Inspection on 13/02/07 for Wells Lodge Nursing Home

This inspection was carried out on 13th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Wells Lodge Nursing Home 08/08/06

Wells Lodge Nursing Home 07/02/06

Wells Lodge Nursing Home 15/06/05

Similar services:

Springfield House

The Shelley

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Wells Lodge Nursing Home Wells Lodge Nursing Home 60 Earls Avenue Folkestone Kent CT20 2HA Lead Inspector Lisbeth Scoones Key Unannounced Inspection 13th February 2007 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 Wells Lodge Nursing Home DS0000062481.V327822.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. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wells Lodge Nursing Home Address Wells Lodge Nursing Home 60 Earls Avenue Folkestone Kent CT20 2HA 01303 850898 01303 220590 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) www.wellscare.com Wells Care Ltd Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users with a diagnosis of DE(E) restricted to one (1) whose DOB is 09/04/1924. 8th August 2006 Date of last inspection Brief Description of the Service: Wells Lodge Nursing Home provides nursing care for 22 older people. The registered provider is Wells Care Ltd, which also owns Wells House in Sandgate. The premises comprise a two storey extended and adapted detached house with gardens in the centre of Folkestone. There are eight parking spaces available as well as on street parking. The home is located near the M20 motorway. Shops, bus stops and the railway station are nearby. The inspection report is available on request. Current weekly fees are in the range of £483 to £650 with additional charges for hairdressing, chiropody and newspapers. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was carried out over 4.30 hours and comprised discussions with the Company’s responsible person Mr P Burns, nurse in charge, two care staff and the housekeeper. During a tour through the home, 7 residents were spoken to and records examined. At the time of the visit, the home had no vacancies. Following the visit, a telephone conversation with the new manager was held. Comment cards were left for residents, relatives, GP’s, care managers and health professionals to complete. Some of these were returned. What the service does well: What has improved since the last inspection? What they could do better: Every resident must have a contract or statement of terms and conditions. In respect of self–funding residents, a clear record must be made of the “free” nursing care component and how this is to be deducted from the fee. The home has been without a manager for some considerable time. With the recent appointment of a manager, the home must now ensure that all delayed managerial duties are undertaken without delay. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 6 Urgent action is needed to ensure that an all staff-training programme be devised based on current skills and the needs of the residents. A formal staff supervision schedule must be set up. As identified at previous inspections, a formal quality assurance system has yet to be introduced. The management currently relies on verbal feedback to ascertain residents’ views. 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. Wells Lodge Nursing Home DS0000062481.V327822.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 Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a combined Statement of Purpose and Service User Guide. It provides detailed information for current and prospective residents to decide whether they wish to move into the home. Not all residents are provided with a contract or statement of terms and conditions. Residents are only admitted to the home following an assessment of need. EVIDENCE: The Service User Guide is offered to all residents and their families. Following the recent appointment of a manager, the document needs updating. A sample of contracts was examined. Some self-funding residents did not have a contract on file, and where these were available, they were incomplete. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 9 A resident said her relatives visited the home before admission to have a look around. A friend had recommended the home to her. A sample of preadmission assessments evidenced that the home could meet the resident’s needs. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide the necessary information for staff to care for the residents. Residents’ health care needs are met with evidence of GP visits and multidisciplinary health professionals input. Residents are protected by the home’s policies and procedures for dealing with medicines. Personal care is offered in a way, which protects the residents’ privacy and dignity and promotes their dependence. EVIDENCE: A sample of care plans examined demonstrated that these are informed by risk assessments and regularly reviewed. Risks in respect of malnutrition and skin breakdown are undertaken and acted upon. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 11 Residents are not routinely invited to contribute to the care-planning process. It is recommended, where appropriate, that such involvement be encouraged. Outside health professionals are involved with the care provision as e.g. dentist, optician, continence advisor, physiotherapist and community psychiatric nurse. The clinical room was tidy and clean. Medication charts are well maintained. Since the previous visit, records of medication disposal are maintained. Residents said that staff are kind and courteous and treat them with patience and respect. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As soon as an activities person is recruited, residents would be provided with suitable activities. Residents receive wholesome and varied meals and have a choice of what they would like to eat. EVIDENCE: Since the previous visit, the activities coordinator left. A resident said he missed the chats with her. The manager said that she is trying to find a replacement. Staff’s working practices are being reviewed to allow staff time to spend with the residents The kitchen was not visited at this inspection but menus seen indicate that a choice of wholesome meals is provided. A resident said, “The food is good.” Lunch served looked appetising. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 13 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. Residents and their relatives feel confident that their complaints will be listened to. Residents are protected form abuse and staff have been trained in the protection of vulnerable people. EVIDENCE: Residents said that they feel comfortable in bringing any issues of concern to the attention of the staff. The home has received no complaints since the past inspection. Staff have been provided with adult protection training. A member of staff demonstrated a good awareness of the issues, which constitute adult protection. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-maintained and homely environment. The home is clean and odour free. EVIDENCE: The home provides a comfortable and attractive environment for the residents. Residents’ room are personalised and there are a number of communal spaces, including two dining areas, available. The home was clean and odour free. A housekeeper and laundry person are employed Monday to Friday. The housekeeper said the staff work as a team. Good clinical waste disposal systems were observed. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 15 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. The numbers of staff on duty meet residents’ needs. The home’s recruitment procedures support and protect the residents. A training programme, which includes NVQ, should be introduced to ensure that residents are in safe hands. EVIDENCE: The owner said that work schedules and practices have recently been reviewed to ensure that staff’s time is optimally used. On the day of the visit, for the morning shift, the home was staffed as follows: nurse in charge, 3 permanent carers and an agency carer. Two new members of staff are receiving induction training based on the Skills for Care standards. Such training could be an introduction to NVQ training. Currently the recommendation that at least 50 of staff are NVQ trained has not been achieved. As already recorded, there is no formal training programme. The manager must ensure that a training matrix be devised and that each member of staff Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 16 has an individual training and development assessment and profile. See also standard 36 in respect of supervision. Staff files were not inspected on this occasion. The standard relating to recruitment and employment was met at the previous visit. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 17 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. A manager has recently been employed. No recorded quality assurance systems are used to ensure that the home is run in the best interest of the residents. Residents’ financial interests are safeguarded. Staff are not appropriately supervised and supported. The health, safety and welfare of the residents and staff are promoted. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 18 EVIDENCE: Residents, staff and the owner of the home expressed delight that a new manager has been appointed. The new manager works “hands on” and is given one supernumerary day every fortnight for additional managerial tasks. In the short time that she has been running the home, “she has made a difference”, said a resident. The appointment coincides with new methods of working recently introduced. Practices, policies, procedures and documentation are to be standardised in line with Wells Care Ltd’s other homes. As a result, roles and responsibilities are to be more clearly defined. Such responsibilities would include auditing care plans and medication records, staff training, determining staffing levels versus residents’ dependency and formal staff supervision. The introduction of a formal quality assurance programme remains outstanding and must now be addressed. Such programme must include formal recorded visits by the provider in accordance with Regulation 26. The home does not deal with residents’ monies and residents’ relatives are invoiced monthly. A formal staff supervision programme is yet to be introduced. Staff are provided with statutory training in respect of fire safety awareness and moving and handling. Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 19 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 2 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x 3 2 x 3 Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? N0 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 OP2 Regulation 5 (1) (b) (c) 5A (5) (a) (b) (i) (ii) Requirement That every resident be provided with a written contract That, where a nursing contribution is paid, a statement be provided regarding the date, and amount (if any) to be deducted. 31/03/07 Timescale for action 31/03/07 2 OP33 24 (1) (a) That a quality assurance system (b) (2) (3) be introduced which should include consultation with residents 26 That the provider undertakes monthly visits and produces a report That staff are appropriately supervised 3 OP33 31/03/07 4 OP36 18 (2) 31/03/07 Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 21 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 OP28 OP30 Good Practice Recommendations That at least 50 of staff are NVQ trained That staff receive training to meet the changing needs of the residents That every member of staff has a training and development assessment and profile That a management structure be devised with clear roles, job descriptions and lines of responsibilities 3 OP31 Wells Lodge Nursing Home DS0000062481.V327822.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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