Inspection on 22/12/06 for The Lodge Nursing Home

This inspection was carried out on 22nd December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 Nursing Home 21/12/05

The Lodge Nursing Home 22/02/05

The Lodge Nursing Home 17/08/04

The Lodge Nursing Home 14/11/03

Similar services:

Bracken House

Sunnycroft

Field Farm House

Edgeview Nursing Home

Church Terrace Nursing & Residential Home

The Forbury

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

CARE HOMES FOR OLDER PEOPLE The Lodge Nursing Home 106 Cannock Road Burntwood Walsall West Midlands WS7 OBG Lead Inspector Mrs Sue Mullin Key Unannounced Inspection 22 December 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 Nursing Home DS0000022347.V321145.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 Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge Nursing Home Address 106 Cannock Road Burntwood Walsall West Midlands WS7 OBG 01543 686188 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) Grangemoor Care Homes Karen Morris Care Home 14 Category(ies) of Dementia (14), Dementia - over 65 years of age registration, with number (14), Mental disorder, excluding learning of places disability or dementia (14), Mental Disorder, excluding learning disability or dementia - over 65 years of age (14) The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. DE Dementia minimum age over 60 years MD Mental disorder, excluding learning disability or dementia minimum age 60 years. 21 December 2005 Date of last inspection Brief Description of the Service: The Lodge Care Home is a small homely run nursing home that admits residents with enduring mental health needs, who enjoy high standards of care and individual attention and require nursing care attention 24 hours a day. There are two lounge areas and a separate dining room along with 14 single bedrooms which all have a hand basin. Hairdressing services are available. There is a passenger lift to both floors. The current company Grangemoor Care Homes has run the home since 1993 and it is set in a semi rural location near to Burntwood village, close to the shops and amenities. There are car parking facilities and a pleasant rear garden. The home is very accessible for visitors. Weekly fees are from £480 up to £650. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this key inspection and the registered care manager was present throughout. The methodologies used to examine the quality of care and the general service delivery, involved a sample inspection of records and systems. A sample tour of the premises was also undertaken, to ensure that the environment was conducive in meeting the needs of the resident group. The inspection process also included informal interviews with residents and staff members to establish their views and opinions, with regards to the services provided at the home. Several of the residents were very confused and unable to make meaningful comments and as such could not contribute to the inspection process. The commission had taken factual information from the pre-inspection questionnaire, completed by the homes care manager and incorporated this into parts of the report. Records relating to the inspection process were readily available and seen to be of good professional standard. There was an open and positive dialogue with the care manager and the overall impression was of a warm welcoming environment, complemented with high standards of care and satisfaction clearly and positively expressed by residents (where able) and relatives. Six CSCI questionnaires had been received from residents; one comment card from a local GP practice and three comment cards from Placements Officer/Community Psychiatric Nurse. Views expressed in the questionnaires are outlined in this report. The home only has 14 beds and the CSCI received eight replies from relatives all with positive comments, which are outlined below: ‘I have found all the staff to be very caring, doing an excellent job with people who need a lot of understanding and help’. ‘Ideally residents need one to one care, having said that there is usually someone on hand when actually needed’. ‘I am very pleased with day-to-day care my mother has in the home. All the staff are very helpful and friendly’. ‘I am pleased with the care and attention my wife is getting’. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 6 ‘This is a well-run nursing home with pleasant and attentive staff. It is easily the best home that my father has been in and he is happy and content to be there’. ‘I feel my fathers needs are well taken care of at the Lodge. My sister and I visit up to four times a week, always unexpected and always made welcome by staff. I can only say that we are totally satisfied with the care our father receives at the Lodge’. ‘This is an example of how a care home should be run. The residents are supervised, dressed properly and very well fed. The staff are welcoming and sensitive to the residents needs’. ‘The Lodge nursing home is an excellent nursing home. I am at the home most days helping with my wife’s care. They do a wonderful job under difficult circumstances’. What the service does well: 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 Nursing Home DS0000022347.V321145.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 Nursing Home DS0000022347.V321145.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): 1,2,3,4,5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract provided which clearly tells them about the service they will receive. The systems for resident (and their representative) consultation in this home are good, with a variety of evidence that indicates that their views are sought and acted upon. Prospective residents are always invited to visit the home prior to admission. EVIDENCE: There is a Statement of Purpose and Service Users Guide, which provides the required information about the home, for prospective residents and their family to make an informed decision about the suitability of the home. