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Care Home: Adelaide Lodge

  • 27 Kings Road Honiton Devon EX14 1HW
  • Tel: 0140442921
  • Fax: 0129724912
  • Planned feature Advertise here!

Adelaide Lodge is a large older property with modern extensions situated on the edge of the town of Honiton close to local amenities. The home can accommodate and provide personal care for up to 48 older people who may also have a dementia type illnesses and/or with physical disabilities. Adelaide Lodge receives support from the local Health Care team. The home has good access throughout and there is a shaft lift between floors for those people who cannot manage the stairs. The home is set back from a main road with ample parking to the front and a good-sized garden with patio to the rear. Copies of inspection reports are available in the home. These can usually be found on the notice board in the entrance hallway.

  • Latitude: 50.798999786377
    Longitude: -3.1789999008179
  • Manager: Ms Melanie Godbeer
  • Price p/w: ~
  • UK
  • Total Capacity: 48
  • Type: Care home only
  • Provider: Adelaide Lodge Care Home LLP
  • Ownership: Private
  • Care Home ID: 1395
Residents Needs:
Dementia, Old age, not falling within any other category

Latest Inspection

This is the latest available inspection report for this service, carried out on 30th September 2009. CQC found this care home to be providing an Excellent service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

For extracts, read the latest CQC inspection for Adelaide Lodge.

What the care home does well We received a great deal of praise for all aspects of the home from the people we talked to during this inspection, and from the people who completed survey forms before this inspection. Comments included, "I am impressed by the evident concern for the well being of the residents as individuals who exhibit a wide variety of needs". "Wonderful! Everything is good. Next best to your own home." "I`m happy here." "Comfort, good food, warmth, very important for the elderly and also as important when residents are unwell. Every effort is made to make them comfortable and sometimes in my experience beyond the call of duty." The home has good admission procedures in place. They have a range of useful written information about Adelaide Lodge that is given to people who may be thinking about moving in. They also have an internet web site. People have been encouraged to visit and get to know the home, and perhaps have a short stay to help them decide if it is the right place for them. The records we looked at showed the manager or a senior member of staff has carried out an assessment of each person before they moved in to make sure they were able to meet the person`s care needs and to check that the home was suitable. The assessments have been used to help them draw up a plan of the person`s care needs. Medicines have been safely stored and administered in the home. Staff have received training on the safe administration of medicines and good procedures have been followed to reduce the risk of mistakes. People told us how much they enjoyed the activities provided in the home. On the day of our visit a professional musician was playing to people in the main lounge. We saw a timetable of the activities planned for the week showing something provided on each weekday. People have been consulted over the things they want to do and suggestions have been followed up, for example, carpet bowls had recently been introduced. People told us they enjoyed the meals and said they always received food that met their preferences and dietary needs. There were four-weekly menus in place that offered a good variety and choice. Each person`s dietary needs had been assessed using risk assessment tools to ensure they were receiving the right level of nutrition. Good procedures were in place to deal with complaints, concerns or grumbles. People told us they knew how to make a complaint and felt confident that any issues they raised would be dealt with satisfactorily. All areas of the home were found to be well maintained, bright, modern comfortable and well equipped. The furnishings were of a very good standard. Bedrooms have been individually decorated and furnished and people have been encouraged to bring with them items of furniture, pictures and personal effects to make their room feel homely. There is a stable and happy staff team. All of the staff were talked to, and those who completed a questionnaire before this inspection demonstrated great pride in their work and the home. People living in the home praised the staff team. We found that the home had usually taken great care when recruiting new staff to make sure they were entirely suitable for the job (with one exception - see What could the home do better). The staff have been well trained and there were efficient systems in place to show when further training and updates were necessary. There were good systems of supervision and monitoring in place and staff said they felt well supported. The home was well managed and ran smoothly. There has been good support for the new manager by the senior management team and the home has been closely monitored. They had a range of methods to check and improve the quality of the services and care provided. The home was clean and safe. Good procedures had been followed to reduce the risk of infection. What has improved since the last inspection? A new extension has been built in the last three years and this has provided new spacious bedrooms with en suite facilities and good access around the home. The lounge area has been extended and the gardens improved. The home is now bright, modern and spacious throughout. In the last year a number of further improvements have been made including the purchase of a new vehicle to be used to take people out and about. The level of activities have increased and there has been more variety. They