Inspection on 09/03/06 for Walker Lodge Residential Home

This inspection was carried out on 9th March 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Walker Lodge Residential Home 13/06/08

Walker Lodge Residential Home 24/08/07

Walker Lodge Residential Home 14/09/06

Walker Lodge Residential Home 24/08/05

Walker Lodge Residential Home 31/08/04

Walker Lodge Residential Home 26/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Walker Lodge Residential Home Wharrier Street Walker Newcastle Upon Tyne Tyne & Wear NE6 3BR Lead Inspector Mary Blake Unannounced Inspection 09:30 9 & 14 March 2006 th th 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 Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 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. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Walker Lodge Residential Home Address Wharrier Street Walker Newcastle Upon Tyne Tyne & Wear NE6 3BR 0191 224 3677 0191 224 2657 walker.lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd (wholly owned subsidiary of Four Seasons Health Care Limited) 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) Care Home 48 Category(ies) of Dementia - over 65 years of age (36), Old age, registration, with number not falling within any other category (12) of places Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Two service users in the OP category are under pensionable age. The home may admit up to 15 people in the OP category and up to 48 people in the DE(E) category, subject to the maximum number of 48 places not being exceeded. 24th August 2005 Date of last inspection Brief Description of the Service: Walker Lodge cares for 48 people in a two storey property adjacent to Brampton Court a nursing home. It is set in a residential area in the centre of Walker. The home is on two floors with a passenger lift to all levels. There are a variety of aids and adaptations to allow service users to move freely around their part of the home. The bedrooms are single ensuite, with communal bathing and toilet facilities situated around the home. There is sufficient communal lounge and dining space. The home is close to local amenities and transport networks. Walker Lodge is registered to provide residential care for frail older people and older people with dementias Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, the second of the year and took place over two days. The inspector had also made an introductory visit where she had met the new manager, staff on duty and residents. A tour of the premises was carried out. Residents care records plus additional statutory records were examined. The Manager, deputy, four care staff and ancillary staff were spoken to and the inspector met with sixteen residents and several relatives during her visits. The new Manager, Mrs Marion Taylor, has been appointed, has applied to be registered and is awaiting her interview to complete this process. What the service does well: Residents and their relatives spoke of a gradual introduction to the home and there was a detailed pre-admission process. The involvement of residents and their families with their care plans is well supported by the Manager and staff. It was observed that staff were kind, considerate and supportive to residents. Residents, where able, and relatives described good relationships with the staff and said they were all polite and helpful. Staff were friendly and relaxed with the inspector and were keen to discuss their work and the residents care needs. There has been minimal staff turnover amongst the care staff, which provides stability and consistency for residents in their day-to-day care. The management of the home promotes good practice to address the care, social and safety needs of residents. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? Previous requirements/recommendations were met or were being addressed. The décor of the home continues to be updated and improved in several areas. The company who run the home continue in the process of changing the banking arrangements for the storage of monies belonging to residents, which will enable residents to access their money easily along with any interest gained. Progress has been made in the improvement of care planning, the manager now undertakes random audit of care plans and has begun to improve care staff involvement in order that they have the information they need to be able to care properly for the people living in the home. Residents and their families are involved with their plans. The Manager has ensured that residents can see chiropodists and dentists at appropriate intervals The basic care of residents had improved, residents who required help with their personal care, dressing and continence, were receiving the help they needed. Residents appeared clean, well groomed and dressed. However, several were without slippers/shoes and the manager addressed this The manager has improved the basic training of staff. New and long-standing staff have enrolled on induction/refresher training and six care staff have enrolled on the NVQ qualification. Training has also been provided for all care staff on the needs of people with dementia to ensure that staff have a good understanding of these conditions and are fully aware of current good practice. The Manager has undertaken refresher training in the procedures to follow if there are suspicions or evidence of abuse, which take account of the multiagency approach to be followed. The staff team have been given in-house training in adult protection and external training is planned, this helps to safeguard residents by making staff aware of what is good and bad practice, and what they should do if they have concerns. Essential equipment has been repaired. Steps had been taken to replace carpets and the home was generally clean and free from offensive odours. The health and safety of residents had been improved by removing television/audio equipment from high tables, updated risk assessment for residents who smoke and thermometers have been provided in bathrooms. A development plan for the home is in place. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 7 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. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 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 Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 & 5 were assessed and met. Walker Lodge does not provide intermediate Prospective residents have the information they need to make and informed chioice about where tolive. Residents have the opportunity to visit the home prior to admission and generally satisfactory pre-admission assessments processes were in place in order to meet their needs. The pre-admission assessment did not provide sufficient information on the mental health needs of residents. EVIDENCE: The Statement of Purpose had been updated and was now available in large print. Relatives spoke of their opportunity to visit the home, to meet with staff and of a gradual introduction to the home. They found the service user guide helpful and enabled them to support their mother by giving her additional information, as she required. They were aware of individual plans of care and of their involvement in this process Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 10 Discussion with residents, relatives, staff and the manager confirmed that their care needs had been assessed prior to admission. Individual records for residents were examined for the last two admissions and assessments had been undertaken however these did not contain enough information about mental health needs. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 assessed and has shortfalls, 8 & 10 assessed and met. Individual care plans continue to improve. Staff use care plans to meet personal needs and are involved in completing them. Residents and their families are involved with their plans. The health and personal needs of residents were met and are kept under review. EVIDENCE: Four individual residents plans of care were examined and have continued to improve. These had been appropriately reviewed and updated with residents and their families involved in the plan. Some had shortfalls and the manager is undertaking random audit of the plans, identifying shortfalls and addressing these shortfalls with staff. There was insufficient information within the care plans to address individual mental health care needs, it was noted that this was improving with details on how individual confusion would impact on the care they required. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 12 Satisfactory health support was given and recorded within the plans examined. Staff are being encouraged to complete plans. The medication was not examined as the home is to change medication systems on the 1st April 2006. To be reviewed at next inspection. It was observed that residents looked clean and well groomed. Staff were courteous when helping residents and were observed to knock before entering bedrooms/toilets. Staff helped individuals make choices and assisted them with drinking and eating, as needed. Relatives and residents confirmed that staff were very patient and gave the following comments “nothing is too much trouble” “they are always willing to help” “they are kind and happy to help” Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 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 were assessed. Social activities are carried out though these are limited in range and are not providing as much variation and stimulation for people living in the home as they could be. Residents are able to maintain contact with family, friends and the local community. EVIDENCE: There is a programme of activities in place including scrapbooks, pamper day, arts and crafts, ball and board games, sing-a-longs and reminiscence. An Activities Organise has recently been recruited. The manager as in interim measure had purchased an activities file for residents with dementia. Relatives and residents spoke of making decisions about visitors, of going into town and visitors were observed to see residents in private. Relatives were aware of care management systems, advocates and access to CSCI. Relatives spoke of residents having choice in personalising their bedrooms. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 were assessed and met Residents and their supporters are confident that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: The home has a complaints procedure in place and there was evidence that this had been used. A new recording system is kept of the complaints made and the outcome of these was now recorded. The Manager demonstrated a clear understanding of the multi-agency approach to adult protection and has undergone refresher training in multi agency safeguarding vulnerable adults. This was also evident in her dealing with issues from another home. Whilst staff have some awareness of types of abuse an in house training session has been provided to strengthen the protection of residents. External training dates have also been identified for staff. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 15 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): 19,21 & 26 were assessed Residents live in a safe, well maintained environment Residents do not always have access to sufficient and suitable bathing facilities The home was clean and pleasant. EVIDENCE: A tour of the premises was undertaken and a large number of bedrooms were seen, these were general clean, well decorated with good personalisation. New flooring has been laid in the ground floor lounge and several bedrooms. The Manager has also organised a re-decoration programme of other parts of the home. Extractor fans and an assisted bath seat were now in working order. It was noted that the tiles within the shower rooms were worn and discoloured; the Manager stated that this is currently being addressed. Two of the six bathrooms are not in use and are being used as storerooms, this was Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 16 discussed with the Manager and agreed that she would review the current use of bathing facilities. It was noted that the corridor carpets were showing sign of wear, this would be a major expenditure, but should be considered within the long term plan of the home. The home was found to be generally clean and free from offensive odours in the communal areas, however some bedrooms did have odours, which the staff were attempting to address. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 17 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 & 30 assessed. EVIDENCE: A statutory requirement made at previous inspections concerning the induction training for care staff has been met in addition experienced staff are also taking refresher foundation training. Discussion with the Manager and with members of the staff team provided evidence that the numbers of care staff on duty, excluding the Manager, are as follows:8 am to 8 pm 8 pm to 8 am 7 care staff (including 2 senior carers) 4 waking night care staff (including 1 senior carer) The Manager’s hours are not included in the above or staff employed for duties such as food preparation, laundry and cleaning. The Manager has reviewed the deployment of staff to ensure there was sufficient staff to meet the care needs of all residents. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 18 All of the care staff had been employed for more than one year, and the majority of the care staff has worked in the home for more than three years providing familiar and consistent care for residents. The Manager confirmed that a further six of the care staff team have enrolled on NVQ2 courses this is positive and working towards the required standard. It was evident that staff has began to undertake training in dementia care and spoke positively about this. Observations made during this inspection also showed consistent practice amongst the staff. The Manager had addressed previous poor care practices with individual staff and this will be continued through training and supervision of staff. First aid training had been completed and certificates displayed. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 19 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): 31,32 & 38 assessed An experienced person who is undergoing the fit person process manages the home and residents benefit from the ethos, leadership and management approach. Health and safety issues had been addressed ensuring that the home provides a safe environment for residents. EVIDENCE: The new manager has many years experience in a caring and managerial role. Undertaking the Registered Managers Award she appeared positive towards the needs and rights of residents and keen to implement change. CSCI have received her application to become registered and she is awaiting interview to complete this process. Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 20 The manager communicates a clear sense of direction and leadership and residents, relatives and staff were well aware of her role and responsibilities, her open approach and the positive changes she had made to the running of the home. The Company are currently in the process of changing the arrangements for storage of money held on behalf of residents, as the current arrangements are unsatisfactory both for the protection of residents and staff. The manager and staff had taken steps to address the health and safety issues identified at the previous inspections. • Updated risk assessments for smokers had been undertaken • Safe storage of audio equipment • Purchase of new thermometers • Staff expressed knowledge of health and safety matters • First aid training completed and certificates displayed • Cleanliness had improved • Service specific health and safety policies & procedures are being developed • Staff to access infection control training • The inspection of the electrical wiring system is not due till 2007 Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 21 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 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 2 X X 3 STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 X X 2 X X 3 Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 22 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 Requirement Timescale for action 01/05/06 2 OP12 16(2)(m) 3 OP28 18 4 OP30 18 The care plans must address all identified needs. Reference should be made to Standard 3.3. Care plans must be reviewed monthly with the service user. Outstanding as of 31/12/05 but good progress being made In addition the mental health needs of residents must be included within the care plan Review the social activities 01/06/06 provided with the residents to ensure that these meet their needs. Ensure that the staff are adequately trained to provide stimulating, worthwhile activities for residents with dementia. Outstanding as of 31/12/05 but progress being made Continue NVQ training 01/07/06 programme to meet 50 target by the end of 2005. Outstanding as of 31/12/ 05 but progress being made Provide suitably in-depth training 01/06/06 for care staff to ensure that they understand and can provide specialist care for people with DS0000000461.V276231.R01.S.doc Version 5.1 Walker Lodge Residential Home Page 23 5 OP3 14 dementia in line with current good practice. Progress being made To update the preadmission assessment to include specific mental health needs of residents 01/05/06 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 Refer to Standard OP21 OP20 Good Practice Recommendations To undertake a review of the bathing facilities available to residents To replace worn corridor carpets Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Walker Lodge Residential Home DS0000000461.V276231.R01.S.doc Version 5.1 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!