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 9 The home initiates a needs assessment prior to admission, usually in the person’s current environment. This consists of the care manager undertaking a thorough pre admission assessment clearly identifying any issues relating to mental and physical health, social needs and so on. When the home confirms it can meet those identified needs, a comprehensive set of care plans are formulated and implemented. Residents are selected carefully into the home so as not to upset the ambience and comfort of the residents already in their care. The home is clear about the types of behaviour that they can manage in the environment of a small home. One comment card completed by a continuing care liaison officer stated ‘ The lodge is an excellent home that manages people with difficult behaviour in a pro-active manner’. Two replies from CPN’s were received one stated ‘ very approachable staff dealing with difficult behaviours, I have no concerns’. The other made no comments but ticked all the positive points. Reviews are held six weeks after the initial settling-in period to confirm the suitability of the placement including the resident’s decision to stay. Prospective residents are always invited to visit the home prior to admission to meet other residents, staff and ‘get a feel for the home’. Service user surveys completed by the residents/relatives (some with the assistance of the staff) stated ‘ I chose the Lodge because local people told me it was a good nursing home and this has been proven right. Excellent care by caring people’. The Lodge Nursing Home DS0000022347.V321145.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): 7,8,10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health needs of the residents are well met with evidence of good multi disciplinary working taking place on a regular basis. The staff have a very good understanding of residents support needs, this is evident from the positive relationships, which have been formed between staff and residents. EVIDENCE: From information provided and following the inspection of a random sample of two residents care records, it was found that there was an individual plan of care for each resident. The plan of care identified how the resident’s needs in respect of their health and welfare were to be met. Care plans had been transferred to individual folders for ease of updating and enabling staff to liaise better with all parties involved in the caring process. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 11 The individual plans of care were comprehensive and informative, outlining for care staff the procedures and observations they were to undertake for each person in their care. Care plans were reviewed monthly or more frequently if required. All required information concerning personal, social and health care needs were in place and adequately and appropriately documented. Care plans contained • Photographs • Risk assessments on pressure area care/nutrition/continence/falls/sleep • Physical and psychological monthly assessments • Short and long term problems • Concentration/memory interaction profiles • Personal hygiene charts • Meaningful daily entries. All care planning documentation was clear, legible, dated and signed. New admissions had base line observations taken and recorded and these were maintained on a regular basis. The manager confirmed that the home had excellent working relationships with their local GP practice and, indeed, the GP had completed a comment card that showed he was satisfied with the overall care provided within the home by adding ‘Excellent home. Caring staff’. Regular appointments were maintained with chiropodists, dentists, opticians to promote residents health care needs. These were clearly recorded. Service user surveys completed by the residents/relatives (some with the assistance of the staff) stated ‘ I receive the medical support I need as the nurse keep trying to get my blood as I am a diabetic’. Another stated ‘ doctors are called if required’. A relative stated ‘ my mother has only been in the home since October but we are all satisfied with the care that she has had since she has been at the Lodge’. Health and safety measures undertaken in the home protect residents and staff from any hazards. Feedback from relatives confirmed that staff were sensitive and respectful at all times. The medication standard was not inspected on this visit but this will be checked at the next inspection. The Lodge Nursing Home DS0000022347.V321145.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 good. This judgement has been made using available evidence including a visit to this service. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Care staff initiated the daily activities programme. Many of the residents were in their 90’s and several in their 80’s and this had an impact on their wishes regarding activities, nevertheless a selection of activities were available. It was apparent that the home endeavoured to meet resident’s daily routine requirements. Residents were observed in the lounges and in places of their choosing some were wandering up and down the corridors. Those residents who liked to spend time in their own rooms were accommodated and monitored. Meals were served either in the dining room or bedrooms according to individual choice and circumstances. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 13 Care plans contained information concerning rising, retiring, bath-times etc. Several residents were seen accessing areas of the home during the inspection. The homes philosophy is to involve family/friends as part of the care need. A relative confirmed he was able to visit in the lounge areas or privacy of his wife bedroom. Advocacy services are accessed as and when required. There was a rotational menu that took account of individual food preferences. Samples of menus were seen that provided a varied and nutritious diet with alternative food choices available. The kitchen was seen and it was found to be domestic in nature and very clean. Fridge/freezer temperatures were recorded daily and food probed and recorded as required. There were cleaning routines in place the effectiveness confirmed in the presentation of the kitchen area. A relative spoke highly of the quality, quantity and varied menus and food provision. Service user surveys completed by the residents/relatives (some with the assistance of the staff) stated ‘ I get a good cooked meal everyday, sweets, sandwiches, snacks etc’. One stated ‘ I need real gravy done properly’. One resident stated that ‘she liked living in the home but thought that Thornton’s toffees should be made available’. The Lodge Nursing Home DS0000022347.V321145.