Care Home: Bruce Lodge

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What the care home does well What has improved since the last inspection? This was the first inspection for this home, which was registered on 29th February 2008. What the care home could do better: Care plans were, in the main, detailed and provided a good overview of what the residents could do for themselves and what they needed help with. However, where residents have more diverse needs, for example, if they have a sensory loss, such as very poor eyesight or hearing difficulties, care plans could be developed further, to help staff identify other resources and methods that could meet people`s needs more fully and enhance their quality of life. As the home is new and consequently staff were awaiting some training, which had been planned as a rolling programme, they were not all fully aware of the procedures related to safeguarding. Until all staff have received the training, the manager should ensure through staff meetings and supervision that they are aware of where the home`s policies and procedures are kept so staff have information easily available to them for reference should they need it. CARE HOMES FOR OLDER PEOPLE Bruce Lodge Turncroft Lane Offerton Stockport Cheshire SK1 4AU Lead Inspector Mrs Fiona Bryan Unannounced Inspection 11th August 2008 08:45 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 Bruce Lodge DS0000071308.V369380.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. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bruce Lodge Address Turncroft Lane Offerton Stockport Cheshire SK1 4AU 0161 429 8797 0161 429 0549 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) Borough Care Limited Mrs Lisa Martin Care Home 42 Category(ies) of Dementia (42), Mental disorder, excluding registration, with number learning disability or dementia (5) of places Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - code PC, to people of the following gender:Either; whose primary care needs on admission to the home are within the following categories: Dementia - Code DE; Mental disorder, excluding learning disability or dementia - Code MD (maximum number of places: 5). The maximum number of people who can be accommodated is: 42. Not applicable. Date of last inspection Brief Description of the Service: Bruce Lodge is a new, purpose built care home owned and managed by Borough Care Ltd. The home stands in its own landscaped gardens besides the woodland setting of Vernon Park in the heart of Stockport, Cheshire. It provides permanent or short-term places. Bruce Lodge Care Home provides accommodation for 42 older people with personal care needs associated with dementia and mental health. All bedrooms are single with en-suite facilities. Facilities such as bathrooms and toilets are environmentally adapted to maximise independence and meet the needs of the residents. Bruce Lodge is divided into four units over two floors. The units are called Bluebell, Sunflower, Fern and Rose and there are communal lounge/dining rooms in each unit, with a kitchen area for residents, visitors and staff to use. There are good sluicing areas and a medical room for drugs. The home has a hair salon and visitors’ toilet. A large conservatory on Bluebell unit provides the focal point when large group entertaining is planned. There are a number of security features within the home. Doors have been fitted with keypads, including the gate, which can be released when the fire alarm is sounded. There is also an intercom for visitors so staff can release the gate and the front door. All these security measures have been agreed with the fire officer. Fees for accommodation and care at the home are £436. A service user guide is available on request. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection, which included a site visit, took place on Monday, 11th August 2008. The staff at the home did not know that this visit was going to take place. This was the first inspection for this service since it was registered in February 2008. All the key inspection standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people who live at the home, the manager, visitors and other members of the staff team. Three people were looked at in detail, looking at their experience of the home from their admission to the present day. A selection of staff and care records was examined, including medication records, training records and staff duty rotas. Before the inspection, we asked for surveys to be sent out to residents and staff, asking what they thought about the care at the home. Six residents and five staff returned their surveys. Comments from these questionnaires are included in the report. We also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we see the service. We feel she completed this well and we agree with what she wrote. She was able to tell us what plans she has in place to continue developing the service. What the service does well: The internal and external appearance of the home is of a very high standard and provides a pleasant, comfortable environment for residents to live in. The home is purpose built and provides suitable aids and adaptations to support people with dementia and promote independence. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 6 The home has lots of space and residents can move around freely and enjoy friendships with each other, regardless of the unit they live on. All the residents’ rooms have en-suite facilities. People are assessed before coming to live at the home so staff can be sure they will be able to meet their needs. Care plans are written for each person, which generally provided good information to staff about the care they needed to deliver. In the main, staff followed the care plans well. Residents who returned surveys were satisfied that staff listened to and acted on what they said and felt they got the medical support they needed. One resident wrote that they had “hurt my leg and support doctor called for as soon as possible”. Other comments from residents included “happy with care and support provided”, “the staff are very attentive” and a relative wrote “my mother has been to the hospital twice