This inspection was carried out on 28th November 2008.
CSCI found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection
report. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.
Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: West Lodge Care Home 238 Hucknall Road Sherwood Nottingham NG5 1FB The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: David Litchfield Date: 2 8 1 1 2 0 0 8 Information about the care home
Name of care home: Address: West Lodge Care Home 238 Hucknall Road Sherwood Nottingham NG5 1FB 01159606075 01159606075 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ms Razma Vanessa Alishan care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability 27 0 27 Over 65 0 27 0 Conditions of registration: The registered provider may provide the following category of service only:- Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admision to the home are within the following category: Old age, not falling within any other category - Code OP Physical Disability - Code PD Dementia - Code DE The maximum number of service suers who can be accommodated is 27. Date of last inspection Brief description of the care home West Lodge Care Home was established in 1987. Located on a main road in Sherwood, it is on a main bus route into Nottingham city centre. The home consists of a large converted house, with a purpose built conservatory. There are 6 double bedrooms and 13 single rooms 4 of which have en-suite facilities. There is ramped access to the Care Homes for Older People Page 2 of 10 building and a passenger lift serves all three floors. The homes grounds are mainly to the front of the building and are well maintained although there is open access to the road. There is car parking space at the front of the home. A copy of iour last inspection report is available in the foyer of the home. The current fees range from £329.85 to £521 per week. Care Homes for Older People Page 3 of 10 What we found:
1. We looked at how peoples continence care is being managed. We looked at 3 peoples records and found that each persons continence had been considered with any needs identified. This had been done together with other professionals including social workers and health professionals. A need was established in two of the cases, and a particular plan drawn up for each person to describe what staff needed to do. These plans were detailed, easy to follow, and checked on a monthly basis to ensure they are still appropriate. We saw that each one was individual to the person, taking into account their particular needs. However, there was no indication about how the people or others important to them were involved in the planning process. We asked the manager about this and we were told that the plans are read out to people or their representatives. She said she would start to record this involvement. We spoke to some members of staff and the manager about continence care and we saw that there is a person assigned to attend regular lectures about continence care who then feeds back any learning to the staff team. Staff told us they dont leave anybody unattended and that we have enough staff to meet peoples continence needs. We observed that when people using the service asked for help, it was quickly made available. We asked people about their care and were told that they help and staff help with any problems. 2. We looked at how peoples laundry and clothing are managed. We went into the laundry room and found that there is suitable equipment and systems for managing peoples laundry. We spoke with a member of staff who showed us how they organise peoples clothing, using name labels to know who each item belongs to. We heard that if clothing loses a label or cannot be identified it was not given out to people. We saw that this is the case, as there was a clothing rail with unidentified items. We were told that the service will then speak to family members and other staff to try to identify who it belongs to. The manager told us that each person has a member of staff especially assigned to them, who have the responsibility for helping the person with things like clothing. We saw a task list for these people which included checking people have the right clothing in their room. A member of staff told us that key-workers have to check everyones alright with their clothing. 3. We looked at how peoples medication is managed. We observed the manager administering medication together with a second member of staff. We were told that this is the usual practice, with a qualified nurse managing the medication trolley and records, and a care worker taking each medication to the individual. We were told this system is described in a policy, but the manager was unable to show it to us on our visit. The medication trolley was taken from its usual locked room, and placed in the Care Homes for Older People Page 4 of 10 conservatory where there were no people at the time. The manager did not leave the trolley unattended at any time. The manager dispensed the medication from their prescribed containers into a pot which was then taken by the care staff to the individual. We saw that the member of staff ensured the person had taken the medication, before returning to the manager and telling them. The manager then signed the medication record but the staff member who actually saw the person take the medication did not sign it. We observed that the manager on two occasions broke a tablet up with bare hands, and did not wash her hands in between. We also observed her putting her fingers directly into the tablet pot on one occasion. We saw that staff are given guidance and training that clearly states this should not be done. The manager told us that she did it without thinking and that she would not do it in the future. She said that the tablets were provided in a form too large for the person. We asked the manager if they had requested the medication in a different form from the pharmacy but we heard that they had not. We saw one example of the medication record being incorrect, with a member of staff having signed for the tablets given that morning, despite that member of staff having not been working that day. The manager was already aware of this, and we saw she had left a note to speak with the member of staff. We saw that the manager undertakes occasional checks of the total quantity of some tablets, but the manager told us there is no regular check of all medication kept in stock. 4. We looked at the environment people live in. We saw that that it was kept at a warm temperature and that people were suitably dressed to stay healthy. We saw that any odours are dealt with, and that communal areas are tidy and clean. We did notice that door frames were looking tired and damaged. In particular the bottom of door frames had been damaged; the manager said this was from trolleys and wheelchairs. In most cases this damage rubbed off all the varnish, leaving bare wood that was beginning to splinter. 5. We looked at how complaints are managed. We saw that the service has a complaints policy and an internal procedure for managing them. The policy was up-to-date with clear information about how people can make their views know. We saw that this information is provided in a guide to people using the service, which we saw is kept in peoples rooms. The information is also provided in the entrance hall to the home. The internal procedure defines complaints as verbal or written expressions of dissatisfaction but says a record is only to be produced when a complaint is made in writing. We asked the manager about this and she said she normally deals with any verbal complaints directly, and may not record them. We also saw that this internal procedure was not up-to-date as it referred to us as the Care Standards Commission which was a different organisation that ended in April 2004. We looked at the records kept and saw that there were two complaints recorded. We Care Homes for Older People Page 5 of 10 saw evidence that the service had taken some actions but the records were incomplete. The manager remembered further details about them, and did find some more information held on a computer, but was unable to produce all the records she said existed about the complaints. The manager mentioned a third complaint that came via the local authority but she had not produced any records about this. We asked if any other complaints had been received this year and were told there werent any. We then told the manager about a complaint we were already aware of that had not been mentioned up to that point. The manager remember this immediately and was able to describe all the steps that had been taken which completely mirrored the information we already had. The manager told us she did have records of the complaint but was unable to find them. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action 1 7 15 Care planning documentation 31/07/2007 must be further developed to enable someone not familiar with the resident to deliver the appropriate care thus promoting the residents safety. 1. Care plans must be developed to provide sufficient information for staff on how to effectively support residents with their identified needs. 2 31 24 Effective quality auditing 31/07/2007 procedures must be performed to ensure that the quality of care provided to residents at the home is reviewed at appropriate intervals and systems are in place for improving service provision for the residents. To ensure service provision is 31/07/2007 effective in promoting the health and wellbeing of residents, Regulation 26 visit must be performed on a monthly basis and a copy of the Regulation 26 reports must be made available to CSCI and the manager at the home. 3 33 26 Care Homes for Older People Page 7 of 10 4 35 20 To ensure that residents are protected from financial abuse the money of individual residents personal allowances must not pooled. The finances of residents must be individuality maintained and appropriate records and receipts are kept. 31/07/2007 Care Homes for Older People Page 8 of 10 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 9 13 There must be safe arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. This will ensure that peoples medication is administered safely. 28/02/2009 2 38 23 The premises must be kept in a good state of repair. This will ensure that people are safe. 28/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 7 The service should record how people and others important to them are involved in planning and agreeing their care. This will ensure that people are at the centre of the support they receive. A full records of all complaints and actions taken should be kept by the service. This will ensure that people can be confident their concerns are taken seriously.
Page 9 of 10 2 16 Care Homes for Older People Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 10 of 10 - 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!
