?’ section for complaints to be clear about their options. The complaints form and any relevant correspondence is all in one place. Complaints are audited quarterly. All residents spoken to felt that they were listened to by staff. They said that even small concerns are quickly dealt with. Two relatives said that they never had any complaints and that the Home was wonderful. All staff have attended a training programme for Protection of Vulnerable Adults. The Alerters’ Guide was at the nurses’ stations and No Secrets training video, which staff said that they had seen. There were clear records relating to Abuse to Staff issues and appropriate multidisciplinary involvement. One carer The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 15 told the inspector that they had studied abuse issues within their NVQ and other staff were also aware of the reporting procedures. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are provided with safe, comfortable and clean surroundings decorated to a very high standard. EVIDENCE: Many residents said that all staff had been wonderful coping with the difficulties during the refurbishment and how lovely their rooms were. Following a major refurbishment, which has increased resident capacity from 42 to 46 overall, a 22 bedded wing, Spicer, has been purpose built, Robeson and Rainbow wings have been completely refurbished as has the Old House all retaining original features of the Victorian building such as three restored Grandfather clocks. There are many communal areas such as a large airy dining room, various small sitting rooms, a conservatory, which will hold a library and kitchenette, a large lounge/reception area with security measures and beautifully landscaped, patioed and planted gardens. All areas are The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 17 wheelchair friendly, including a wheelchair entrance and there are passenger lifts throughout the development. All areas have been well thought out to cater for residents’ needs with new furniture and soft furnishings. Residents are able to choose the décor and have been consulted on many of the changes taking place such as paintings that they prefer in the communal areas and choice of rooms such as one where a resident can see their relative getting off the bus. There will be a Devon corner including local magazines. There is a team of domestics led by the Team Leader for Domestic Services and all areas of the Home were immaculate but remaining homely. There is a comprehensive infection control policy and good provision of gloves and alcohol gel. The top floor of Old House is designated to staff only where there are staff changing and shower facilities and a training room and kitchenette. There are plenty of sluices in each area and substances which could be harmful to health were stored safely. Some residents praised the work of the laundry staff saying that often their clothes are ready the same day. The laundry has been refurbished and is a large room with clear ‘dirty’ and ‘clean’ areas in the basement. The maintenance man also has a large workshop in the basement and residents may ask for odd jobs to be done such as hanging pictures. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from having skilled experienced and friendly staff that have a good understanding of their needs. The procedures for the recruitment of staff are robust and consistently protect residents. EVIDENCE: There were the clinical manager, administrator, activities co-ordinator, kitchen staff, laundry, two Registered General Nurses and four carers on duty at the time of the inspection to care for 23 residents. At present most residents are in Spicer wing but the Home will look at deployment of staff and levels as the Home fills up, now that refurbishment is almost complete. Call bells were answered promptly and residents confirmed that this was always the case. The Home has a paging system, which means that staff can focus on the individual more easily. Residents commented that ‘the staff are wonderful, so kind, marvellous and always cheerful’ as they were during the inspection. The Home has 13 carers, 10 who have achieved National Vocational Qualifications (NVQ) 2 or 3 qualifications including some bank staff. The Home does not use any agency staff to ensure consistency of care and many staff have worked at the Home The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 19 for many years, some between 20 and 30 years resulting in a stable staff team. Staff are encouraged to achieve NVQ including ancilliary staff. One staff member said that they ‘had got the learning bug’ and were enjoying the training in their field. Staff spoken to throughout the inspection said that ‘they were very lucky to work here’. One staff member said that ‘it’s the residents that count’, and a lovely rapport was seen between staff and residents such as ‘anything I can do for you’. Some staff surveys said that staff would like more communication between night and day staff, all other comments were positive. All staff said that they had completed a Home induction training programme on starting employment. The Home has recently employed a new maintenance man who is currently undergoing an induction programme. Staff individual training files were looked at and included a wide range of relevant training in addition to mandatory training. Staff said that they could choose what they wished to go on such as Parkinsons study day, nutrition, palliative care and conferences. Three staff recruitment files were inspected including newly appointed staff. The Home currently recruiting due to the increase in resident accommodation. Files were clear and organised with checklists and photographic identification. All files contained the required documentation such as Criminal Records Bureau disclosures (CRB), full application forms and two references. New staff had attended the 2 hour induction talk followed by shadowing shifts with the clinical manager. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are reliable systems in place to ensure the good health and welfare of residents. EVIDENCE: The newly appointed manager, Deborah Skinner, qualified as a Registered Nurse in 1993 and following 4 years as a Clinical Link Nurse in the Community went on to manage care homes, including a 64 bedded unit for the elderly and those living with dementia. She is currently applying to be Registered with CSCI as the manager for The Lodge. The Home has a corporate quality assurance policy and the bi-annual questionnaires are being gathered from residents at present. These can be The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 21 anonymous if residents wish. Ten have been returned so far and these are very comprehensive, including housekeeping, catering ‘are there any cakes you would like?’ with answers such as ‘I would like some jam doughnuts’, home routines and night-time care with all being positive so far. When these are collated the findings will be sent to CSCI. There are regular staff and residents’ meetings and minutes were seen. Residents clearly are involved in the running of the Home even down to which magazine residents wish the Home to subscribe to. The Home Committee also meet regularly to discuss issues which may affect residents. Staff spoken to said that they felt well supported by management at the Home. There have been regular staff meetings since the new manager’s appointment and the manager is very visible at the Home with an open door policy. The Home has a computerised communication system for staff and any issues, new policies etc are posted to ensure that staff are kept well informed. There is a very low staff turnover and staff are obviously very happy working at the Lodge. All records were up to date and there was strong evidence that staff and residents are listened to, and valued. The manager was mindful that staff would continue to need support as the residents’ numbers rise from 18 to 46 in the next few weeks especially as the Home has been running with high staffing levels since the commencement of the refurbishment. During the major refurbishment period all residents spoken to and who replied to surveys felt that the management and staff had consistently kept them informed as to the progress and how any changes would be managed. Residents have been fully involved in the choice of décor and uses of rooms such as the proposed video library, choice of paintings, colours and hotel services have maintained a very high standard throughout the disruption. Residents had enjoyed exploring the new areas once they were made safe. Residents have been able to choose whether to move to remain in the new build or to move back to the refurbished accommodation. They were looking forward to the official opening. All safety regulations and standards relating to the premises were adhered to by Elizabeth Finn Trust and this also refers to the newly refurbished areas. Three residents’ financial records were looked at and found to be correct. These are checked monthly and any entries are signed by two staff. Only the manager or administrator has access to the safe. The Home is not an appointee for anyone and relatives or representatives manage these for residents. Residents may manage their own finances if they wish and some do. All residents’ financial skills and wishes are recorded in their care plans. The care plans encourage independence. Some residents like to see their accontants and solicitors in their rooms and make their own arrangements. For example one resident arranges their own dental appointments. Monies are kept in named individual pockets in the safe with any receipts and staff can go shopping for residents if they need something. Records are clear and itemised. Residents are advised to keep up to £100 only at the Home. This is covered under general Home insurance. There is lockable storage available in all The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 22 bedrooms so that residents can keep money readily available to them at all times. All fire equipment was checked appropriately. The fire log book was clear and any teething problems relating to the refurbishment had been dealt with immediately. Fire risk assessments were comprehensive and included upholstery, smoking and training with clear zones identified. Windows are all fitted with safety restrictors and radiators are covered. Accident records are computerised as well as on forms with the care plans and these are looked at to ensure that any issues that these raise are dealt with. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 23 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 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x 3 x x 3 The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 24 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. Standard Regulation 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 OP9 Good Practice Recommendations It is recommeded that staff administering medication ensure that residents take their medication prior to signing that it has been administered. This refers to checking that residents are not keeping any medication to take at a later time than that prescribed. The Lodge, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Devon Office Unit D1 Linhay Business Park Ashbuton Devon TQ13 7UP National Enquiry Line: 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 © 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, Exeter DS0000064453.V312941.R01.S.doc Version 5.2 Page 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. 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