Inspection on 27/09/07 for White Lodge Residential Home

This inspection was carried out on 27th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

White Lodge Residential Home 26/09/08

White Lodge Residential Home 16/02/07

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 Residential Home 62 West End Kemsing Sevenoaks Kent TN15 6QB Lead Inspector Mark Hemmings Key Unannounced Inspection 09:00 27 September 2007 th 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 DS0000066253.V345309.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 DS0000066253.V345309.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Lodge Residential Home Address 62 West End Kemsing Sevenoaks Kent TN15 6QB 01732 761227 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) Synchronized Limited Mrs Brenda Dorathy Turley Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2007 Brief Description of the Service: White Lodge (the Service) is registered to provide accommodation and personal care for 13 older people. The property is a detached house located in the village of Kemsing. It is close to shops and to other amenities. There are gardens and off-road parking for several cars. The accommodation is arranged on the ground floor and the first floor. All of bedrooms are currently being used for single occupancy. When the Service is full, one of the bedrooms can be used for shared occupancy. All of the bedrooms have a private was hand basin. Eight of the bedrooms also have a private toilet and shower. There is a choice of communal areas with two lounges and a separate dining room. There is a passenger lift between the floors. Also, there is a call bell system with call points present in each of the bedrooms. The Registered Provider is a private limited company. The current weekly fee for residence in the Service runs from £500.00 to £580.00 per week. Additional costs include those for services such as consultations with the chiropodist and those for goods such as newspapers. Further information about the fees and costs payable, are available from the Registered Manager. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Report is based upon a number of sources of evidence. These include a review of the correspondence in relation to the Service received by the Commission since the last inspection. A part of this, is the Registered Provider’s own appraisal of its performance that was submitted to the Commission in accordance with the Regulations. Another source of evidence involves any written information received from the people who use the Service, from their relatives and from care managers (social workers). Also, the Inspector completed an unannounced inspection visit to the Service. This took about six hours to complete. During this time, the Inspector spoke in some detail with three of the people who use the Service. All of these discussions were in private. The Inspector consulted with the Registered Manager and with two of the care workers. In addition to this, the Inspector examined various parts of the accommodation and he reviewed a selection of the key records and documents. What the service does well: What has improved since the last inspection? The Registered Provider has addressed in a systematic manner most of the improvements required and recommended at the time of the last inspection. There are improvements to note in a number of the arrangements used to White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 6 manage medicines. Various aspects of the systems used to plan and to deliver personal care have been strengthened. The completion of security checks in relation to new care workers, have been tightened. The delivery of induction and ongoing training has been extended and refined. Various improvements to the property and to the accommodation have been completed, or are about to be completed. Some oversights in relation to the promotion of peoples’ health and safety, have been addressed. These developments will need to be sustained. This is so that the Service can continue to deliver positive outcomes for the people in residence in the manner required by the Regulations. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. White Lodge Residential Home DS0000066253.V345309.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 DS0000066253.V345309.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): Standards 1, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. Prospective people who might use the Service, have access to the information they need in order to establish if the Service will meet their requirements. Also, they have their needs assessed and their preferences recognised. EVIDENCE: Prospective people who might use the Service, are provided with a range of written information about the facilities and services available in White Lodge. They can read the Service Users’ Guide. This is a brochure that outlines what someone moving into the Service can expect to receive. Also, there is a document called the Statement of Purpose. This gives a more detailed account White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 9 than does the Guide. A copy of the Commission’s most recent inspection report is available in the Service. The Registered Manager says that she is always willing to build upon these sources of information, by answering questions about points of detail. The Registered Manager completes an assessment of the needs and wishes of each person who might want to move into the Service. This involves speaking with the person so that their needs for assistance can be identified. Also, it entails her getting a clear understanding of their preferences and of their expectations. The assessment is undertaken so that a decision can be made about whether or not the Service is the most appropriate place for the person concerned. The Registered Manager says that nearly all of the people who elect to move into the Service, do so with the intention of making White Lodge their longer term home. However, there is provision for people to stay for shorter periods. This might be necessary for example if they are recuperating before going home after having been in hospital. The Registered Manager is aware of the need to assist this process so that the necessary arrangements for the return home are made in a timely manner. White Lodge Residential Home DS0000066253.V345309.