have purchased a large screen television for the main lounge and a games console giving people a variety of games and entertainments. Staff have received training on equal opportunities and their equality and diversity policy has been reviewed and updated. What the care home could do better: While there were good care planning systems in place some improvements could be made to make the information even easier to find and to follow. The manager was already planning some changes to the care plan files and we suggested she could take the opportunity to make some further changes to make sure the information is very clear and easy to follow. While the staff recruitment files showed that most staff had been very carefully recruited, on person had started work before at least two satisfactory written references and a criminal records bureau (CRB) check had been received. The manager, Melanie Godbeer explained the reasons why this decision was taken, and said the risks were minimal, but we advised that safe procedures must always be followed and clear evidence must be in place at all times before new staff begin work in order to protect people who may be vulnerable. We also suggested the job application forms are revised to include details of all previous employment details. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Adelaide Lodge 27 Kings Road Honiton Devon EX14 1HW     The quality rating for this care home is:   three star excellent 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. Lead inspector: Vivien Stephens     Date: 3 0 0 9 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 32 Information about the care home Name of care home: Address: Adelaide Lodge 27 Kings Road Honiton Devon EX14 1HW 0140442921 0129724912 carehomesllp@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Melanie Godbeer Type of registration: Number of places registered: Adelaide Lodge Care Home LLP care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 48. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) - maximum of 48 places Dementia (Code DE) - maximum of 48 places Date of last inspection 48 0 Over 65 0 48 Care Homes for Older People Page 4 of 32 Brief description of the care home Adelaide Lodge is a large older property with modern extensions situated on the edge of the town of Honiton close to local amenities. The home can accommodate and provide personal care for up to 48 older people who may also have a dementia type illnesses and/or with physical disabilities. Adelaide Lodge receives support from the local Health Care team. The home has good access throughout and there is a shaft lift between floors for those people who cannot manage the stairs. The home is set back from a main road with ample parking to the front and a good-sized garden with patio to the rear. Copies of inspection reports are available in the home. These can usually be found on the notice board in the entrance hallway. Care Homes for Older People Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Several weeks before this inspection took place we asked the home to complete an Annual Quality Assurance Assessment (AQAA). They completed it and returned it to us by the required date. The completed form gave us very good information about the management of the home and daily routines and services. We also sent a number of survey forms to the home and asked them to distribute these at random to some of the people living in the home, staff and health and social care professionals. On the day of this inspection we also gave out some surveys for relatives and friends and these were returned after our visit. At the time this report was completed we received 15 completed forms from people living in the home, 12 from staff, 3 from health and social care professionals and 3 from relatives and friends. This unannounced inspection lated approximately 8 hours. During the day we talked to Care Homes for Older People Page 6 of 32 the Manager, Melanie Godbeer, the Managing Director, four people who live in the home, and three members of staff. We carried out a tour of the home. We also looked at the records the home is required to maintain including care plans, medicine administration, staff recruitment and training, and health and safety records. What the care home does well: We received a great deal of praise for all aspects of the home from the people we talked to during this inspection, and from the people who completed survey forms before this inspection. Comments included, I am impressed by the evident concern for the well being of the residents as individuals who exhibit a wide variety of needs. Wonderful! Everything is good. Next best to your own home. Im happy here. Comfort, good food, warmth, very important for the elderly and also as important when residents are unwell. Every effort is made to make them comfortable and sometimes in my experience beyond the call of duty. The home has good admission procedures in place. They have a range of useful written information about Adelaide Lodge that is given to people who may be thinking about moving in. They also have an internet web site. People have been encouraged to visit and get to know the home, and perhaps have a short stay to help them decide if it is the right place for them. The records we looked at showed the manager or a senior member of staff has carried out an assessment of each person before they moved in to make sure they were able to meet the persons care needs and to check that the home was suitable. The assessments have been used to help them draw up a plan of the persons care needs. Medicines have been safely stored and administered in the home. Staff have received training on the safe administration of medicines and good procedures have been followed to reduce the risk of mistakes. People told us how much they enjoyed the activities provided in the home. On the day of our visit a professional musician was playing to people