CARE HOMES FOR OLDER PEOPLE
Trent Lodge 6-8 Essex Road Enfield Middlesex EN2 6TZ Lead Inspector
Tony Brennan Key Unannounced Inspection 9th November 2006 11:00 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 Trent Lodge DS0000010693.V315857.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. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Trent Lodge Address 6-8 Essex Road Enfield Middlesex EN2 6TZ 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) 020 8367 2159 020 8364 5328 Dr Sirjit Singh Seyan Mr Jashvant Babulal Kotecha Mrs Janet Tracey Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th October 2006 Brief Description of the Service: Trent Lodge is part of an organisation that has a number of homes. Trent Lodge is a care home registered for sixteen service users who are over the age of 65. The home is well established and is near the centre of Enfield Town. The home has twelve single rooms and two double rooms. None of the rooms have en suite facilities. The home has a stair lift. The home is situated near one of the entrances to Enfield Town Park. It is easily accessed by car and public transport and within walking distance of the town centre. The home benefits from a large garden at the rear of the house. The garden is well maintained and a pleasant place for service users to sit. The home provides care for service users of either sex who are older and in need of personal care only. The fees are between £400 and £450 a week. This report is available through the internet. Copies may also be obtained from the provider of this service. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key unannounced inspection was undertaken as part of the annual inspection programme. The inspection took place over one day. The registered manager, Janet Tracey, assisted the inspector. The inspector received comment cards from the service users and professionals who live, or are connected with Trent Lodge. The inspector spoke with six service users, three relatives and three staff. The inspector observed care practice and staff interaction with service users. The inspector toured the building and examined a number of records relating to the care, health and safety and management of the home. The inspector would like to thank the registered provider and staff who assisted him by answering questions about the running of the home. The inspector would also like to thank people who live at the home and their representatives for commenting on the service. What the service does well: What has improved since the last inspection?
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 6 Fourteen areas for improvement were identified at the last inspection and eight of these were found to have been met. A multi-disciplinary review had been held. This had identified areas where further professional involvement was needed to ensure a person who lives at the home is appropriately supported. Records of the support provided by health professionals are now clearly recorded to ensure that people who live at the home are appropriately supported. A person who lives at the home, who was identified at the last inspection to have tissue viability needs, is now receiving the appropriate care from district nurses. People who live at the home confirmed that they felt their dignity and privacy was maintained. Staff understood the need to shut doors before providing personal care. People who live at the home were observed to be appropriately dressed. A redecoration plan is now in place. The dining room has been redecorated to improve the environment for people who live at the home. A contingency plan is in place to cover unplanned staff absences. What they could do better:
Fifteen areas for improvement were identified at this inspection. Care plans for one person who lives at the home and has diabetes need to identify the details of their condition and how staff can support him. Care plans need to provide detailed information on the needs of people who live at the home. Care plans need to identify dementia care needs of people who live at the home. People who live at the home must be referred to a nutritionist to ensure they receive the necessary support to maintain a healthy diet. Risk assessments for nutrition and susceptibility to develop pressure sores must be put in place. Varied activities must be offered that reflect the interests and needs of people who live at the home. Staff need to engage in positive interaction with people who live at the home. Bedroom doors were found to be wedged open creating a potential fire safety risk for people who live at the home. Where people who live at the home wish to have their doors open, then an automatic closure device must be fitted. Faulty extinguishers must be replaced to ensure the safety of those who live at the home. Newly appointed staff are not given induction and foundation training. Staff have not been trained in all the areas of statutory training that is required to ensure the safety and support of people who live at the home. A programme of training on dementia care is needed to ensure that all staff have a range of skills to meet the needs of people who live at the home. 50 of staff need to achieve the National Vocational Qualification at level 2 in care. All staff need to receive supervision six times a year to ensure that they are supported to meet the needs of people who live at the home. Three requirements made at the last inspection have not yet been met and have been restated in this report, with a new timescale for compliance. In the ‘Timescale for Action’ column, the date in ordinary type relates to the timescale given at the last inspection. The date in bold type relates to the new timescale. Further information about unmet requirements can be found in the relevant
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 7 standard. Unmet requirements impact upon the welfare and safety of service users. Failure to comply by the revised timescale will lead to the Commission for Social Care Inspection considering enforcement action to secure compliance. 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. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 8 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 Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 9 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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed prior to admission to the home to ensure they receive the care and support they need. EVIDENCE: Comment cards received from service users and their representatives confirmed that they had their needs identified prior to coming to live at the home and were provided with information on how the service would manage and meet their needs. A service user said, “I do like it here, it’s got to be my home”. The two service users case tracked all had initial assessments carried out prior to their admission to the home. The assessments identified their needs. One service user who had been case tracked at a random inspection of 4/10/06 was found to have additional needs not supported by health
