Inspection on 27/07/06 for Totham Lodge

This inspection was carried out on 27th July 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

Totham Lodge 21/06/07

Totham Lodge 08/12/05

Totham Lodge 21/07/05

Totham Lodge 03/03/05

Totham Lodge 22/10/04

Totham Lodge 30/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Totham Lodge Broad Street Green Road Great Totham Maldon Essex CM9 8NU Lead Inspector A Thompson Unannounced Inspection 27th July 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 Totham Lodge DS0000017982.V306180.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. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Totham Lodge Address Broad Street Green Road Great Totham Maldon Essex CM9 8NU 01621 891209 01621 893582 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) Mrs Maureen Page Joanne Page Care Home 28 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (14), Old age, not falling within any other of places category (28) Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Persons of either sex, aged 65 years and over, only falling within the category of old age (not to exceed 28 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 14 persons) The total number of service users accommodated must not exceed 28 persons The registered person must not admit persons subject to the Mental Health Act 1983 or the Patients in the Community (Amendment) Act 1995 One named service user, under the age of 65 years, who requires care by reason of dementia 4th May 2006 Date of last inspection Brief Description of the Service: Totham Lodge is a large fully detached grade 2 listed property. The home was built in 1830 and was originally used as a hunting lodge. It is situated in a rural location accessed by a long private gated driveway. Accommodation is provided on two floors, in nineteen single and four shared rooms. All but two bedrooms have private en-suite wcs. Communal areas comprise of the large inner hallway sitting area, an inner conservatory, a large lounge/dining room and a small dining/sitting room, all on the ground floor. Access between floors is provided by a passenger shaft lift. Totham Lodge is set in approximately seven and a half acres of grounds, all enclosed. Many rooms in the home benefit from views of the grounds and surrounding countryside. Ample visitor car parking is available to the front of the property. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Thursday 27th July 2006. The content of this report reflects the inspector’s findings on the day of the inspection along with information provided by the service and feedback by service users, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions took place with six service users, the registered provider, registered manager, three members of staff and two visitors. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All residents spoken to expressed satisfaction with the care they received and with the quality of the food and accommodation offered. Relatives spoken with were complimentary of the care and support provided to residents by the staff and management team. Questionnaires were left at the home so that relatives not spoken with on the day had the opportunity to make their views on the service known to the Commission. Staff confirmed they received good support from management. They also confirmed that they had been offered NVQ training. Twenty-eight standards were inspected with twenty-four met and four almost met. What the service does well: The home is set in spacious peaceful grounds. The staffing team includes several long serving (in excess of ten years) and experienced individuals offering sound support and guidance to newer employees. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Staff have been trained in medication practices and procedures, but consideration should be given to updating this to cover any recent changes in medications prescribed. The method of recording accidents should ensure confidentiality. Work should be finalised on covering radiators (it is understood covers have been ordered). ----------------------- 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. Totham Lodge DS0000017982.V306180.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 Totham Lodge DS0000017982.V306180.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s assessment format and process was adequate for ensuring that initial perceived needs were identified upon admission. Anyone considering moving into the home may visit to meet residents, staff and facilities, to enable them to assess the suitability of the service. EVIDENCE: The home’s pre-admission needs assessment format was unchanged. This included assessment headings of: mobility, toilet needs, continence, dressing, eating/feeding, washing, bathing, speech, sight, hearing, memory, orientation, awareness, behaviour, social needs, breathing, travel needs, sleep, oral health, diet, weight, dying, personal safety, hobbies. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 9 The assessment is compiled by the manager and/or proprietor who visit (unless long distances involved), prospective new residents at home or in hospital. Written information is also provided on services and facilities in the home. The contract/ terms & conditions of residency states that new admissions are on a four-week trial basis. The registered manager confirmed that prospective new residents and their relatives are invited to visit the home prior to deciding on moving in, to see rooms and to meet with existing residents and staff. Emergency admissions do not generally take place as the home has a waiting list. Totham Lodge DS0000017982.V306180.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Care plans in place set out the residents daily needs to provide staff with the actions required to meet these. The health care needs of residents were generally assured. The home’s medication procedures, practices and staff training appeared to provide adequate guidance for dealing with medicines. Staff pay attention to ensuring that residents privacy and dignity is respected. EVIDENCE: The care plan format was unchanged since the last inspection. Needs were based on the home’s pre-admission assessment format, with actions identified as required from staff, including specific daily needs. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 11 Individual care plan files included general risk assessment, falls and pressure sore risk assessment, records of visits by GPs district nurses etc and full background details. Care plans seen had been reviewed by staff. Residents personal and health care needs were recorded within care plan assessments. These included oral care, foot care, records of visits to GP, hospital and visiting nurses. Residents should be weighted regularly (with the individual’s agreement) to ensure that any weight gain or loss is recognised as quickly as possible. In recognition of this point the registered provider had purchased a set of ‘sit on’ scales. These had not been delivered at the time of this inspection so there is a recommendation made until this practice is evidenced. The home had introduced improved recording methods for noting amounts of food consumed by residents at mealtimes, these were seen. New residents may retain their own GP if possible, otherwise the home’s GP is used. District nurses visit the home regularly, nursing notes were held in the home. Tissue viability advice and the treatment of pressure sores is provided by district nurses, who also provide pressure relieving aids and equipment to the home along with guidance on use Advice on continence issues is accessed through the continence advisor based at a local hospital, but who also visits the home regularly and offers close support to staff. Annual assessments are compiled for all residents with assessed continence issues. Dietary advice is accessed through the GP or the diabetic nurse. Some staff have received training in diabetes awareness. Community Psychiatric Nursing and Consultant Psychiatric support is on-going to residents assessed as in need of this service/treatment. Chiropody, optician and dental services regularly visit the home, to provide tests and treatment to residents. Hearing tests are available at the local hospital. The manager advised that at the time of this inspection there were no residents attending to their own medication needs. Lockable facilities are provided though and the home’s written policy on self-administration of medicines was available. The home’s policy on the storage, administering and returning unused medication was unchanged. This includes written guidelines regarding receipt of new supplies. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 12 Medication administration records were inspected. Only senior staff deal with medication and they must sign each shift to accept responsibility for the safe keeping of keys to medication supplies. Staff administering medication have received certificated training on medication issues, entitled ‘Safe Handling of Medicines’. Certificates were available for inspection. The manager had also commenced in-house training on medication to two newer staff. Staff who have already attended the full medication handling training may now benefit from ‘refresher’ training on medication to ensure up to date awareness of reasons for prescribed medicines, along with possible side effects. There is a good practice recommendation regarding this point, in this report. The pharmacist service includes the collection of unused supplies and the ordering of fresh supplies from the GP practice. They also deliver new supplies direct to the home. No shortfalls were noted at this inspection with regard to medication procedures, however the home had agreed to an assessment of procedures by a pharmacist from the local Primary Care Trust (PCT). This had taken place prior to todays’s inspection but to date of completing this report the CSCI were awaiting a copy of the pharmacist’s report. Any identified areas for attention identified will be reviewed by CSCI when a copy of the report is forthcoming from the PCT. Residents spoken with confirmed that staff show respect and consideration towards their privacy and dignity when providing personal care support. Residents also said they wear their own clothes and that staff refer to them by their preferred term of address. Staff spoken with confirmed that at induction, when commencing employment, they were made aware of the expectation to treat residents with respect at all times. Screens were provided for use in shared rooms. The home’s ‘privacy & dignity’ policy provided clear written expectations to staff on the headings under this standard. There was a payphone telephone in the entrance lobby and some residents had private telephone lines in their rooms. The office portable phone was also available for incoming calls. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Regular opportunities are provided to residents to meet their recreational, social and religious interests and needs. The home appeared to have maintained good contact with, and encouraged involvement from relatives. Residents were enabled to exercise choice on a day-to-day basis. Meals provided would appear to ensure a wholesome, varied and nutritious diet for residents. EVIDENCE: Outside entertainers continue to be brought into the home regularly. A garden tea had been planned for the week following this inspection. The manager confirmed that daily activities are still offered to residents by staff. These included: seated exercise, catch ball, quiz, music, hoopla, manicures, singalongs, reminiscence, hand massage and reflexology (by an Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 14 outside practitioner). Records had been kept of daily activities offered and a record was seen of dates visiting entertainers have been in the home. Residents previous interests/hobbies were recorded in care plans. The manager has undertaken training specific to providing a service for people suffering with dementia (evidence seen). This included consideration towards types of activities which should be offered. Local clergy and an outreach church group still visit monthly. Residents spoken with who expressed an opinion confirmed that they get up and go to bed when they choose, they are able to eat in the dining room or in