and has been accompanied by staff who have been very helpful”. The provision of leisure activities was very good and the manager and staff were working at developing links with the local community and involving relatives and friends as much as possible. One resident commented “there are lots of activities, including trips out which are very enjoyable”. The manager and staff valued the role that relatives and friends could continue to play in the lives of the residents and they were encouraged to visit whenever they wished. The residents have been involved in deciding the type of social activities and events they want to participate in. Comments were positive about the food provided at the home. One relative said, “my mother enjoys all the meals” and five of the six residents who returned surveys said they always or usually liked the food. We observed residents enjoying breakfast and lunch. Both mealtimes were pleasant occasions, the meals looked appetising and residents said the food was “tasty”. Residents and relatives expressed satisfaction with the manager, saying she was approachable and would sort out any problems for them. The manager operates an open door policy and is available most of the time, around and about the home. People said they would feel comfortable raising any issues that concerned them. One relative said the manager was “always there to listen to you. I have no doubt she would deal with any problems – she is a very efficient person without being bossy”. Staff said that they regularly met with the manager and other senior members of the staff team and got feedback about their work. They were able to discuss their role and give suggestions about how they did their job and what training they needed. Records of these meetings were seen and showed that staff were well supported. One member of staff who returned a survey wrote, “My manager is very good and always asks if everything is alright. I know if I have a problem and am unsure what to do she will talk to me and resolve the matter”. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 7 Although the home has only been open for a few months, the staff team appear to be working well together and sound systems had been put in place to deliver all aspects of care effectively. One relative commented that, “the care home appears to be running quite smoothly and X is well cared for”. What has improved since the last inspection? 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. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 8 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 Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 9 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 and 3 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Residents were assessed in full, before coming into the home, thus ensuring staff were able to meet their identified needs. EVIDENCE: The records for three people who lived at the home were looked at in detail. Pre-admission assessments, contracts, financial details and archived records were kept in the manager’s office, whilst risk assessments and care plans were kept in each person’s own room so that staff could use them every day as working documents. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 10 An assessment had been undertaken for each person before they came into the home. Staff used a “trigger” system to assess if new residents needed referral to the district nurses for further assessment of their nutrition or pressure areas. Staff undertook their own assessments regarding the risk of falls and moving and handling. Detailed assessments were completed by staff at the home prior to admission but assessments from the local authority responsible for placing the resident were also provided. Evidence was available that some residents had visited the home on a trial basis before admission. One visitor said the resident they visited had looked round the home before admission and had settled in very well. A statement of purpose contained all the necessary information required by prospective residents and their relatives to understand what services the home offered. All the residents that returned surveys confirmed that they had received enough information about the home. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence, including a visit to this service. The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: On the day of the inspection, all the residents seen appeared well cared for and content. Residents were dressed appropriately for the weather and their hair, teeth and nails were clean. One relative said that the resident they visited always looked smart and well dressed. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 12 Three residents were looked at in detail and their care files were examined. All had care plans that were fairly person-centred and gave details about specific preferences of the residents. We checked and were able to see that the care written in residents’ care plans was, in the main, the care staff were providing in practice, for example, one resident’s care plan said they needed adapted crockery to help them eat independently. At lunchtime this resident was observed using the correct plate and they were managing to eat well on their own. However, staff need to work at making the care plans for residents with more diverse needs more specific as to how those needs will be met. One resident had very poor eyesight and although a care plan was in place, it focussed on ensuring the resident could locate key areas of the home. The plan could be developed to explore other resources that could be accessed for the resident to enhance the quality of their life. This resident also had difficulties in managing their personal hygiene, which had not been fully defined and planned for in their care file. Risk management forms had been completed for each resident to address how staff would minimise assessed risks to the residents. It wasn’t always clear how often the risk assessments had been reviewed; a record was kept of when care plans were reviewed but this did not always specify if risk assessments had been reviewed at the same time. Records showed that residents