Inspection on 15/06/05 for Wells Lodge Nursing Home

This inspection was carried out on 15th June 2005.

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 13/02/07

Wells Lodge Nursing Home 08/08/06

Wells Lodge Nursing Home 07/02/06

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 60 Earls Avenue Folkestone Kent CT20 2HA Lead Inspector Lisbeth Scoones Unannounced 15 June 2005 10.00 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 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 H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wells Lodge Nursing Home Address 60 Earls Avenue, Folkestone, Kent, CT20 2HA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01303 850898 Wells Care Ltd Care Home with nursing 22 Category(ies) of Older People x 22 registration, with number of places Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Wells Lodge is a recently registered Care Home providing 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. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 5 hours and comprised discussions with the manager, registered nurse, two care assistants and other staff. The inspector met with 6 residents, toured the building and examined records. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 7 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 standard(s) 1, 2, 3, 4 The home has a combined Statement of Purpose and Service User guide, which provides excellent information for current and prospective residents to decide whether they wish to move into the home. A written contract setting out the terms and conditions of residence is provided to each resident. Residents are only admitted to the home following an assessment of need. EVIDENCE: It was noted that residents had information about the home available to them. Residents said they would know what to do if they wish to make a complaint. Copies of residents’ contracts were seen in the care notes and include details of the “free nursing care” component and how this is deducted from the fee to be paid. From discussions with the manager and records seen, it is confirmed that no resident is admitted to the home unless a full and comprehensive assessment of need is made. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 8 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 standard(s) 7, 8, 9, 10 The care planning system is not clear and consistent to provide staff with the information they need to meet the residents’ needs. Residents’ health care needs are met with evidence of multi-disciplinary health professionals input. The system for non-medication administration is poorly defined and the clinical room is in need of stock control and clear out. Apart from a practice identified, 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 and reviewed by risk assessments. However, the system is not consistently used and does not include all care needs. It was agreed that further clarity is needed in respect of wound care recording and catheter care management. It was said that, due to recent staff changes, the manager and registered nurse do not have supernumerary time to complete the care plans in a timely manner or to undertake audits Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 9 The manager ensures that appropriate health professionals are involved with the care provision as e.g. dentist, continence advisor and community psychiatric nurse. The clinical room was cluttered with miscellaneous items. A drawer containing wound dressings was untidy and contained out of date items. The floor was not clean and the vinyl flooring rucked. There was no wall-mounted paper towel dispenser and the bin is not foot operated. Medication charts were in general well maintained but contained gaps indicating non-administration. For one resident who regularly refused the controlled drug prescribed, there were no records reflecting that this had been discussed with the GP. It was recommended that pain charts be used for all residents on regular analgesia. Residents said that staff are kind and courteous and treat them with patience and respect. It was noted that continence pads were left on chairs. The dignity aspect of this practice was discussed and it was agreed that these be put away when not in use. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 13, 14, 15 Residents maintain contact with their family and friends. Residents are helped to exercise choice and control over their lives. Not all the meals provided are of the quality residents expect. EVIDENCE: It was evident that visits by family and friends are encouraged. Good interaction was seen between the staff and residents’ relatives. No judgement was made about the quality of entertainment or social activities provided. It was said that the post of activities coordinator is currently being advertised. Residents said that they are encouraged to bring their own possessions to ensure that their room is as homely and individual as they would wish. Due to recent catering staff turnover, some residents said that the meals currently are not as good as they were before. On the day of the inspection, the chef from the company’s other home prepared the lunch. A new recently appointed supper person was still in her induction period. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 16,18 The home has a complaints procedure, which residents and their relatives are confident to use knowing that their complaints and concerns will be listened to and acted upon. Staff have a good knowledge and understanding of adult protection issues, which protects residents from abuse. EVIDENCE: Residents said that they feel comfortable in bringing any issues of concern to the attention of the manager and her staff. Staff demonstrated that they have been trained in issues of adult protection and would know what to do if this was ever suspected or witnessed. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 19, 20, 22, 23, 24, 25, 26 This newly registered home provides a comfortable and attractive environment for the residents. However, not all residents have been provided with a satisfactory arrangement to protect their personal belongings. Residents’ room are well personalised and there are a number of communal spaces, including a dining area, available. Residents moving and handling needs are met and risks of developing pressure ulcers reduced. The home provides a clean, odour free environment. However, the standard of cleanliness in the clinical room needs to be raised. EVIDENCE: The environment is comfortable and well cared for. It was however noted that not all residents have a lockable facility available to them to safely store away items of value, thereby posing a risk of loss. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 13 Equipment to meet residents’ specialist needs in respect of safe moving is available a well as pressure relieving equipment for those residents deemed at risk of developing pressure ulcers. The need for a system to raise and maintain the standard of cleanliness in the clinical room has already been discussed. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 The numbers and skills of the staff meet residents’ needs. However the staffing levels may need to be reviewed in order to balance numbers with workload. EVIDENCE: On the day of the inspection, the home was run by a registered nurse, two permant care staff and two agency staff. The manager, although it was her day off, was also in the home to assist with meal preparation. It is acknowledged that the directors are recruiting more staff. Staff spoken to said that they enjoyed caring for the residents but that they were very tired. The manager currently has little supernumerary time, which prevents her from reviewing staffing levels. Such review should include residents’ dependency and care staff’s involvement with catering duties. Staff said that staffing levels were adequate when there were fewer residents. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 36, 37, 38 The manager has a good understanding of her role and the needs of the residents but has insufficient time to manage effectively. Staff are not appropriately supervised and supported. Residents’ care records are not kept secure. The health, safety and welfare of the residents and staff are promoted but insufficiently protected due to inadequate systems for effective management. EVIDENCE: The manager is not yet registered with the CSCI and is waiting to start the NVQ 4 in management course, which is a required qualification for registered managers. The manager is supported by the director and another registered nurse. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 16 There is a need for roles and responsibilities to be clearly defined. Due to recent staff changes, currently there is insufficient supernumerary time for the manager or her deputy to manage effectively in respect of auditing care plans and medication records, staff training, staffing levels, job description review and formal staff supervision. The residents praised the manager in respect of her managerial skills, flexible approach and commitment to provide a good service. Currently care plans are kept in an unlocked office, which may compromise the security of such records. The director is aware and is in the process of obtaining lockable filing cabinets for this purpose. The director regularly visits the home and undertakes formal monthly visits and produces a report in accordance with Regulation 26. Staff are provided with statutory training in respect of fire safety awareness, moving and handling, food hygiene, first aid and infection control. Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 3 3 x 3 3 2 x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 2 x x x 2 2 2 Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 18 NA 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. 2. 3. 4. Standard 7.1 9.1 27, 32 31 Regulation 15 13 (2) 18 (1) (a) 8 (1) (a) Requirement That every resident has a comprehensive care plan That staff adhere to the homes medication policy in respect of administration and recording That sytems are in place that ensure that adequate staffing levels are maintained at all times That the home appoints a registered manager Timescale for action 31 July 2005 15 Jun 2005 31 July 2005 31 July 2005 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. 5. 6. Refer to Standard 10.1 15 24.7 26 32.2 37.3 Good Practice Recommendations That incontinence pads are used discreetly That residents receive appetising meals at all times That every resident be provided with a lockable facility That the standard of cleanliness and tidyness in the clinical room be raised That the manager has adequate time to manage effectively That residents records are kept up to date and stored securely Wells Lodge Nursing Home H56-H05 S62481 Wells Lodge Nursing Home V225637 140605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 11th Floor, International Housee Dover Place Ashford, Kent TN23 1HU 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. 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