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 10 professionals or detailed care planning by the home. For example, no assessment of nutritional needs to reflect a poor diet, risk of pressure sores, and regular changes to medication. As a result of this a multi disciplinary review was organised at which it was agreed that referrals be made to a nutritionist and psychogerietrican. The service user had recently had a review of her medication by her GP. The District Nurses had been involved to provide support with maintaining the service user’s tissue viability. The inspector spoke with the service user who said, “staff treat me well”. The service user’s daughter was at the home on the day of the inspection and told the inspector, “Mum has got everything she needs”. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 11 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 poor. This judgement has been made using available evidence including a visit to this service. Service users personal, social and medical care needs are not fully planned for. A service user assessed as being at risk of weight loss did not have appropriate monitoring and professional advice had not been sought. Service users are fully protected by safe procedures for handling medication. Service users right to privacy is supported. EVIDENCE: Comment cards received from service users, their relatives and professionals were generally positive about the care and support provided. A service user said, “they do their best for you”. The inspector case tracked three service users and found that there were a number of concerns regarding how their physical, social and medical needs were being addressed. One service user case tracked was identified in their care plan as having a poor diet. This service user had been weighed regularly and between August 06 and November 06 he had lost four kilos. The medical and care plan records did not show any action taken to address this. There was no nutritional assessment in place to
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 12 establish the level of risk that this presented for this service user. The service user’s care plan identified that he was diabetic and records showed that District Nurses came daily to administer insulin by injection. The care plan had been prepared to cover this, but did not provide guidance on symptoms and issues relating to diet. Care plans need to identify these areas so that all the service user’s needs are addressed. At the last inspection care plans were found not to provide detailed information on how the needs of service users would be met. While some work had been done to provide more information on how to meet the needs of service users care plans still needed further work to ensure they provided sufficient personalised information on the needs of service users. Staff spoken to could only provide general descriptions of the needs of service users. Staff could not provide detailed information on the needs of individual service users. Care plans seen by the inspector had been reviewed monthly since the last inspection to identify changes in the needs of service users. The inspector spoke with a service user who was diagnosed as having dementia. The service user expressed concern that he did not feel that he understood why he was living at the home and what had happened to his house. The inspector found that there was no life history information for this service user. Staff spoken to were not able to explain what could be done to support this service user’s well being. The inspector found that care plans for this service user did not provide guidance on how the service user’s dementia needs could be met in a manner that reflected the service users preferences and interest. The registered manager explained that since the last inspection a system had been put in place to ensure that information on the medical support provided to service users was clearly recorded and easily accessible. The inspector found that the service users case tracked all had information that clearly identified recent medical needs and the support which had been provided. Service users spoken to confirmed that they had access to their General Practitioner. One service user found at the last inspection to have difficulty walking and needing an Occupational Therapist assessment had now been assessed. The Occupational Therapist report recommended that no further action was required to support this service user. One of the service users case tracked was receiving support from the District Nurses to maintain her tissue viability. Details of this support were recorded in the service users medical notes. A turning chart was in place. Staff had recorded when they had assisted the service user to turn. The inspector discussed with the registered manager how the home identified those service users who might be at risk of developing pressure sores. The registered manager explained that the home does not have a risk assessment for this. The inspector asked that the registered manager develop a risk assessment to assess service users susceptibility to developing pressure sores. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 13 The inspector examined the medication records for medicines received, administered and returned, and found these were complete. One service user is currently prescribed controlled medication. The inspector found that this medicine was stored securely. Two staff had signed to confirm they had administered the controlled medication to the service user. A record is maintained of the temperature of the areas where medication is stored. This showed that the temperature was below 25ºC. The inspector observed staff administering medication to service users. This was done safely with appropriate checks being made to ensure that service users receive their medication. Staff explained and showed medicines to service users to ensure they understood what was happening. Staff spoken to confirmed that they had recently received training in how to administer medication safely from the home’s pharmacist. Training records confirmed this training had taken place. A service user case tracked had recently had her medication reviewed as a result of concerns raised at the last inspection. The level of sedation had been decreased and the service user had been put on multi vitamins. A service user said, “staff always knock on the door before coming into my bedroom”. A relative spoken to confirmed that this was the case. The inspector observed that all service users were appropriately dressed. Staff spoken to understood the importance of clean and appropriate dress to maintain service users dignity. Service users spoken to explained that staff always shut doors before assisting them with personal care. The registered manager explained that she had spoken to all staff and explained the importance of closing doors before assisting service users with personal care. The inspector observed staff assisting service users and found that they close doors to bedrooms before assisting them with personal care. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 14 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 adequate. This judgement has been made using available evidence including a visit to this service. Service users need to be provided with varied activities to meet their needs. Service users are supported to maintain contact with relatives and other representatives of their choice. Service users are able to make choices about how they live in the home. The menu reflects the preferences of service users and offers a balanced diet. EVIDENCE: The inspector spoke with three service users who felt that not enough activities were provided. One service user said, “there isn’t a lot to do, it’s a bit boring”. The inspector observed that no activities took place on the day of the inspection. The registered manager explained that the home has a regular entertainer and other activities will be planned around the coming Christmas celebrations. The inspector observed that there was little interaction between staff and service users apart from at lunchtime. One service user was observed for ten minutes on three occasions by the inspector. She was sitting alone. Staff did not to talk to her on these occasions. This was discussed with the registered manager who agreed that service users should be supported to have meaningful interaction with others.