in the main lounge. We saw a timetable of the activities planned for the week showing something provided on each weekday. People have been consulted over the things they want to do and suggestions have been followed up, for example, carpet bowls had recently been introduced. People told us they enjoyed the meals and said they always received food that met their preferences and dietary needs. There were four-weekly menus in place that offered a good variety and choice. Each persons dietary needs had been assessed using risk assessment tools to ensure they were receiving the right level of nutrition. Good procedures were in place to deal with complaints, concerns or grumbles. People told us they knew how to make a complaint and felt confident that any issues they raised would be dealt with satisfactorily. All areas of the home were found to be well maintained, bright, modern comfortable and well equipped. The furnishings were of a very good standard. Bedrooms have been individually decorated and furnished and people have been encouraged to bring with them items of furniture, pictures and personal effects to make their room feel homely. There is a stable and happy staff team. All of the staff were talked to, and those who completed a questionnaire before this inspection demonstrated great pride in their work and the home. People living in the home praised the staff team. We found that the home had usually taken great care when recruiting new staff to make sure they Care Homes for Older People Page 8 of 32 were entirely suitable for the job (with one exception - see What could the home do better). The staff have been well trained and there were efficient systems in place to show when further training and updates were necessary. There were good systems of supervision and monitoring in place and staff said they felt well supported. The home was well managed and ran smoothly. There has been good support for the new manager by the senior management team and the home has been closely monitored. They had a range of methods to check and improve the quality of the services and care provided. The home was clean and safe. Good procedures had been followed to reduce the risk of infection. What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Older People Page 9 of 32 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 10 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has excellent admission and assessment procedures in place, helping people able to make an informed choice about where they want to live and ensuring people do not move in unless the home is confident they can meet the persons needs. Evidence: We looked at the information and opportunities people have been given to visit and get to know the home before they move in. There is an informative brochure, service user guide and Statement of Purpose, and people have been offered a copy of the last inspection report. There is also an internet website that gives a good range of useful information and photographs of the home. People have been encouraged to visit the home as many times as they wish and given time to make a decision. Some people have chosen to have day care or short stays, and the first month is usually treated as a trial period to allow the person to make up their mind. Care Homes for Older People Page 12 of 32 Evidence: We looked at four care plan files to find out how much information had been gathered about each person before they moved in. There were various assessment tools to help them to look at all aspects of the persons abilities and to find out what tasks they needed assistance with. They also gathered information from health and social services where possible to help them decide if they were able to provide the right care, support and facilities for each person. The manager or a senior member of staff has visited the person where possible in hospital or their own home to complete the assessment. We heard that a gift of a plant or bouquet of flowers and a welcome card has usually been placed in the persons room before they arrived to make them feel welcomed and they have offered whatever support the person has wanted to help them settle in. We talked to four people about the way they chose the home, and the care taken by the home to get to know them. People told us they were very happy with the admission process and they said they were given plenty of opportunity to visit and get to know the home before deciding if it was the right place. One person we talked to was there for a short period to get over a period of illness and hoped to be returning home. They praised all aspects of the admission process and said they were certain they made the right choice. The home does not provide intermediate care. Care Homes for Older People Page 13 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the staff will know and understand their care needs and they will be offered all the care and support necessary to keep them safe and well. However, some aspects of the care planning systems could be improved to make sure staff always have access to clear, comprehensive and up to date instructions about each persons care needs. Medicines are safely stored and administered by trained staff following good recording tools. Evidence: We looked at four care plan files to find out how the home had consulted with each person to draw up and agree the assistance they needed throughout the day, and how the staff would meet those needs. On the day of this inspection the care plans were stored in a cupboard in the dining room. We heard that the new manager, Melanie Godbeer, was planning to make some changes to the files by separating the information into separate A4 clip files, one for each person, and these will be stored in a wheeled trolley that will be kept in a locked cupboard when not in use. This will Care Homes for Older People Page 14 of 32 Evidence: mean that staff will have easier access to