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): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The health and personal care which people who use the Service receive, is based upon their individual needs. Suitable arrangements are in place to manage medication. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The people who use the Service, say that the care workers offer them all the assistance they need. Also, they say that this is provided in a reliable and consistent manner. There is a written plan of care for each service user. These are important documents. This is because they form one of the means by which people who use the Service can be informed about and can agree to the White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 11 assistance they will receive. Also, the plans constitute a source of reference information for care workers. In general, the system is well organised and the information is quite detailed. However, there is an omission in an aspect of the arrangements in place in relation to one of the people who use the Service. The Registered Provider is going to address this oversight by 1 November 2007. The people who use the Service, are assisted to maintain their physical health. Care workers keep a tactful eye open, so that medical attention can be sought promptly should the need arise. Since the last inspection visit, family practitioners, the local district nursing service and various other hospital-based medical services have been involved in supporting the care provided in the Service. There is an omission in the arrangements used to plan the assistance provided in the Service for one of the people in residence. The Registered Provider is going to address this oversight by 1 November 2007. Suitable arrangements are in place to enable medication to be stored securely and to be administered in accordance with the doctors’ instructions. The people who use the Service say that the care workers are kind and considerate. There is a family atmosphere in the Service. White Lodge Residential Home DS0000066253.V345309.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): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The people who use the Service have things to do. They keep in touch with members of their families. Good quality meals are served. EVIDENCE: The people who use the Service say that they are free to choose what to do each day. The pace of daily life is relaxed. They say that there are no unnecessary rules or routines to disrupt the experience of a normal domestic setting. Most of the people who use the Service, consider themselves to be suitably occupied. However, some people would like more social activities to be organised. The Registered Provider is going to respond to this observation by White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 13 consulting with each person about what more they might like to do. This exercise is going to be completed by 1 December 2007. The people who use the Service, are assisted to keep in touch with family and friends. People can receive visitors at any reasonable hour. They can meet with their visitors in the privacy of their bedroom if they wish to do so. The Registered Manager keeps in touch with relatives so that they know how things are going. The people who use the Service, say that they receive good quality meals and they always have enough to eat. The menu indicates that a normally varied diet is provided. People are free to dine in the privacy of their bedroom if this is their wish. White Lodge Residential Home DS0000066253.V345309.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There is an effective system for dealing with complaints. The wellbeing of the people who use the Service, is safeguarded. EVIDENCE: The Registered Provider is aware of the need to ensure that complaints about the Service are investigated thoroughly and resolved promptly. Since the last inspection, neither the Registered Provider nor the Commission have received any formal complaints about the Service. The care workers with whom the Inspector spoke, have a sound understanding of what constitutes good care practice. As part of this, they are aware of the need to be alert to instances in which the well being of people who use the Service might become jeopardised. The people who use the Service feel safe living in White Lodge. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 15 White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 16 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): Standards 19, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The accommodation is well presented and maintained. EVIDENCE: The people who use the Service, consider the accommodation to be homely and welcoming. The Registered Provider is about to install new windows throughout the building. A number of the existing ones have patches of rot and they look very unsightly. After the windows are replaced, some of the discoloured white masonry paintwork is going to be re-done. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 17 The premises are fitted with an automated fire detection and fire management system. The Registered Provider has completed an organised assessment of the adequacy of the fire safety measures in use in the Service. This indicates that there are no significant hazards that have yet to be addressed. The premises comply with the principal requirements of the local Department of Environmental Health. The kitchen is equipped adequately. Also, it is clean and well organised. Members of staff are aware of the principles of good food hygiene practice. The people who use the Service say that their accommodation is kept comfortably warm and there is an adequate supply of hot water. Suitable steps have been taken to help prevent someone being burnt or scalded. All residential care service are required to comply with new regulations which have been introduced to help prevent used water from leaking back into the main cold water supply. The Registered Provider is going to clarify with the water supply company what (if any) additional steps may need to be taken in relation to this matter in the Service. This will be undertaken by 1 November 2007. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There are enough members of staff on duty. Security checks are completed in relation to new employees. Care workers know what they are doing. EVIDENCE: There are at least two care workers on duty at all times. At night time, there is someone on waking duty. There are enough care workers on duty at the moment given that only eight people are in residence. However, when the number in residence increases, more care workers may well be needed. The Registered Provider needs to keep this matter under careful review. About one half of the care workers employed in the Service have acquired or are in the process of acquiring, a National Vocational Qualification (NVQ) in health and social care. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 19 The Registered Provider completes a number of security checks for new care workers. These are designed to ensure that all members of staff are suitable people to be entrusted with access to service users who may be vulnerable. All new care workers receive introductory training. This is designed to ensure that they have the basic knowledge and skills they need in order to be able to work without direct supervision. This is important because the quality of care delivered in the Service, depends largely upon the adequacy of the competencies care workers have to hand. In addition to the introductory training, existing care workers undertake a number of training courses. These are designed to further develop their skills. The Registered Manager is going to add to this system. This will be done, by reviewing the adequacy of the skills and knowledge of each of the existing care workers. This is a very good idea, because it double-checks that each care worker has the competencies they need. This exercise will be completed by 1 April 2008. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the Service. The Service is well managed. The quality assurance system needs to be developed further. Sensible measures are in place to safeguard peoples’ health and safety. EVIDENCE: The Registered Manager has a good knowledge of how the Service runs. She has acquired both of the formal qualifications that are required by the White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 21 Regulations. Care workers say that they like the way she consults with them. They think that this contributes to there being good team-work. The Registered Manager meets periodically with each care worker to review their work and as necessary to offer guidance. The people who use the Service, are invited to comment informally to staff about how things are going. In addition to this, the Registered Provider operates a more organised quality assurance system. This involves the people who use the Service and other interested parties being invited to complete questionnaires about how things are going. This arrangement is now going to strengthened further. This will be done by the preparation of an annual quality report. This document that will be shared with the people who use the Service, will summarise the comments received. Also, it will explain what action will be taken to introduce any suggested improvements. The first such report will be available by 1 January 2008. A representative of the Registered Provider visits the Service twice a month in order to check out first hand how things are going. The Registered Provider assists some of the people in residence by paying for them to receive additional services. It then invoices their representatives for reimbursement. The Commission has not received any expressions of concern about the arrangement. However, the records relating to the system were not available at the time of the inspection to be reviewed. Therefore, the actual operation of the arrangement could not be audited. The Registered Provider will need to ensure that the records in question are available to be accessed at the time of future inspection visits. There have not been any accidents or other untoward events in the Service since the last inspection, that are out-of-the-ordinary. The Registered Provider has prepared various written policies and procedures. These are designed to help care workers complete their duties in an effective and consistent manner. The Registered Manager says that all items of equipment in use in the Service remain in good working order. There are various service documents in place that are consistent with this account. The Registered Provider is completing a number of ongoing that are designed to ensure that the Service’s fire safety equipment remains in good working order. Also, there are regular fire drills. Since the last inspection, most of the care workers have attended a fire safety course. The Registered Manager is now going to develop this arrangement further. This will be done by periodically double-checking that each member of staff does indeed know how to operate reliably the Service’s fire safety procedure. This development will be completed by 1 December 2007. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 22 The Registered Provider monitors the premises and the accommodation. This is done so that potential hazards to health and safety can be identified and resolved. The Registered Manager says that there are no significant hazards waiting to be addressed. White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 23 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 X 3 X X 3 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 3 2 X X X X 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 3 X 2 White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 DS0000066253.V345309.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI White Lodge Residential Home DS0000066253.V345309.R01.S.doc Version 5.2 Page 26 - 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. 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