Inspection on 23/05/06 for Wessex Lodge [Poole]

This inspection was carried out on 23rd May 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

Wessex Lodge [Poole] 06/08/08

Wessex Lodge [Poole] 10/08/07

Wessex Lodge [Poole] 07/10/05

Wessex Lodge [Poole] 05/04/05

Wessex Lodge [Poole] 05/11/04

Wessex Lodge [Poole] 27/04/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Wessex Lodge 16 Munster Road Parkstone Poole Dorset BH14 9PU Lead Inspector Martin Bayne Unannounced Inspection 09:00 23rd May 2006 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 Wessex Lodge DS0000004067.V297538.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. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Wessex Lodge Address 16 Munster Road Parkstone Poole Dorset BH14 9PU 01202 738234 01202 730215 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) Mr Arthur Roy Bolson Mrs Doreen Bolson Ms Julie Lorraine Dayman Care Home 29 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (14) of places Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. With effect from 1st January 2004, service users whose mobility requires the use of equipment must not be admitted to the upper level of the first floor of the home. One named person (as known by the CSCI) under the age of 65 may be accommodated to receive care. This condition will be removed upon the service users 65th birthday. 7th October 2005 2. Date of last inspection Brief Description of the Service: Wessex Lodge is a care home providing personal care and accommodation for a maximum of 29 older people. The home can accommodate a maximum of 15 people with a diagnosis of dementia. Wessex Lodge is owned by Mr & Mrs Bolson and managed by Mrs Julie Dayman. Wessex Lodge is situated in a residential area between Canford Cliffs and Parkstone. Set back from the road, the home is secluded by mature trees and shrubs to the front with parking spaces for several cars. The rear of the home has pleasant grounds, which provide seating for service users in the summer months. Wessex Lodge is not on a main bus route but the local communities of Parkstone, Poole, Bournemouth and Westbourne are a short drive away. The home is a twostorey house that has been extended. There are 23 single bedrooms, 15 with en-suite facilities, 3 shared rooms 2 with en-suite facilities. Each floor of the home is accessible by means of a central stairway and a passenger lift. A stair lift also accesses the first floor. The first floor is on two levels part of which is accessed by two steps necessitating full mobility of service users accommodated in the rooms accessed by the steps. Communal sitting and dining room space is provided with a lounge area on both the ground and first floor. Also on the ground floor are the kitchen and laundry areas. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place between 9am and 3.30pm. This was a key inspection and so the home was evaluated against all of the core standards. During the inspection a tour of the building was made, ten of the residents spoken with during the morning and a further group of nine residents during lunchtime. Records were viewed and discussions took place with both the Registered Manager and one of the providers, Mr Bolson, on how the home met needs of the residents. Requirements from the previous inspection were also followed up. What the service does well: What has improved since the last inspection? What they could do better: A requirement was made at the last inspection with regards recruitment. It had been found that staff had started working at the home without a Criminal Record Bureau (CRB) or a PovaFirst check, (a check against the register of people who have been disbarred from working with vulnerable adults). At this inspection it was found that these checks had been carried out, but one member of staff had been working in the home for one month prior to a POVFirst check being received. At the last inspection it had been noted that level of odour had reduced in the home. At this inspection it was found that in some areas there were unwanted odours and could be improved. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 6 A requirement from the last inspection is still outstanding in respect of adult protection training for the staff. A course has however been booked for the summer to provide this training. With regards to staff records, evidence must be obtained that the staff are mentally and physically fit for the purposes of their work. 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. Wessex Lodge DS0000004067.V297538.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 Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 36 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are assessed prior to their being offered a place at the home. EVIDENCE: Mrs Dayman, the registered manager informed that for each person referred to the home, a care management assessment is sought and is used as the basis of the assessment. Any issues arising from this assessment are discussed as to how needs can be met with the care manager. In addition the potential resident or their relatives are made welcome to visit the home and they are given a copies of information relating to the service that is provided. It was recommended that the Statement of Purpose be revised to inform that the home cannot accommodate residents who may wander from the home, as it is not possible to secure all exits from the building. Once a person has been assessed and accepted for a place at the home a letter is sent offering a trial period of residence. The home does not offer a service for intermediate care and therefore standard 6 does not apply. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Through the assessment process a care plan is developed for each resident. Health needs of residents were met at the home. Medication is administered safely at the home. Residents are treated with respect and their dignity maintained. EVIDENCE: At the last inspection a requirement was made concerning care plans as it had been found that not all care needs had been written into the plan. Throughout the inspection the files relating to four residents were used to track the required paperwork that should be kept in relation to residents. For these four residents it was found that there were up to date care plans. Mrs Dayman informed that these are re-written each month to ensure that they are kept current. Mrs Dayman was informed that the plans only require to be reviewed each month and if still a reflection of care needs, can be signed and dated each month to confirm that the plan is still up to date. The plans seen reflected the care needs of the residents. Daily records are maintained by the staff in respect of residents and from these it was evident that health needs are addressed by staff. There was Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 10 evidence of doctors visits being arranged when residents were not well and also appointments made for other health needs such as eye care, dentistry and chiropody. Moving and handling assessments have been carried out in respect to each resident, however the inspector observed staff assisting a resident using techniques not considered best practice. It was also noted that compulsory moving and handling training had been arranged for all the staff to take place in June and staff should adopt practices taught on this course. The home does have three hoists and staff are trained to use this equipment. At the time of inspection one of the residents was confined through ill health to their bed. A specialist mattress had been supplied to this resident and staff were competing a ‘turning sheet’ as part of the care plan to prevent skin breakdown. The care planning system also links to risk assessments that had been carried out in order to deliver safe care practices. The home has policies and procedures for the safe administration of medication in the home. On admission residents are assessed as to their capability to manage their own medication. At the time of inspection all of the residents were having medication administered by the staff. The deputy manager has delegated responsibility for medication in the home. A unit dosage system is used and medicines are delivered to the home. Staff who administer medication have received training through the pharmacist. The pharmacist also visits the home to advise on procedures, record keeping and storage. The medication administration records for all of the residents were seen and it was found that these were being completed correctly with no gaps within the record. It was recommended that in cases where staff have to complete the medication to be administered, one person should enter the drugs to be administered and a second person should check and sign the document. The medication cabinet was seen and it was found that medicines were stored correctly. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In general residents are supported to maintain their preferred lifestyle choice. More needs to be recorded to demonstrate that residents with dementia are offered appropriate recreational activities. Visitors are welcome at the home. A balanced diet of offered to residents and food provided is of a good standard. EVIDENCE: Residents spoken with said that they could get up and go to bed when they chose. Those with dementia are free to wander around the home. Residents also informed that entertainers visit the home to provide stimulation. Currently three singers visit the home and one resident who plays the drums joins in the entertainment. Other examples of activities arranged in the home included craft sessions, manicures and poetry reading. At the last inspection a requirement was made that more be provided to stimulate those residents who suffer from dementia. Mrs Dayman said that these residents join in with the singing groups and other activities and that individual attention and stimulation was given to the residents with dementia. It was recommended that where individual time is spent with these residents, this be recorded in the daily record to provide evidence of activity and stimulation for these residents. This will be followed up at the next inspection. Residents’ birthdays are celebrated in the home. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 12 A Church of England Holy Communion service is held regularly in the home. Residents receive their mail unopened, except in cases where they lack mental capacity and need assistance or there has been permission from relatives to assist with mail. Residents are able to make private calls either by using the pay phone in the hall or by using the home’s portable phone. On the day of inspection two relatives were visiting the home. Residents informed that they could receive visitors at any time. The home has two dining areas, one upstairs and one downstairs. The residents able to eat without assistance use the dining room upstairs and those who require assistance use the downstairs dining room. On the day of inspection the inspector had lunch with the residents in the upstairs dining room. The meal was of a good standard and residents said that the food provided in the home was always of a good standard and that there was plenty to eat. They also informed that they were offered a choice and that their likes and dislikes of food were known. Residents informed that they had their breakfast and evening meal in their rooms. Mrs Dayman said that all of the staff who prepare food have the minimum of basic food hygiene training. Wessex Lodge DS0000004067.V297538.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has full complaints procedures available to residents and their relatives. Residents will be better protected once all staff have received adult protection training. EVIDENCE: Mrs Dayman reported that the home maintains a log for the recording of complaints made about the home, however none have been raised since the time of the last inspection. The complaints procedure is detailed within the terms and conditions of residence and also within the Statement of Purpose. At the point of admission the resident or their relatives are given copies of these documents and therefore they are informed of the procedure. At the last inspection a requirement was made that the home provide adult protection training to the staff. The home has internal policies and procedures for in respect of adult protection and all the staff are required to read these policies. Those staff who have completed NVQ training have received some adult protection training as part of the course. Mrs Dayman informed that a course will be arranged in the home later in the year. The requirement remains in force until such time as this training is given to those staff who have not yet received formal training. Wessex Lodge DS0000004067.V297538.