individual care plan files, and will also improve the security and confidentiality of personal information. At the front of each persons section there was a page that gave important information such as date of birth, next of kin, doctor, and any professionals and people involved in the persons care. There was also an up to date photo of the person. The main plan of care needs was set out on a form near the front of the file. The plans gave brief statements about the assistance each person needed. There were also cards in each persons bedroom, usually discretely stored in a cupboard, giving further instructions to care staff about the support needed with dressing and personal hygiene. The plans had been hand written, and a form attached provided evidence of regular reviews and any subsequent changes to the plan. The care staff had also completed daily evaluation sheets that provided good evidence of the care and support they had given. While the care plans generally gave a good explanation of each persons care needs we found a few areas where the information could be improved. For example, one care plan instructed care workers to encourage the person to wash and shave themselves, while the daily evaluation sheets showed that this had changed and care workers were regularly doing these tasks for him. In another care plan we saw an entry in the daily evaluation records informing staff that the person had been advised by a health professional they should do daily standing and stretching exercises. This information had not been transferred to the main care plan to inform care staff about how to support the person to carry out these exercises. One care plan file had a note on the front sheet advising staff to make a note of what the person was wearing each day, but there was no further instruction in the main care plan, and we found no evidence that the care staff had made a written record each morning of the clothes the person was wearing. One persons care plan file contained a chart that had been completed because the person had been displaying aggressive behaviour. This showed that the home were trying to understand what was happening and why. However, there was little information in the care plan about the possibility of aggression or what might cause the person to become upset, and how the staff could support the person to avoid them becoming upset, or to divert them to help them calm down. We talked to the manager, Melanie Godbeer about ways the care plans could be adjusted (for example, by considering typing on the computer) to enable adjustments to the main care plan to be made easily. We also suggested the home considers the Care Homes for Older People Page 15 of 32 Evidence: way the daily care tasks are set out in the main care plan so that staff have one clear set of instructions they can follow throughout each day. We talked to four people about the care they received from the staff team. Each person said they were completely satisfied with the care they received. We also received many positive comments from people who completed a survey form before this inspection took place. Comments included Very good at caring. Comfort, good food, warmth, very important for the elderly and also as important when residents are unwell. Every effort is made to make them comfortable and sometimes in my experience beyond the call of duty. Efficient staff who give a good service. Staff friendly and approachable and give good care. In my opinion Adelaide Lodge was a very good choice for my Mother, She and I are very happy with the care (not only for her but for me also, always ready to listen and give help at all times day and night. I really think you cant get better. We heard that there is a stable staff team and people felt confident that the staff knew them well and understood their care needs very well. There was a good daily handover system and we saw evidence to show there was good communication throughout the home and any changes in care needs were explained to care workers clearly. We saw evidence to show that whenever a person has shown signs of illness, or if their illness became worse, the home has sought medical treatment appropriately. One health care professional who completed a survey form before this inspection told us the home is Sensitive to individuals needs and they Engage with other agencies ie. District Nurses and GPs as appropriate. The manager, Melanie Godbeer, told us that if people needed assistance with creams and lotions a creams chart had been placed in the persons bedroom for care staff to complete each time the cream had been administered. This demonstrated good practice. One persons care plan file contained a record in the daily evaluation notes showing that the person may be at risk of developing a pressure sore. Cream had been applied to soothe the area but there was no evidence that the person has been referred to their GP or district nursing service to assess the risk of pressure sores and determine the correct equipment and treatment to prevent skin damage developing. The home did not routinely use a risk assessment tools to check and regularly review the risk of pressure sores - this is recommended. We looked at the way medicines have been stored and administered. There was a Care Homes for Older People Page 16 of 32 Evidence: secure room on the ground floor where medicines were stored. The home used a monitored dosage system provided by a local pharmacy that offered a safe and easy to use system. There were two medicine trolleys that provided a safe method of transporting medicines around the home. There was a secure cupboard and good recording system for controlled drugs. There was also a secure refrigerator specifically for medicines that needed to be kept cool. We looked at the records of medicines that had been administered in recent weeks to the four people whose care we had been following from their care plans. The