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): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a robust, effective complaints procedure and have their legal rights protected. Staff have a good sound knowledge and understanding of Adult Protection issues which provides a safe environment that protects residents from abuse. EVIDENCE: The home had a comprehensive complaints procedure that was displayed in the main hallway and was, therefore, readily accessible to residents and visitors. The CSCI had received no formal complaints about the home in the last twelve months. No formal complaints have been received by the home and domestic matters are usually dealt with appropriately as they are raised. Service user surveys completed by the residents/relatives (some with the assistance of the staff) stated ‘ I only had to complain once and that was attended to quickly and that was appreciated’. Another stated ‘ I know how to complain to all the staff’. A relative confirmed that if he had concerns he would feel confident raising these with the manager, in fact he had reason to complain soon after his wife was admitted but stated that was dealt with very quickly. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 15 Residents/relatives meetings are held and the care manager confirmed that she saw most relatives on a regular basis should they wish to discuss anything. Relatives support residents in their legal rights. The home confirmed that they would initiate the involvement of an Independent Advocate where required. The home had a Vulnerable Adults Procedure and staff were advised of this during their induction and on-going training. There had been no vulnerable adult issues in relation to service users in this home since the last inspection Sensitive and kindly interaction was observed between residents and staff. . The Lodge Nursing Home DS0000022347.V321145.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): 19,21,22, 24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The home was decorated in a domestic manner and it was clean, comfortable and homely. It was clear that residents lived in a safe, well-maintained environment. There were sufficient bathing and toilet facilities provided to meet the needs of residents. The home was fitted with aids to daily living to maximise resident’s independence. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 17 Bedrooms were personalised and reflected individual preferences and life styles. There were no malodours evident and the environment was bright and airy. The Lodge Nursing Home DS0000022347.V321145.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 good. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. EVIDENCE: There were 14 residents in the home on the day of the inspection and the staffing was considered adequate for the numbers and needs of the present residents. The duty rotas were checked and projected good staffing levels and skill mix. There is a qualified member of staff on duty 24hours a day and on the early and late shift there are two care staff. At night there is one care staff with the nurse. The owners undertake administration work and there is a handyman available when required. Care staff undertake domestic and laundry duties and the home provides sufficient kitchen staff over a seven-day week. The manager confirmed that all mandatory training was up to date. The following training had taken place in the last 12 months: The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 19 • • • • NVQ Fire Safety and drills Moving and Handling POVA Health and Safety levels 2 & 3 in care are ongoing in the home. An inspection of two personnel files found robust recruitment practices including two written references, a POVA 1st check and CRB clearance. Induction is underway for new staff and this is in line with the National Minimum Standards. There was evidence to confirm that regular meetings were taking place at all levels. Staff received regular one-to-one supervision and annual appraisal. The Lodge Nursing Home DS0000022347.V321145.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): 31,32,33,36,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Health and safety measures undertaken in the home protect residents and staff from any hazards. EVIDENCE: There is an experienced and qualified manager in post who takes a positive lead in the home. Karen Morris has undergone her Registered Manager Award and has been working in the home for 12 years. There are regular staff meetings and an open management style evident. A good rapport was observed between all members of the staff team. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 21 A relative engaged in conversation spoke highly of the caring attitude of the staff and commented that they made a good team. There were clear lines of accountability in the home and good leadership promoted professional relationships throughout. Infection control practices were observed to be good with hand washing and protective equipment readily available in relevant areas of the home. The staff were clear about incidents which must be reported to the Commission and all required notifications received. Accident forms were examined and completed in line with requirements. Evidence was seen to confirm that regular supervision was taking place. Personal and confidential records were securely stored in lockable filing cabinets and accessible only to those staff with authorisation to see them. Health and safety aspects checked included: • • • • • • • Fire extinguishers serviced 14/04/06 Hoist check 23/11/06 Sling checked 01/08/06 Passenger lift serviced 02/05/06 Bath hoist checks 14/11/06 Gas service 16/02/05 Fire Alarm test 28/02/06 Staff report an adequate supply of all stocks required. Clinical waste in disposed of in line with infection control guidelines. The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 22 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 3 4 4 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 X 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X X 3 X 3 The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations The Lodge Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Nursing Home DS0000022347.V321145.R01.S.doc Version 5.2 Page 25 - 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!