Inspection on 02/08/05 for White Lodge

This inspection was carried out on 2nd August 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

White Lodge 19/02/08

White Lodge 22/03/07

White Lodge 19/12/05

White Lodge 11/03/05

White Lodge 11/05/04

White Lodge 05/02/04

Similar services:

The Shelley

Springfield House

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 White Lodge 44-46 Madeira Road Cliftonville Margate, Kent CT9 2QQ Lead Inspector Elizabeth Hendry Announced 02/08/2005 at 9:15hrs 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. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service White Lodge Address 44-46 Madeira Road, Clifftonville, Margate, kentCT9 2QQ 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) 01843 225956 Mr Michael Joseph Toppingt Care Home 23 Category(ies) of 22 Older People 1 Learning Disability 1 registration, with number of places White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: no Date of last inspection 11th March 2005 Brief Description of the Service: White Lodge is large fronted property situated in the residential area of cliftonville, close to local shops and ammenities. The home is registered to provide residential care and support for up to 23 older persons who require varing degrees of assistance. To the rear of the property there is a large garden with seating area. There is adequate street parking to front of premises. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first annual announced inspection that took place over the course of a day. Policies and procedures were examined, care plans viewed and staff and service users spoken with. A tour of the home was undertaken and all areas were found to be decorated and furnished to a high standard. Service users appeared comfortable and relaxed within their surroundings. What the service does well: What has improved since the last inspection? What they could do better: Staff require training on adult protection and abuse awareness to ensure service users are fully protected. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 6 The management of the home must ensure that recruitment procedures are fully adhered to, and all required information regarding staff members is held on file. A service user guide must be complied to ensure prospective service users are provided with detailed information prior to admission into the home. 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. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 standard(s) 1,3 and 6 The homes does not have a service user guide, therefore prospective service users are not provided with sufficient information needed to make an informed choice about moving into the home. A comprehensive needs assessment is undertaken prior to admission into the home, which ensures individual needs can be fully met. EVIDENCE: The homes statement of purpose was viewed and found to fully meet the care homes regulations. The responsible individual confirmed that the home does not have a service user guide. The registered manager said that the home does not have any allocated intermediate care beds, respite care cannot be booked in advance and is only offered if there is a vacancy. Individual care plans were viewed and found to contain a detailed needs assessment completed prior to admission into the home. Care management assessments were evidenced within many service user files. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 9 The registered manager confirmed that no service user would be admitted if the home were unable to fully meet their needs. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8, 9 and 10 The care planning system is clear and consistent, providing staff with the information they need to meet the needs of the Service Users. Service users health care needs are fully met. Procedures within the home for the recording of medication are poor, potentially placing service users at risk. EVIDENCE: Service user care plans were viewed and found to contain clear and concise information for staff to follow to ensure individual needs can be fully met. Staff observed, were seen to have a sound knowledge of the needs and personal limitations of each service user. Service users spoken with were aware of the contents of their care plan, confirming that both their social and personal care needs were met. Many service users spoke of staff treating them with respect maintaining their dignity and independence. The healthcare needs of all residents are fully met, staff closely monitor all residents to ensure their healthcare needs are met, and any problems identified are quickly addressed. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 11 Records viewed confirmed that service users frequently access services from chiropodists, dentists and opticians. The management of the home confirmed that advice and guidance is sought from district nurses, doctors and pharmacists as and when required. Medication administration records were viewed and found to contain a number of omitted entries. Medication held within the home was checked and did not tally with records held. The registered manager confirmed that only after receiving training in the safe handling of medication are staff involved in the management of medication. Home remedies are administered to service users with their consent. The management of the home explained that they are in the process of receiving written consent from individual G.P’s to confirm the safety and suitability of administering the simple remedies. Controlled drugs held within the home are suitably stored and recorded. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 Recreational facilities within the home are good, providing Service users with a wide variety of choice to ensure individual tastes and interests are fully catered for. Dietary needs of Service Users are well catered for with a balanced and varied selection of food available that meets the Service Users tastes and choices. EVIDENCE: During the inspection, a singer was providing entertainment to the residents within the rear lounge. This was well received by all service users who appeared to be joining in and enjoying themselves. Service users spoke of being able to choose from a wide range of activities and crafts. The management of the home confirmed that activities available include gentle exercises, board games, bingo, dominoes and carpet bowls. Trips into the local community are encouraged with many service users enjoying trips to the pantomime, theatre, shops and sea front. Service users spoke highly of the meals provided within the home, and dietary needs and advice is catered for. The home employs two cooks who prepare all White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 13 meals and are fully aware of individual’s likes and dislikes regarding food. Snacks and drinks are available throughout the day. Menus showed careful planning and indicated choices available for each meal. Food stores were examined and found to contain a vide variety of branded products of good quality, and in sufficient quantities. The fridge was examined and found to contain unlabelled produce, which did not identify the date of opening or day of cooking. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 standard(s) 18 Arrangements for protecting service users are not satisfactory. EVIDENCE: Records viewed identified only four members of staff have attended formal adult protection training. The management of the home confirmed that a further four members of staff are due to attend a training course later in the year, and three members of staff undertook the abuse unit while completing their NVQ. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 standard(s) 19 and 26 The standard of the environment within the home is good providing Service Users with an attractive and homely place to live. Infection control measures are in place, which promotes the wellbeing and health of service users and staff. EVIDENCE: A tour of the home was undertaken, and all areas were found to be decorated and furnished to a high standard. The majority of fixtures and fittings were domestic in nature. Within the home there are three lounges, one smoking and two non-smoking. The management of the home confirmed that there is an ongoing programme of maintenance. The home was found to be clean and no offensive odours were present. Infection control notices were seen around the home. The Registered manager confirmed that all staff attend infection control training during the induction process. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 16 White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 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) 27,29 and 30 Staffing levels within the home are high providing consistent care to the service users. Recruitment policies have not been consistently followed resulting in Service users receiving care from staff who have not been appropriately vetted. Staff receive training relevant to the needs of the service users. EVIDENCE: On the day of the inspection there were good levels of staff on duty, staff rotas viewed confirmed that this is consistent practice. Staff were seen to have an excellent rapport and communicated well with all residents. The registered manager confirmed that there are no staff under the age of eighteen working within the home and no one under the age of twenty-one is left in charge of the home. Domestic staff are employed in sufficient quantities to ensure that the standards relating to food, meals and nutrition are fully met, and that the home is maintained in a clean and hygienic state, free from dirt and unpleasant odours. Staff records viewed did not contain all of the required information in accordance with The Care Homes Regulations 2001, many files did not contain a completed CRB check, references or any form of identification. The registered manager explained the procedure for the advertisement of new staff. No volunteers are involved in the home. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 18 The homes training matrix clearly identified the training needs of all staff involved in the care of residents. The registered manager explained that on commencement of employment, each member of staff completes an induction to ensure they have the necessary skills needed for meeting all of the residents needs. The home has a positive ethos for encouraging and supporting staff to undertake and achieve NVQ Level 2 in Care. The home has an identified training need for adult protection and abuse awareness training for all members of staff who have yet to attend formal training. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 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) 35 Procedures in place for the management of service users monies are poor. EVIDENCE: Service users monies held within the home were checked and were found not to tally with records kept. The registered provider explained that some entries had been omitted by mistake. Receipts are only kept for one service user, with the remaining service users having the receipts returned to them along with their goods. The registered providers explained that only the senior or manager on duty can access service user finances. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x 2 x x x White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 21 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 1 Regulation 5 Requirement The registered person shall produce a written guide to the care home. (Compile a service user guide) The registered person shall make arrangements by training staff or by other measures to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. (ensure all staff are aware of adult protection procedures and attend training in abuse awareness.) The registered person shall where appropriate and unless it is impracticable to carry out such consultation, after consultation with the service user or a representative of his, revise the service users plan. (ensure all care plans are signed by service user or representative and are revised at least once a month.) The registered person shall make arrangements for the recording, handling, safe keeping, safe administration and disposal of medicines received into care home. (Ensure all medication administered is appropriately H05 H56 S23623 White Lodge V235973 Stage 4.doc Timescale for action 1st November 2005 1st October 2005 2. 18 13 3. 7 15 1st October 2005 4. 9 13 3rd August 2005 White Lodge Version 1.40 Page 22 recorded.) 5. 29 19 The registered person shall not employ a person to work at the care home unless, a) the person is fit to do so, b) subject to paragraph 1 to 7 of schedule 2. (ensure all paperwork and crb checks are held within each staff file.) The registered person shall maintain in the care home the records specified in schedule 4. A record of all money deposited by a service user for safekeeping, or received on behalf of the service user, which shall state the date on which the money was deposited, the date on which any money was returned to a service user, and where applicable the purpose for which the money was used. 1st October 2005 6. 35 17 3rd August 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. Refer to Standard 29 Good Practice Recommendations Obtain copies of the GSCC code of conduct and distrubute to staff team. White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 11th Floor International House 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. Extracts may not be used or reproduced without the express permission of CSCI White Lodge H05 H56 S23623 White Lodge V235973 Stage 4.doc Version 1.40 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. 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