records were generally very well maintained and showed most medicines had been administered correctly. However, one person had possibly missed their early evening medication on at least three occasions. We asked the home to investigate this matter. The manager telephoned the following day to say she had carried out an audit and full investigation and was satisfied the medicines had been correctly administered, although the staff had failed to record this correctly. She said they have improved the recording systems to make sure this does not happen again. A new recording tool was about to be introduced to each file to give end of life instructions for staff when a person becomes seriously ill. Care Homes for Older People Page 17 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily life at Adelaide Lodge is stimulating and varied. People can lead their lives as they wish and are offered choices throughout each day. Evidence: We looked at the range of activities offered by the home and how they catered for the interests and preferences of each person living in the home. During our visit we were given a copy of the activities planned for the current week showing a different activity each week day including games, visits from two different visiting musicians, an inhouse shop, and visits from a hairdresser. The home had recently purchased a large screen television and a computer games console and many people have enjoyed watching the new television and playing some of the games. In the last year they have had regular visits from the library, the local Donkey Sanctuary and from an organisation known as Pets as Therapy. They also have a clothing supplier who visits the home several times a year for clothing parties. They have has various outings through the summer months, and they have also organised theatre trips. In the last year the home has purchased a new vehicle. People have been encouraged Care Homes for Older People Page 18 of 32 Evidence: to participate in external clubs and social activities. This has included regular visits to a chapel for those people who have wanted to participate. The manager, Melanie Godbeer told us that they have organised swimming sessions at a local pool in the past for some people and they hope to re-start these soon. The gardens were attractively laid out with various places to walk or sit during warmer weather. People told us about various activities that have been provided in the garden in the summer, including ball games and how much these had been enjoyed. One person also said he had suggested they introduce indoor carpet bowls in the new wing where the corridor is long and wide. This has also been very successful. All of the people who completed a survey form before this inspection told us the home always or usually arranges activities they can take part in. Several people told us that activities and entertainment is something the home does well. The people we talked to told us they were able to lead their lives as they wished and were given choices in all their daily activities. We heard from people living in the home and from relatives who confirmed that visitors are always made welcome. Relatives have been invited to residents and relatives meeting held in the home. There was a four weekly menu cycle. Menus were placed on the dining tables so that people could see what meals were offered and they could ask for an alternative if they did not like the main meal offered. The home told us that there were organised meal times but people could choose to eat their meals at alternate times if they preferred, and they could choose where they wanted to have their meals. The care plan files showed that the home had good records of all individual likes and dislikes and special dietary preferences. They also contained risk assessment tools (known as MUST assessments) to help them check if people may be at risk of malnutrition. People told us they were happy with the variety and standard of the meals provided. One relative told us Lunch is usually praised. Another person told us I enjoy the meals here. Care Homes for Older People Page 19 of 32 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident the home will listen and take any necessary action to address all concerns, complaints or grumbles. The staff are well trained and good procedures are in place to protect people from possible harm or abuse. Evidence: In the last year the Commission has received two letters from the family of a person who stayed at Adelaide Lodge for a short period. The letters were passed to the home and they were asked to investigate the matter following their complaints procedures. They did this and we saw the outcome during this inspection. We were satisfied the home took the matter seriously, carried out a full investigation, and took action where necessary. The home responded to the Commission following their investigation but unfortunately due to an administrative error by the Commission their response was not seen or acted upon at the time. Following this inspection letters have been sent by the Commission to the complainants. In the last year the manager, Melanie Godbeer has been registered. During her fit person interview we were unsure if she had a clear working knowledge of Devon County Councils safeguarding procedure. During this inspection we were satisfied she had taken action to address this. We saw a flow diagram of the safeguarding procedures she had obtained and pinned on the office wall near her desk. She has also booked a place on a training course for the near future. Care Homes for Older People Page 20 of 32 Evidence: The home told us that staff have been made aware of forms of abuse and the protection of vulnerable adults through training both at induction and then more indepth training by their in-house trainer and through the use of DVD/video training materials. This was confirmed by the staff who completed a survey form