had seen GP’s, chiropodists, opticians and dentists. One resident was visiting the dentist on the afternoon of the inspection and a member of staff was accompanying them. The weight of each resident was monitored monthly. Two health care professionals visiting the home to treat some of the residents on the day of the inspection said that this was the second time they had been to the home. They stated that staff were helpful and co-operative in organising which residents they needed to see. Relatives said that staff were good at keeping them informed about the health of residents. This was particularly important to one visitor who lived a long distance away, but had confidence that her relative was safe and well cared for and staff would keep her up to date with any changes in their condition. Residents returning surveys commented “(I am) happy with care and support provided” and “the staff are very attentive”. One relative wrote, “my mother has been to the hospital twice and has been accompanied by staff who have been very helpful”. Another relative spoken to on the day of the inspection said, “If I said it was superb I would not be exaggerating”. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 13 The procedures for managing medicines within the home were generally satisfactory. The records for several people were examined and had been completed properly. Medicines were stored correctly. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 14 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. This judgement has been made using available evidence, including a visit to this service. Choice and independence were encouraged and staff were developing the range of opportunities available for residents to pursue leisure and recreational activities to meet their expectations and abilities. EVIDENCE: The manager, staff, residents and visitors to the home all told us about different social events and activities that had been arranged and taken place since the home opened. An activities plan for the week was displayed in the reception areas and a copy was also put in each resident’s room. There was no specifically designated activities organiser employed but one of the care supervisors was responsible for organising and arranging resources and another was responsible for planning trips out of the home, arranging transport, etc. The care supervisor on duty each day at 2pm overviewed the plans for the afternoon and made sure the programme was taking place. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 15 It was reported that a gardening club, walking club and knitting circle had been set up. Photographs showed members of the walking club out on one of their excursions. The proximity of the home to the park is convenient for residents to visit regularly for their walks. A recent coffee morning had been very successful. Relatives and friends had been invited and a guest speaker had given an informal talk about dementia and relatives had had the opportunity to ask questions and learn more about the condition. Another coffee morning was being planned for September with a representative from the library being invited. The manager said they were trying to build links with the local community and access as many resources as possible for the residents. Other activities that had taken place had been poetry reading, arts and crafts sessions, pot planting, social afternoons with residents enjoying music and dancing, reminiscence sessions, board games, darts and hoopla, nail and hand massage and armchair exercises. During the morning on the day of the inspection several residents were seen enjoying the garden and one resident was busy watering the plants. In the afternoon a birthday party was held and many of the residents joined in the celebrations. Arrangements had been made for those residents who wished to receive Holy Communion. Trips out of the home had been arranged and residents told us they had been to Tatton park, Southport, the garden centre, Chester zoo and Harry Ramsden’s for fish and chips! Five of the six residents who returned surveys said there were always or usually activities provided. One wrote, “there are lots of activities including trips out which are very enjoyable”. Visitors said they were made welcome and one person said that as they lived a distance away, staff were helpful in making sure that they were able to speak to their relative on the phone. The menu rotated over a four-week period. The majority of residents had breakfast in the conservatory on the Bluebell unit unless they specifically wanted to have breakfast on their own unit or in their own room. A breakfast assistant was employed each morning to help serve the breakfast and assist residents who need help to eat. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 16 Breakfast on the day of the inspection was a cheerful occasion. Easy listening music was playing and some residents were singing along. Residents could choose from porridge and cereals to toast or a cooked breakfast. The options for the cooked breakfast each morning were displayed in the dining room and also on the notice board by the lift on the first floor, so residents coming downstairs for breakfast could see what the choices were. The lunchtime and teatime meals were served in the smaller dining rooms on each unit. On each unit, dining tables were nicely laid with cloths and flowers. We were told that the lunchtime meal was normally a light snack with a large pudding, whilst at teatime a main meal was served, with a lighter dessert. Menus were varied and residents said they had plenty to eat. Lunch on the day of the inspection was soup and sandwiches or omelette and salad. Residents were asked and said the soup was “very nice”. The omelettes looked appetising and one resident said it was “very tasty”. Staff were heard asking the residents if they wanted a second helping. Staff were seen in all the dining rooms, offering residents a choice of soft drinks to accompany their meal. Residents had been asked before the meal to choose from the options. In one dining room residents were quite independent and staff encouraged this, ensuring that jugs of milk and bowls of sugar were provided on the tables so residents could serve themselves tea and coffee. All the residents that returned surveys said they always or usually liked the food and one relative wrote, “my mother enjoys all the meals”. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 17 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. This judgement has been made using available evidence, including a visit to this service. Residents and their relatives had confidence that any concerns would be listened to and dealt with. EVIDENCE: In the AQAA the manager confirmed that there was a complaints procedure that residents and families were made aware of, as it was attached to the terms and conditions of admission and given to them when they came into the home. Additionally, the complaints procedure is on view in the home and available to any visitor. All the staff that returned surveys said they were aware of the complaints policy. However two of the six residents that returned surveys said they did not know how to make a complaint. One wrote that they had “no complaints at the moment” and another wrote, “never been in that situation but we know who to speak to if it was to arise”. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 18 Visitors spoken to on the day of the inspection said that if they had any concerns or complaints they would speak to the manager or the deputy manager and were confident that any issues would be taken seriously and dealt with appropriately. One relative said they had brought up several fairly minor complaints and these had been dealt with straight away. Another relative said the manager was “always there to listen to you”. A complaints log was available but nothing had been recorded in it, although one visitor, as stated, had told us she had raised several minor matters. The value of recording even fairly small complaints, as a quality assurance tool and a means of demonstrating how people are listened to and their views acted on was discussed with the manager. We have received no complaints about the service since it opened. Relatives told us they felt their relatives were safe in the home. Staff said that if they suspected abuse they would report it to the manager. However, some of the staff spoken to were not completely sure of the procedures to follow and some staff were still awaiting training. The manager said all staff would be receiving the training as part of a rolling programme. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 19 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, 20, 21, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. The physical design and layout of the home enables residents to live in a safe, well-maintained and comfortable environment. EVIDENCE: Bruce Lodge opened in February 2008 and, as a purpose built home, provides a very pleasant, clean, comfortable environment for people to live in. The home is divided into four units, two on the ground floor and two on the first floor. Bluebell unit on the ground floor has seven bedrooms and Rose unit also on the ground floor has 13 rooms. On the first floor Fern unit has 12 rooms and Sunflower has ten rooms. Each unit has a lounge, dining room and kitchenette to enable residents, if they are able, or relatives and staff to make snacks and drinks. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 20 All bedrooms offer en-suite facilities that include a toilet, wash hand basin and shower facilities. Additional assisted bath facilities and a larger shower room were also provided. The furniture, fittings and decoration of the home is of a very high standard and facilities such as bathrooms and toilets are environmentally adapted to maximise independence and meet the needs of the service users. The home does have a slightly “corporate feel” with standardised bedding and soft furnishings, etc., but the staff were working hard at personalising each unit and were implementing ideas that maximised the benefits of the environment to suit people with dementia. For example, many residents had “memory boxes” outside the door to their room, with photographs and other mementos to help them identify which room was theirs. The largest communal room in the home was the conservatory on Bluebell unit. Doors opened out into the garden area, which was enclosed and safe for residents to use independently if they were able. The manager said that this room was used when outside entertainers visited, as more people could be comfortably seated. A “loop” system was installed in the conservatory to enhance the sound for residents wearing hearing aids. The conservatory had a huge flat screen television and all the lounges on the other units also had flat screen televisions. Also on Bluebell unit a small room was set aside for the use of residents that wished to smoke, and on the Sunflower unit a “quiet” room was available for residents that wanted to sit peacefully if televisions or radios were on elsewhere. There are a number of security features with the home. Doors, including the entrance gate, have been fitted with keypads, which can be released when the fire alarm is sounded. There is also an intercom for visitors so staff can release the gate and the front door. All these security measures have been agreed with the fire officer. The manager said that three maintenance personnel work for the Borough Care group of homes and visit the home regularly to undertake routine maintenance and health and safety checks of the building and equipment. More urgent jobs are telephoned to the head office and attended to on the same day, if necessary. All of the residents who returned surveys said the home was always or usually fresh and clean. One visitor said the home was kept “spotlessly clean”. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 21 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. This judgement has been made using available evidence, including a visit to this service. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. EVIDENCE: It was reported that there were normally seven carers on duty each morning together with a care supervisor and either the manager or the deputy manager. In addition, a breakfast assistant is employed specifically to help over the busy period when residents are getting up and wanting their breakfast. During the afternoon we were told there were five carers on duty as well as a care supervisor. Two carers are on duty at night with a senior carer sleeping in. Staffing levels meant that in the mornings there was one carer on each unit with another carer on each floor “floating” between two units. Another carer was designated each morning to help the breakfast assistant in the conservatory where the majority of residents chose to eat breakfast. Staff said that the deputy manager and the manager were regularly on hand around the home and helped with care tasks when there was a particular need. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 22 Staff duty rotas confirmed the above arrangements, which appeared to be satisfactory and workable. All the residents that returned surveys said that there were always or usually enough staff on duty to meet their needs. The manager commented in the AQAA that the senior staff team was very flexible with regards to availability for covering hours if the need arose. Borough Care also has a pool of bank staff who work for the company who are available for covering shifts at short notice and who undergo the full complement of staff training. It was reported that out of 30 care staff, 17 have successfully completed NVQ training. Three staff personnel files were examined. All contained the documents and evidence needed to ensure that the people recruited were suitable to work in a care home. One application form did not provide sufficient information about the individual’s employment history. Applicants should give a detailed history so that any gaps in employment can be checked and explained. Each file contained a good record showing that staff had received supervision where their training needs had been reviewed and practices and policies within the home discussed. Training records showed that staff had received adequate induction training within the home, being supervised by a mentor and a record kept of their competence in and understanding of their role. As it is a new home and a number of staff were newly recruited (some staff transferred from other homes within the Borough Care group) a rolling programme was in operation for staff to attend the head office for their formal 3½ days’ induction. It was reported that staff had received training in topics such as health and safety, infection control, continence, falls prevention and dementia and further training days were booked. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 23 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, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The manager is supported well by the senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The manager holds the Registered Manager’s Award and has over 20 years’ experience working with people in care homes. Her mandatory training was up to date in relation to First Aid, Moving and Handling, Risk Assessment and Medication. The manager had attended training in dementia and a briefing about the Mental Capacity Act. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 24 The manager has been registered with the CSCI and was able to demonstrate that she has the necessary skills, and experience and knowledge of the legislation to fulfil her role as registered manager for Bruce Lodge Care Home. Staff and relatives described her as supportive, approachable and efficient. Meetings had been held with various groups of staff and a residents meeting had been held on 17th June 2008. Minutes of these meetings were available. The minutes of staff meetings showed that staff had discussed changes to certain practices and routines, etc. The minutes of the residents meetings showed that residents had been asked to make suggestions about activities and outings they would like to initiate. Some suggestions had been acted on, for example, a trip to Chester zoo was proposed and arranged. The manager had also attended a meeting with the local GP’s to ensure that everyone was happy with the protocols for contacting the GP, requesting visits, etc., so good multi-disciplinary relationships could be established. Questionnaires had been distributed to residents asking for their views and comments about the food and the social activities provided, although it wasn’t clear from the questionnaires if some of the suggestions had been followed up. The questionnaires also need to be dated so it is clear how recent the information is. Small amounts of money were held at the home for people living there to purchase small items; systems were in place to ensure the safe handling and storage of service users’ monies. It was reported that the company’s finance manager undertakes an annual audit. We did not examine these records during this inspection. Weekly checks had been made of the building and equipment in respect of fire prevention and health and safety. Records showed that fire drills had been held regularly. Staff were observed to be working using safe working practices. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 25 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 N/A 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 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 4 X X 3 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 4 X 3 X 3 3 X 3 Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? N/A 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. 1 2 Refer to Standard OP7 OP18 Good Practice Recommendations Staff should work at expanding care plans for people with diverse needs so they look at specific issues and opportunities to maximise their quality of life. The manager should make sure that all staff are aware of where to find the home’s policies and procedures particularly in relation to safe guarding adults. Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Manchester Area Office Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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 Bruce Lodge DS0000071308.V369380.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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