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 15 A relative spoken to confirmed that they were able to visit whenever they wished. A service user said, “my friend comes when I want, no one tells them when they can visit”. The inspector observed that visitors and service users were offered the choice to spend time in private. Staff spoken to understood the need to support service users to make choices about how they wished to live. Comment cards from service users were all positive about the food provided. The inspector found that the menu showed that main and second choice of lunchtime meal was offered each day. A service user said, “they come round and ask you what you want for lunch each day”. The inspector saw that there was a record of what service users had chosen for lunch each day. The inspector observed lunch and saw that meals were well presented. A service user commented, “the food is very good”. The inspector observed that two service users needed staff support to eat. Support was provided in a way that gave the service users the opportunity to eat at their own pace. Food was cut and staff took time to feed the service users. Sufficient staff were available to support all service users. At one point a service user did not wish to carry on eating. Staff explained to the service user that her meal would be saved and she could eat when she was ready. Shortly after the other service users had finished eating staff offered the service user her meal. The inspector saw that meals were well presented and they were provided in a relaxed environment. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 16 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. Service users are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: Comment cards received from service users showed that they understood how to make a complaint. The complaints policy explained how to make a complaint and how it would be dealt with. A service user said, “I know that the manager will deal with any issues”. The complaints record showed actions taken to resolve complaints. There had been one complaint since the last inspection. The Commission had investigated the complaint and the findings are outlined in the summary of this report. There were comprehensive policies on handling abuse and protection. Staff spoken to were clear about the signs of abuse and how suspected abuse should be handled. The inspector found that staff have received training on POVA. Trent Lodge DS0000010693.V315857.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Service users live in a home that does not provide a safe environment. The home is clean and hygienic. EVIDENCE: The inspector toured the home and found that there were a number of areas for improvement of the home’s environment. Bedrooms were found to be personalised. A service user spoken to confirmed that he had chosen furniture and other personal items to have in his bedroom. New furniture had been purchased for most bedrooms. The dining room had been redecorated and kitchen door had been replaced. A new cooker had been purchased for the kitchen. A plan for the refurbishment of the home had been put in place to ensure that the home maintained the standard of decoration. The inspector found that two bedroom doors had not been fitted with automatic closure devices and were wedged open. The registered provider
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 18 explained that these were on order. The inspector asked that these be obtained and put in place to ensure the safety of service users. The inspector found that two fire extinguishers had signs on them to say that they were no longer effective and should be replaced. The registered provider explained that these had been on order since the last fire inspection, but had not been delivered. Records showed this had taken place in March 06. The inspector asked that the fire extinguishers are replaced as a matter of urgency. The home has been adapted to meet the needs of service users. There are raised toilet seats and accessible baths. There is a chair lift for service users to use to access the first floor. The inspector found that this was working. Records showed that regular maintenance checks of the chair lift had been carried out. The inspector saw that the home was clean. The inspector found that all bathrooms and toilets had liquid soap and paper towels in them. Staff spoken to understood how to prevent cross infection when assisting service users with personal care tasks. Trent Lodge DS0000010693.V315857.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient staff are available at all times to meet service users needs. Staff do not have all the skills to meet all the assessed needs of service users. Service users are protected by the home’s recruitment practices. EVIDENCE: A service user said, “staff are always there to help when I need them”. Comment cards from service users showed that they felt that sufficient staff are available to meet their needs. The rota for the previous four weeks was examined and showed that a consistent staffing level was maintained. The registered manager explained that since the last random inspection three new staff had started working at the home. The home now has an agreement with those staff that will work at short notice to cover sickness. Training records and discussion with the registered manager confirmed that since the last inspection no staff have completed the National Vocational Qualification in care at level 2. The home still needs to achieve 50 of staff having the National Vocational Qualification in care at level 2. The inspector spoke with two new members of staff. They told the inspector that they had not completed the induction and foundation training. While they both had training on food hygiene and medication administration, they had none of the other areas of statutory required training. Training records showed that these