before this inspection. We also looked at the homes policy on accepting gifts. Following our visit the Melanie Godbeer forwarded a copy of the homes policy that all staff have been made aware of. The policy was clear and straightforward. The home also had a range of policies in place relating to all aspects of prevention of abuse. The home has given each person a copy of the homes Service User Guide, and the complaints procedure is included in this document. It is also displayed in the entrance lobby. All of the people we talked to and those who responded to our questionnaires told us they knew how to make a formal complaint. Care Homes for Older People Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, well maintained, clean and safe home that has been decorated, furnished and equipped to a very high standard throughout. Evidence: Since the last key inspection a new extension has been built to enlarge the home. The new rooms were spacious, bright, and had modern en suite facilities. Other parts of the home have also been enlarged and improved including one of the lounges. The gardens have been landscaped with a large patio, paths and attractive sitting areas. During this inspection we carried out a tour of the home looking in a number of bedrooms at random. We also looked in the communal areas including toilets and bathrooms. We found all areas were bright, clean, well decorated and comfortable. Good quality furnishings and fittings have been used throughout the home. People have been encouraged to bring items of furniture, pictures and personal effects with them to make their rooms feel homely. New carpets that were laid when the new extension was completed have been found to be faulty and the home has reached agreement with the manufacturer for these to be replaced in the very near future. All areas of the home have been maintained to a very high standard both internally Care Homes for Older People Page 22 of 32 Evidence: and externally. All decorations were in good order throughout. The home had a good range of moving and handling equipment so that staff could assist people with poor mobility in a safe manner. The home told us the equipment had been regularly serviced and maintained. There was level access throughout the home and a shaft lift so that people could get around safely and easily. The home had completed risk assessments on all areas to make sure all anticipated risks were identified and action taken to minimise or reduce those risks where possible. Information provided by the home showed that staff have received training on infection control and have been issued with protective clothing, equipment, cleaning products and anti bacterial hand gels to minimise the risk of cross contamination. Care Homes for Older People Page 23 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by sufficient well trained and well supervised and supported staff. The home usually follows safe recruitment procedures, although some improvements are necessary to make sure people are fully protected from possible harm. Evidence: On the day that the home completed their Annual Quality Assurance Assessment (AQAA) there were 47 people living in the home. 33 permanent care staff were employed. All of the people who completed a survey form before this inspection took place (including residents, staff and relatives) praised the staff team highly and said the home always or usually meets the needs of the people living there. Comments included, The care workers are observant and know the names of residents and make contact effectively, It is pleasant and the staff are nice, Efficient staff who give a good service. Staff friendly and approachable and give good care, All the staff are considerate and kind! Its never too much trouble to help you. They always do their best to sort out any problems that sometimes occur. We looked at the recruitment files of five staff employed since the last inspection of the home. We checked to see that the home had taken care to obtain satisfactory references and criminal records checks before the staff had begun work. We found that all records were in order for four members of staff, but one person had begun Care Homes for Older People Page 24 of 32 Evidence: work a few days before satisfactory documents had been received. We talked to the Manager, Melanie Godbeer who explained that this person had previously worked at the home and had returned to work after a period working elsewhere. We explained that, even though they knew the person well they must still follow safe recruitment procedures and must have good written evidence to show the person is suitable for the job. The homes application form did not ask job applicants to provide full details of all previous jobs, and we advised they should adjust the form to make sure they receive this information. All staff employed by the home have completed a thorough induction training at the start of their work. Almost 50 of the staff team held a nationally recognised qualification know as an NVQ. More staff were in the process of obtaining this qualification and when completed this will bring the number of staff holding a relevant qualification to above the recommended level. On the day of this inspection we were given a copy of the homes training matrix. This was displayed on the office wall and provided an easy and effective way of checking the dates each member of staff had completed mandatory health and safety training topics. It also showed the dates staff had attended other courses including the mental capacity act, infection control, medicine management, supervision training, challenging behaviour, dementia, diabetes, pressure area and skin care, diet and nutrition, catheter care accident reporting, and risk assessment. This showed that the home has placed a very high priority on making sure staff are well trained in all relevant areas of their work. We talked to three members of