their own private room and that there is flexibility around meal times. Records were seen of the residents meeting that took place earlier this year. The manager advised that another meeting is due. The meeting held included discussion on meals, activities and any other issues as raised by residents. The home’s policy towards visitors confirms that visitors are welcome at all reasonable times and contact is encouraged. Staff support residents right to refuse visitors. Residents spoken with confirmed that staff always make visitors feel welcome. One resident continues to maintain control of his/her own finances. The remainder were supported by relatives. Discussion and evidence seen confirmed that new residents are able to bring personal items of possessions into the home. Information regarding access to independent advocacy support was displayed in the hallway. Confidentiality is generally maintained but it was noted that accident records sometimes included more that one entry to a page. These records should only show individual entries on each page, there is a recommendation on this point in this report. Nutrition records were seen. Breakfast is provided in residents own rooms, except to those who require breakfast in the dining room. The main meal of the day is lunch. The registered provider confirmed that menus are based on the known likes and dislikes of residents, and that an alternative is provided to any who did not like the set menued meal. Tea is still served at 4.30 pm, with supper snack meals of sandwiches or cake also provided around 7pm. The registered provider again confirmed that staff are always available at mealtimes to offer assistance and support. Some residents require feeding. Individual residents spoken with indicated that the food was satisfactory. Food stocks seen were considered fully appropriate for the numbers catered for. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s complaints procedure allowed for residents and relatives to formally raise any concerns or areas of dissatisfaction with the service. Procedures and polices in place were aimed at protecting residents from abuse. EVIDENCE: The home’s complaints policy/procedure was seen. The policy included information on how to make a complaint and the expected timescales for response from the home. Details were also included on how to contact the registration authority and the local Social Services office. Staff have attended training on POVA (protection of vulnerable adults) procedures. The registered manager is a qualified POVA trainer which enables her to provide in-house training to staff on the ‘Protection of Vulnerable Adults’. The workbook for this includes headings of definition of abuse, responding & reporting, categories of abuse and indicators requiring action. The home’s policy statement on abuse was unchanged. This defined types of abuse ie: physical, passive, psychological, financial, sexual abuse. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 16 A checklist was included on the actions to be taken by staff if an allegation or suspicion of abuse occurs. The home had a copy of the latest available guidelines regarding the Department of Health’s protection of vulnerable adults (POVA) scheme, and of the Essex Vulnerable Adults Protection Committee guidance booklet and reporting template. The separate ‘whistleblowing’ policy sets out staff responsibilities to report any suspicions or incidents of abuse or malpractice, to their supervisor. In March 2006 an allegation of neglect was made against the home. As a result a POVA strategy group meeting was held to consider the issues raised. This was led by Essex Social Services in Maldon. At the request of the strategy group the CSCI undertook a random unannounced inspection of Totham Lodge on the 4th May 2006. This was to verify records which the home had presented to the strategy group. All records seen confirmed the information provided by the home, and to date it is understood by CSCI that there is no evidence to substantiate the allegation made against Totham Lodge. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service Furnishings in the home looked comfortable and areas of the premises seen were generally acceptably maintained, however until all radiators are guarded there is a potential risk to residents. Private accommodation was comfortable and suited to needs and preferences. The premises were accessible, and had sufficient (according to these standards) numbers of toilets and bathrooms. The home looked clean and was considered to be hygienic. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 18 EVIDENCE: Private and communal accommodation was regarded to be comfortable and homely. Many communal and private rooms benefit from views over the grounds and surrounding countryside. Residents have access to the grounds, usually with full staff support. An area of garden to the immediate side and front of the home has been enclosed with a fence and gate. General day to day maintenance is undertaken by the home’s maintenance person Communal space comprises a large inner hallway sitting area, one large lounge dining room, one small dining/sitting room and an inner conservatory. Twenty one bedrooms benefit from private ensuite facilities. There are three bathrooms and one shower, all providing assisted bathing facilities. One bath has a jacuzzi facility. All rooms were fitted with curtains or blinds, a mirror and appropriate bedside lighting was available. Furnishings are provided to individual wishes and choices. Door locks and keys are fitted/available for residents. All but three bedrooms met recommended size standards. Rooms inspected were individually and naturally ventilated with windows. All rooms were centrally heated with radiator guards fitted to most bedroom radiators however not all radiators in the home, including those in communal areas and two bedrooms, were guarded. This issue was highlighted in the last report and the registered provider advised action has been taken with new covers having been ordered. However until fitting takes place the recommendation must be carried into this report. Regulator valves had been fitted to all baths and wash hand basins, water temperature was not tested at this inspection. The manager has obtained a test metre so that staff can test the temperature regularly. Lighting in the home was considered to be domestic in character. Emergency lighting is fitted throughout. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staffing levels and skills appeared to meet the needs of residents. Staff were provided training opportunities to equip them with the skills for their role. Staff recruitment procedures aimed at the protection of residents had been followed. EVIDENCE: Staffing levels remain at: five carers mornings shifts until 1300 hrs, then four carers until 1400 hrs, three carers until 1530 hrs, four carers until 1830 hrs, three carers until 2000 hrs. Night time staffing was two awake carers with one on sleeping-in support and a further two senior staff on standby call close by. The manager hours were again advised as supernumery. Additional staff were employed for cooking, cleaning, maintenance and administrative duties. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 20 The management structure of the home includes (in addition to the registered manager and registered provider), two assistant managers, one care coordinator and three senior carers. Eight staff have now achieved NVQ level 2 awards with two gaining NVQ level 3. Three staff were undertaking NVQ level 2. This equates to over 50 of the staff team. The manager is an NVQ assessor and a moving & handling and adult protection trainer. She also holds the C & G Advanced Management in Care award and is undertaking the NVQ level 4 in Health & Social Care. Staff training records are maintained and induction training takes place on new staff (confirmed by staff spoken with). The induction format was a modular format and met the standard for subjects included. NVQ training is offered to new staff as soon as possible. Staff training records and certificates of attendance seen included short course subjects of: health & safety, food hygiene, abuse & POVA, loss & bereavement, fire safety, funerals, first aid (NVQ level 2 training also includes first aid), falls prevention, pressure care, catheter & bowel care, dementia, alzheimers the person centred approach, manual handling and medication. New staff have a training needs profile compiled as part of the induction process. Staff recruitment records seen included two written references, a CRB check, proof of ID including a copy photograph, an application form and a contract of employment. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service The registered manager is committed towards ensuring the home is run effectively and efficiently. Procedures for gaining the views of residents and relatives were in place and had been effected. Financial practices in the home appeared to have been competently managed. Records required by regulation were up to date. The health and safety of residents and staff was generally assured. Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 22 EVIDENCE: The registered manager’s qualifications and training have been reported on under standards 18,28 & 30. On-going training and development had taken place to ensure awareness of the needs of service users. Details of the home’s management structure are reported on under standard 27. The registered provider continues to take an active part in the day-to-day function of the home and on the service provision. The home’s quality assurance (QA) questionnaires were seen. Topics included accommodation, care provided, staff attitudes, cleanliness, meals, décor, complaints, laundry and social activities. The quality assurance process had been implemented in March 2006, and a summary of the findings from the 2005 QA exercise was in place. This met the recommendation made in the last report. The home did not hold any residents’ monies for safe keeping, relatives provide support. Any expenditure incurred by the home, on behalf of a resident, is invoiced to the resident or designated relative. The inspector was advised that one resident continues to control his/her own finances, the remaining receiving support from relatives. Written records were kept of furniture brought into the home by new residents. Random samples of records required to be kept were inspected. These included: care plans, assessments, staff rota, staff recruitment, medication, visitors book, regulation 37 notices, fire drills, background information and next of kin details, all seen were considered appropriately maintained. A discussion took place with the registered provider regarding latest guidance concerning regulation 26 reports, copies of these will be checked at future inspections. The home’s premises risk assessment was seen and was considered satisfactory. Staff had been trained in moving and handling, fire safety, food hygiene, first aid and occupational health & safety. The home’s policy on infection control was also available. Evidence was available to confirm that the home’s electrical installation supply, hoists, fire alarms, fire fighting equipment, boilers, portable electrical appliances, emergency lighting and shaft passenger lift had all been tested/serviced at appropriate intervals. Totham Lodge DS0000017982.V306180.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 2 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 X 3 X 3 X 3 3 Totham Lodge DS0000017982.V306180.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. 2. 3. 4. Refer to Standard OP8 OP9 OP14 Good Practice Recommendations The registered manager should ensure that a record is maintained of service users’ weight gain or loss. The registered provider should consider providing update training to staff on medication. The registered manager should ensure that personal information is stored so as to maintain confidentiality. The registered provider should ensure that all radiators in the home are guarded or have guaranteed low surface temperatures. OP25 Totham Lodge DS0000017982.V306180.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Totham Lodge DS0000017982.V306180.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. 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!