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe and well-maintained environment that complies with infection control measures. EVIDENCE: At the last inspection a requirement was made in respect of the laundry room floor, in which there was a small hole. This was being repaired on the day of inspection. As noted earlier in the report there were odours in some areas of the home. Mrs Dayman informed that these areas would be cleaned. The home has carpet cleaners specifically for this purpose. In other respects the home was found to be clean and in reasonable decorative order throughout. The home has a garden to the rear of the home that residents can access. The home has policies and procedures for infection control and all staff are given alcohol gels for cleaning hands. The laundry room has a sluicing sink for the cleaning of commodes and is equipped with a commercial and domestic Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 15 washing machine as well as driers. There are hand washing facilities in the laundry room. Within the home some of the radiators are covered and some not. Mr Bolson informed that initially the intention was to cover all of the radiators to protect residents form the risk of burns. However a different strategy was taken in that a temperature regulator has now been fitted to the outlet to the heating system so that radiators do not reach temperatures that could in a risk of burns. Mr Bolson said that a suitable ambient temperature could still be maintained within the home. It was also reported that all of the hot water outlets have been fitted with thermostatic mixer valves in order to protect residents from scalding water. In the corridors of the extension there were free standing heaters, which had been purchased earlier in the year when there had been a power failure. It was agreed that these would be stored away to give free walkway in the corridors. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 The Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home provides good levels of staffing. Staff will have received adequate training once those staff without adult protection training receive this. Residents are potentially exposed to risk by not all recruitment checks having been undertaken in respect of the staff. EVIDENCE: At the last inspection three requirements were made relating to the recruitment of staff; namely that staff must have a POVAFirst check undertaken before they start work in the home, two written references undertaken and workers from overseas must have appropriate paperwork to demonstrate that they are legally employed. With respect to POVAFirst it was found that from the sample of staff records viewed, one member of staff had been working at the home for a period of a month prior to receipt of a POVAFirst check. The requirement therefore remains in force. Concerning references and documentation for overseas workers, records were in place for the staff records sampled and therefore these requirements were met. It was however found that in respect of all the staff records viewed that there was no evidence that the staff were physically and mentally fit for the purposes of their work as required under Regulations. It is therefore required that that this is evidenced. The home employs a staff team of 24 carers of whom 9 have completed training to NVQ level 2. The home provides god levels of staff with five carers Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 17 on duty in the mornings three in the afternoons and evenings with two awake night staff on duty. In addition the home employs separate staff for cleaning and cooking. Mrs Dayman is supernumerary to the above staffing. It was found that staff have received training in core subjects such as fire safety, moving and handling, induction and foundation training, first aid and infection control. Staff have also undertaken distance learning in the care of people with dementia. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is effectively managed and run with the interests of residents in mind. Health and safety of staff and residents is promoted. Residents’ finances are safeguarded. EVIDENCE: Mrs Dayman has completed NVQ level 4 in management and care. Mr & Mrs Bolson have a property on site of the home and are actively involved supporting the manager to run the home. The manager was able to show that resident and relative user surveys have been carried out and letters of thanks are held to testify that the home is run in the interests of the residents. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 19 With regards to residents’ finances all residents with the exception of one look after their own affairs or have relatives who take on this role. For the one person whom the home assists, a small float of money is held and full records are maintained showing a balance of money held. The fire logbook was seen and it was found that tests and inspections of the fire safety system were taking place to the required timescale. The accident book was seen and provided evidence that accidents were being recorded. The criteria for sending notifications under Regulation 37 were discussed and it was agreed that these would be sent to CSCI for emergency admissions of residents to hospital. Records were available to demonstrate that the staff receive supervision to the required timescale. Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 20 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 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 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 OP18 Regulation 18(1)(c) (i) Requirement All care staff must receive adult protection training within 6 months of employment Care staff must not work in the home unsupervised without the POVA first check completed. This requirement is repeated from the inspection of 07/10/05 You are required to provide evidence that staff are physically and mentally fit for the purposes of the work which they are to perform and where it is impractical for them to obtain such evidence, a declaration should be signed by the staff member should be signed by the person. Timescale for action 15/07/06 2. OP29 19(4)(b) (i) 23/05/06 3 OP29 Schedule 2 15/07/06 Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 22 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 OP1 OP12 Good Practice Recommendations It is recommended that the Statement of Purpose be revised to inform that the home does not accommodate residents in the dementia category who wander. It is recommended that where individual time is spent by staff with residents with dementia this is recorded as evidence of stimulation and recreation. It is recommended that in cases where staff have to make up the medication administration record, one member of staff enters the information and a second person checks the record. 3 OP7 Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Wessex Lodge DS0000004067.V297538.R01.S.doc Version 5.2 Page 24 - 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!