Inspection on 25/04/07 for White Lodge Residential Home

This inspection was carried out on 25th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 Residential Home 01/02/10

White Lodge Residential Home 09/06/09

White Lodge Residential Home 03/06/08

White Lodge Residential Home 29/11/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE White Lodge Residential Home White Lodge Fenn Green Alveley Nr Bridgnorth Shropshire WV15 6JA Lead Inspector Mike Moloney Unannounced Inspection 25th April 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address White Lodge Residential Home DS0000067278.V337577.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. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Lodge Residential Home Address White Lodge Fenn Green Alveley Nr Bridgnorth Shropshire WV15 6JA 01299 861120 01299 862038 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) Oldfield Residential Care Limited vacant post Care Home 36 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (21) of places White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Maximum number of Service Users is 36 (Thirty Six). Date of last inspection 29th November 2006 Brief Description of the Service: White Lodge is a large adapted building currently providing personal care and accommodation for up to 36 older people. The home is located in a rural position on the A 442 between Bridgnorth and Kidderminster offering both single and double bedroom accommodation. A large communal lounge and separate dining room are situated on the ground floor with a further lounge/dining area on the second floor. The home is owned by Oldfield Care Ltd with White Lodge being one of a number of care homes within this company. Weekly fees range from £430.00 - £ 450.00. Information about the home and the provision of the service are available in the statement of purpose and service user guide. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service What the service does well: What has improved since the last inspection? What they could do better: The quality management of the home must be improved, not only to comply with the requirements of the Care Homes Regulations 2001, but also to ensure that errors like those found in the recording of the controlled drugs are quickly identified and addressed and to generally check that the service that is being received by the residents is of an acceptable standard. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. White Lodge Residential Home DS0000067278.V337577.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 White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, and 3 Quality in this outcome area is good. Prospective residents and their representatives have the information needed to choose a home which will meet their needs made available in the form of a completed service user guide and statement of purpose. A robust admissions procedure ensures they have their needs assessed and they will have a contract which clearly tells them about the service they will receive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of a person who had recently been admitted to the home were looked at and these showed that an assessment had been carried out that provided the home with the information that enabled them to formulate a plan of how they would meet that person’s needs. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 9 Those records also contained a signed copy of the care contract between that person and the home which showed what services were paid for and by whom as well as what was expected by both parties in honouring the agreement. A service user guide and a statement of purpose were also seen that outlined what both prospective and current service users could expect from the home. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. The health and personal care that a resident receives is based on their individual needs. These have been detailed in care plans that show how they should be met, however shortfalls in the management and administration of medication means that it cannot be said that this is done safely. The principles of respect, dignity and privacy are put into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of a further two service users were examined. The care plans contained the information about their physical, mental and social needs and how they should be met. These care plans were seen to have been reviewed on a monthly basis. Manual handling risk assessments were seen to have been carried out as had risk assessments relating to behavioural issues. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 11 The home is regularly visited by District Nurses, one of which was there on the day of the inspection. She was complimentary about the way residents were cared for at the home. The management and administration of medication was looked at and it was seen that it is stored in a dedicated medication room that is equipped with hand washing facilities, a purpose designed drugs trolley that is locked to the wall when not in use, a controlled drugs cabinet and a medication fridge. The records relating to the medication were looked at and it was seen that a number of the controlled drugs that were found in the controlled drugs cabinet could not be accounted for in the records. One dose was also found to not have a pharmacist’s label that identified who it was intended for. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Residents are able to choose their life style, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs a member of staff whose job title is activities organiser. Her job is to organise communal activities for the residents to take part in. Looking at the records that she maintains it could be seen that the home identifies what type of activities that individuals like and then organises activities that are designed to meet those wishes. Each person’s participation is then noted with a view to either developing those activities or not. Talking with a number of the residents established that most enjoyed joining in with what was organised and those that did not said that they appreciated the opportunity. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 13 Activities such as quizzes, card making, a session called ‘physio fun’ and craft session are amongst the activities offered. The Activities Organiser said that she is currently organising a trip to a safari park. The manager said that the home has access to a local community car and voluntary services minibus scheme. The Statement of Purpose states that a local vicar visits fortnightly and this was confirmed by some of the residents. The religious preferences of each resident was seen to be recorded in their records as was the name by which they liked to be known. Throughout the inspection a number of relatives were seen entering and leaving the home and being made welcome by the staff. Staff were seen knocking on doors before they entered rooms out of respect for the occupants privacy. The bedroom doors were all seen to have an appropriate style of lock although most of the residents spoken to said that they did not feel the need to leave their rooms locked. A number of the service users spoken to were very complimentary about the food provided by the home. They said the quality of the cooking and the size of the portions was always good. Looking at the records showed that the menus were traditionally ‘British’ but varied. The meal seen on the day of the inspection looked and smelled appetising. Talking with the cook established that she was aware of any special medical dietary needs as well as individual preferences and was therefore able to offer suitable alternatives when necessary. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. Residents have access to a robust and effective complaints procedure, are protected from abuse and have their legal rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was seen to have a complaints procedure and this was included within the service user guide. The manager stated that no complaints had been received since the last inspection. A copy of the local policies and procedures for the safeguarding of adults was seen in the carers’ office. Staff confirmed that they were about to receive training on this subject in the near future. The manager confirmed that no referrals into these procedures have been necessary. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment that encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although sited in a rural area the White Lodge is easily accessible from a nearby main road and has plenty of car parking. The home is furnished, decorated and maintained to a high standard. When talking to residents they spoke of their satisfaction with their bedrooms as well as the communal areas. There is a seven bedded unit on the second floor and when asked the residents using the lounge in that area said that they found the area more personal and to their liking. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 16 All of the bedrooms looked at contained lots of personal items of decoration and furniture with the furniture that had been provided by the home being in good condition. All areas of the home were seen to be clean and a well equipped laundry room was sited in the basement. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. Staff in the home are now trained, skilled and in sufficient numbers to fill the aims of the home and meet the changing needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Talking to the service users as well as observing the care that they received showed that there were adequate numbers of staff on duty. Looking at the staff rotas and talking to the staff showed that the numbers on duty at other times were the same as those seen during the inspection. The services of catering and maintenance staff were also available along with those of an Activities Organiser making more time for the care staff to look after the health and personal care needs of the service users. The staff team reflected the same ethnic mix as the service users. Looking at the records of the staff training and talking with staff established that a training programme was in place that would give staff the skills to meet the care needs of the people living at the home. This included NVQ training to a number of levels. The records of staff who had recently started at the home were looked at and these contained evidence that all of the checks had been carried out that are White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 18 required to ensure that people who are employed by the home are fit to work with vulnerable people. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is adequate. An effective quality assurance system has not been developed and although a number of routine safety checks are carried out regularly the safety of the service users cannot be said to be fully monitored. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is in the process of applying for registration with the Commission for Social Care Inspection. No evidence was seen during the inspection of the further development of quality assurance procedure for the home which would include a range of measures such as satisfaction surveys or the checking of controlled drugs. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 20 The manager stated that the monthly visits required when the registered provider is an organisation had not been carried out. The management of hazardous substances within the home was looked at. The storage was seen to be in the basement and therefore inaccessible to the service users but the risk assessments for their safe storage and use had yet to be developed. Various records relating to safety monitoring such as portable appliance testing and hot water temperatures were seen to be maintained with action being taken over issues identified as necessary. Accident record were seen to be kept within the individual’s files and contained notes about any actions needed as a result of an incident. An officer from the Shropshire Fire and Rescue Service visited during this inspection and although some minor recommendations were made she felt that, in respect of fire safety, the home maintained a safe environment for the service users. The manager stated that the home does store small amounts of cash for service users. Ledgers for each person were seen and the manager said that she balances these every week to ensure that they are accurate. White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 1 x 3 x x 2 White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 22 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 OP9 Regulation 13(2) Requirement Timescale for action 31/05/07 2 OP33 26(2),(3) and (4) 3 OP33 24(1) 4 OP38 13(4) Arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home must be in place so that service users receive the correct medication and records are accurately maintained The home must be visited once a 30/06/07 month by the responsible person, another director or person responsible for the management of the company, to ensure that it is being run in the best interests of the service users. The registered provider must 31/05/07 ensure that a quality assurance and monitoring system is developed, so that compliance with procedures and service user satisfaction can be measured Previous requirement 31/08/06 not fully met. Risk assessments around the use 30/06/07 of hazardous substances must be developed, so that staff and service users are protected from harm DS0000067278.V337577.R01.S.doc Version 5.2 White Lodge Residential Home Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations White Lodge Residential Home DS0000067278.V337577.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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