staff on the day of this inspection. We also received 12 completed survey forms from staff. All of the staff expressed complete satisfaction in their jobs. There was a very happy atmosphere among the staff group and a great sense of pride in their jobs. We received many positive comments from the staff and the following are just a few of the things they told us As far as I am concerned the home does everything well; the care, the ways the home is looked after, the training, I enjoy working here, its a good atmosphere and the relationship with residents and colleagues is good, I have worked at Adelaide lodge for 12 years now and still to this day I enjoy working here. The staff are fun to work with and the management are always approachable, so hope to be here for years to come, Adelaide Lodge strives as a team to do the best they can at any given point in time, The home is very good Care Homes for Older People Page 25 of 32 Evidence: in all aspects of care and we try to deal with any situations we are placed in. As the training we receive improves our knowledge and gives us a greater understanding in all aspects of care and team work. We heard that all staff receive regular supervision and attend regular staff meetings. Two staff said they would like to have an opportunity to attend team building in an external venue. The manager said she would follow this suggestion up. Care Homes for Older People Page 26 of 32 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and safe. Evidence: Melanie Godbeer was appointed as manager earlier this year having worked in the home for many years. Over the years she has worked her way up from junior to senior positions, most recently as Deputy Manager. An application to register her was submitted to the Commission a few months ago and we carried out checks and took up references. We found that she is suitably qualified, experienced and capable to manage the home. She is supported and supervised by an experienced team of senior managers, and she can also call on the support of other managers of homes in the area also owned by the company. The people we talked to during the inspection, and the survey forms we received before our visit all showed that people were entirely satisfied with the management of the home. Staff told us they received enough support from their manager. Comments included Adelaide Lodge is up to standard, eg care, and the health and safety of the Care Homes for Older People Page 27 of 32 Evidence: vulnerable; employer and employees sharing information; up to date training courses. The home is good in all aspects of Quality Care, good staff and management. The management team have met at least once a month to look at all aspects of the running of the home. Minutes of these meetings have been given to the Commission and they provided good evidence to show that they have good monitoring systems in place to review and improve the quality of the care, facilities and services. They have sent out questionnaires to people seeking their views on all aspects of the home. Residents and relatives meetings have been held regularly and the minutes have been circulated so that any people who were unable to attend could see what was discussed and what actions have been taken. We looked at the way the home managed cash held on behalf of those people who did not want to keep cash in their rooms. The money was held safely and there were clear and accurate records to show all transactions. Regular expenditure such as hairdressing and chiropody have been paid by the home and people have been invoiced once a month for these items. We saw evidence during the inspection of good health and safety systems. Risk assessments have been carried out for all areas of the home. The manager and staff team have received training and updates on all aspects of health and safety. The maintenance person from one of the other homes in the group is about to complete an in-depth health and safety course in the near future and he will be overseeing all health and safety issues following completion of the course. The fire log book was seen and it showed all aspects of fire safety including routine maintenance and checks and staff training have been followed as recommended. Care Homes for Older People Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 29 of 32 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 29 19 At least two satisfactory 30/10/2009 references and a criminal records bureau check should be received before a new staff member begins working directly with vulnerable people. This is to provide written proof that the person is entirely suitable for the work they will be expected to perform. 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 Consideration should be given to the layout and level of detail in the main care plan form to ensure that care staff have one source of clear, easy to follow and up to date instructions about how each person want to be assisted and supported throughout the day. The home should introduce a method of checking the risk of people developing pressure sores or skin damage. Any person who may be considered to be at risk of developing Page 30 of 32 2 8 Care Homes for Older People 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 pressure sores or skin damage should be referred promptly to their GP or district nursing service. 3 29 Job application forms should direct the applicant to provide full details of all previous employment. Any unexplained gaps should be explored and the home should obtain as much information as possible about previous work experience to assure themselves that the person is trustworthy, reliable and honest. Care Homes for Older People Page 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) 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 32 of 32 - 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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