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 20 staff had not received training in manual handling, infection control, first aid or fire safety. This was discussed with the registered manager who agreed to ensure that all staff have the necessary induction and foundation training to ensure the safety of service users. All other areas of statutory required training would also need to be covered. The home provides care and support for service users who have dementia. The inspector found that the staff spoken to had not had training on dementia. Training records showed that other staff had only done a one day awareness course on dementia. Given the issues already highlighted in this report relating to the lack of interaction with service users and the needs of service users dementia needs not being fully identified the registered manager needs to ensure that an on going programme of training in dementia care is put in place. Three new staff had started working at the home since the last inspection. The records relating to their recruitment were complete. The inspector examined other staff records, which were also found to contain all the required information. Trent Lodge DS0000010693.V315857.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 36 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager does have the necessary qualifications to manage the home effectively and in the best interests of service users. Service users are consulted about the quality of the service provided and encouraged to make suggestions for improvement. Service users financial interests are protected by the home’s procedures. Staff are not supervised to ensure that they are able to meet the needs of service users consistently. Service users and staff are protected by the home’s health and safety procedures. EVIDENCE: The inspector spoke with staff who confirmed that the registered manager provided support to them to meet the needs of service users. A service user said, “you can talk to the manager”. The registered manager demonstrated to
Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 22 the inspector that she understood the needs of service users. The registered manager is completing the Registered Manger’s Award. The home has a system for obtaining views of the quality of the service. It provides and ensures that any areas for improvement are addressed. A survey of the views of service users has been carried out as to the quality of the service provided. A report is being prepared on the findings of this survey and a copy will be sent to the Commission once it is completed. Staff and service users are consulted through meetings. The registered manager explained that while the home has the necessary procedures to manage service users finances securely, the home does not hold any money for service users. Social services or their families manage service users finances. The inspector examined a number of staff files and found that these did not contain up to date supervision records to confirm that staff are receiving supervision six times a year. Staff said that they had not had supervision. Fire drills were taking place and the fire alarm was tested regularly. The system had been regularly checked and any maintenance needed had been carried out. The fire risk assessment includes an assessment of all the potential fire risks in the home. The inspector questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. The inspector discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents. The inspector found that the temperature of cooked food, fridges and freezer are recorded. Trent Lodge DS0000010693.V315857.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 1 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 2 x 3 Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15(1) Requirement Timescale for action 20/12/06 2 OP7 3 OP7 4 OP8 5 OP8 6 OP12 The registered persons must ensure that the care plan for one service user with diabetes identifies details of their condition. 15(1) The registered persons must ensure that care plans provide detailed information on the needs of service users. The timescale of 01/11/06 was not met. 15(1) The registered persons must ensure that care plans are in place that outline service users dementia care needs. 13(1)(b) The registered persons must ensure that service users are referred to a nutritionist to ensure they receive the necessary support to maintain a healthy diet. The timescale of 01/11/06 was not met. 14 The registered persons must ensure that risk assessments to assess whether service users are at risk from poor nutrition or of developing pressure sores need to be put in place. 16(2)(m,n The registered persons must
DS0000010693.V315857.R01.S.doc 01/01/07 01/01/07 01/12/06 01/01/07 01/01/07
Page 25 Trent Lodge Version 5.2 ) 7 OP19 23(4)(c)(i ) 8 OP19 23(4)(c)(i v) 18(1)(a) 9 OP30 10 OP30 18(1)(a) 11 OP30 18(1)(a) 12 OP36 18(2) ensure that varied activities are offered to service users that reflect their interests and needs. The registered persons must ensure that bedroom doors are not wedged open. Where a service user wishes to have their door open then an automatic closure device must be fitted. The registered persons must ensure that all fire extinguishers are in working order. Faulty extinguishers must be replaced. The registered persons must ensure that all newly appointed staff are given induction and foundation training. The registered persons must ensure that all staff have been trained in all the areas of statutory required training as highlighted in this report. The registered persons must ensure that a programme of training on dementia care is provided for staff. The registered persons must ensure that all staff receive supervision six times a year. 20/12/06 01/12/06 01/01/07 28/02/07 28/02/07 30/12/06 Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 26 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 Refer to Standard OP7 OP12 OP28 Good Practice Recommendations The registered persons should ensure that service users have a life history detailing significant events and interests in their life. The registered persons should ensure that staff regularly engage in positive interaction with service users. The responsible person should ensure that 50 of staff achieve NVQ at level 2 in care. Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Trent Lodge DS0000010693.V315857.R01.S.doc Version 5.2 Page 28 - 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!
