Care Home: Camden Lodge Residential Care Home

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What the care home does well The home is kept clean and comfortable. Staff are kind and caring towards the people who live at the home, which is confirmed by the comments that were made during this inspection. Record keeping is generally satisfactory and care plans are reviewed regularly. What has improved since the last inspection? A total of 20 requirements were made as the result of the previous key standards inspection and it is positive to note that almost all of these have been achieved. Cultural and religious needs and preferences are now included in the service users` care plan. Staff are only now permitted to administer medication when trained to do so. The registered person now consults the people who use this service and has devised a programme of activities. The repair and refurbishments that were required as a result of the previous inspection have now been attended to and fire safety precautions have improved as the practise of wedging open fire doors in the basement has ceased. What the care home could do better: The registered person must ensure that risk assessments encompass all known health and welfare needs of the people who use this service. Recruitment procedures must also still improve in particular regard to verifying the authenticity of references for new staff and the manager must apply to the Commission to be registered. CARE HOMES FOR OLDER PEOPLE Camden Lodge Residential Care Home 137 Palmerston Road London N22 8QX Lead Inspector Jackie Izzard Key Unannounced Inspection 20th November 2007 09:30 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 Camden Lodge Residential Care Home DS0000010654.V338353.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. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camden Lodge Residential Care Home Address 137 Palmerston Road London N22 8QX 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) 020 8829 9438 020 8829 9439 Mr Munundev Gunputh Eleni Constantinou Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Old age, registration, with number not falling within any other category (24) of places Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: Camden Lodge is set in a residential street in Palmers Green close to local shops and amenities in Green Lanes. There are 24 registered places for people over the age of 65 who may have dementia. This home is purpose-built and has a lift and a garden. All bedrooms are single and have en suite toilet and washbasin. There are bedrooms on each of the three floors, and a large lounge/dining room on the ground floor. The registered provider owns four other homes in the area. The aims of the home include to offer a warm welcome, which combines comfort with the support of a caring professionals. The cost of placements was reported by the manager to be £361.90-508.61 per week. Following Inspecting for Better Lives, the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over the course of one day. The care manager was present during this inspection and provided assistance during this visit. No written surveys were received from service users, relatives or other stakeholders prior to this visit. However some of the service users and a relative did give their view about the home during the inspection. These comments did not indicate that there are any concerns about the standard of care at the home and indeed positive remarks were made about the improvements to the service over recent months. A number of records were also examined, including care plans, assessments, management records and those that relate to medication handling and administration. A tour of the building also took place. What the service does well: What has improved since the last inspection? A total of 20 requirements were made as the result of the previous key standards inspection and it is positive to note that almost all of these have been achieved. Cultural and religious needs and preferences are now included in the service users’ care plan. Staff are only now permitted to administer medication when trained to do so. The registered person now consults the people who use this service and has devised a programme of activities. The repair and refurbishments that were required as a result of the previous inspection have now been attended to and fire safety precautions have improved as the practise of wedging open fire doors in the basement has ceased. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 6 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. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 1, 2, 3, 4, 5 & 6 were assessed at this inspection. The people who use this service can be assured that the home provides enough information for potential service users and their relatives to make an informed decision about moving in to the home. The home effectively assesses and reviews people who come to live here in order to ensure that this is the most appropriate place to meet their care and support needs. EVIDENCE: The previous key standards inspection identified that although assessments for admission were of a standard, they lacked information about people’s cultural needs. Cultural needs were not fully assessed or recorded at that time. A requirement was made to ensure cultural and religious needs are assessed and met. Examination of the assessments for placement of two newly admitted service users showed that cultural and religious needs are now being Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 9 considered in more detail and it is concluded that the home has achieved the requirement that was previously made. Camden Lodge does not provide intermediate care so standard 6 is not applicable to the home. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 7, 8, 9 & 10 were assessed at this inspection. The people who use this service can feel confident that their personal care needs and physical and emotional health needs are properly documented by the home. They can also be confident that their health care needs will continue to be attended to and that will receive the support, nursing care and treatment that they require. EVIDENCE: Five care plans were looked at in detail and two of them were discussed with the people to who these plans refer. Appropriate risk assessments are mostly in place and the standard of the care plans has improved. One person does suffer from epilepsy although this is not referred to in their in risk assessment. The registered person must ensure that all relevant risks are recorded and this must include responses and risk reduction measures. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 11 Care plan reviews are now carried out by manager and /or deputy manager as it was seen at the previous key standards inspection that care staff werent doing them properly. Care plans and daily records match and it is evident that the tasks in the care plans are being carried out. The people who spoke about their life at the home were satisfied with how they are supported and cared for. Health care is good and extra staff are placed on shift to ensure that there is enough staffing support available for people who need to attend medical appointments. The views of the people who live her about what they would prefer to happen in the event of a seriuous illness or their death are recorded. Over a third of the people who use this service suffer from diabetes. Due to the complications that can arise from this condition their eyes and feet are regualrly checked in order to identify if any problems are arising. The people who spoke about their care at the home confirm that this does happen. The home has also improved protocols for pressure sore management and the previous requirement that was made is now considered to have been achieved. Care plans now address cultural and religious needs which means that the home has achieved the requirements that were made at the previous inspection. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 14 & 15 were assessed at this inspection. The people who use this service can be confident that the home has, and continues, to improve upon the opportunity to engage in activities and social events. The home also continues to actively encourage and support each person who lives here to keep and maintain contact with family and friends. EVIDENCE: The people who live here now have a more comprehensive and varied programme of recreational activities, inside and outside of the home. Although further improvements should be made it is evident from conversation with the manager that this is recognised and there is a commitment to continuing progress. The previous requirement that was made in this regard will now be considered by the Commission to have been achieved. The home must, however, remain mindful of the need to continually examine how they can maximise these opportunities for the people who live here. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 13 Visitors continue to be very welcome to the come to the home, which was confirmed by the comments that were made during this visit by some of the people who live here. There has been much improvement to the menu, and comments that were made by people who use this service show that they agree that this is the case. Cultural and religious food preferences are being recognised far more than was previously the case. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 16 & 18 were assessed at this inspection. The people who use this service can feel confident that if they were ever to have any concerns about the home that these would be properly addressed. They can also feel safe in the knowledge that the staff of the home do all that they can to ensure that service users are protected from abuse or neglect. EVIDENCE: The record of complaints was available to see during this visit. The home has recorded one complaint since the previous key standards inspection. This was investigated and was found to be unsubstantiated. The people who use this service that gave their views did not raise any complaints about their care at the home. No complaints of abuse have been made to the Commission or local authority since the previous inspection and the service users made none during this visit. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 19 & 26 were assessed at this inspection. The people who use this service can feel confident that they live in a comfortable, clean and well maintained home that has all of the necessary facilities to meet their needs. EVIDENCE: The home comprises of three floors and a repair, redecoration and refurbishment programme has been completed since the previous key standards inspection. The previous inspection identified that one sink was loose as it was coming away from the wall; Fire doors in the basement where the laundry and kitchen are situated were found to be wedged open; the clinical waste bin was seen to be overflowing and in one bedroom more appropriate Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 16 lighting was needed for the person who uses that room. All of these areas have now been addressed. A tour of the premises took place and it was found that the home was clean and tidy throughout. This is helped by the fact that a detailed cleaning schedule is in place, which obviously helps this standard to be maintained. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Standards 27, 28, 29 & 30 were assessed at this inspection. The people who use this service cannot feel entirely confident that the home does all that is required to ensure that the staff are safe people to work here. Verification of references remains a particular shortcoming that needs to be addressed. There is, however, continuing indication that there are enough staff that are properly trained and qualified to support them. EVIDENCE: A requirement was made at the previous two inspections that the home had to increase staff to four on duty at all times and to undertake a review of staffing and send a copy to the CSCI. This review has now taken place and the staffing level has been increased accordingly. The previous requirement is therefore now considered to have been achieved. The home also has a cook and domestic cleaner on duty during the day. The inspector sampled staff members’ files to look for evidence of proper safe recruitment and induction training. References are still not being verifies as was required at the previous inspection. All other background checks were seen to be in place on the sample Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 18 of staff files that were examined, however, the lack of reference verification still poses a risks. The induction training provided to staff was seen to be of a basic level at the time of the previous inspection and did not meet the national minimum standard. A requirement was made to improve induction training. Staff induction booklets have been introduced and this previous requirement has now been achieved. The supervision records for four staff were also examined and these show that all are receiving the required level of supervision, which is currently at least six times per year. The Area Manager informed the inspector at the previous inspection that the home exceeds the requirement of 50 of staff to have completed NVQ 2 training. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Standards 31, 33, 35 & 38 were assessed at this inspection. The people who use this service can feel increasingly confident that they are living in a home that is well managed and that their necessary health and safety is properly considered. EVIDENCE: The manager started in November 2006 but has not as yet submitted an application for registration to the Commission. An application must be submitted without further delay. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 20 The registered person has a quality assurance system in place and although previous outcomes were noted as needing attention, these have been subsequently achieved. From this inspection it is noted that comments that were made directly by the people who live here and a relative indicate a generally good degree of satisfaction with the service. A concern that had been raised prior to the previous key standards inspection about the management of the personal finances of the people who use this service. Examination of personal financial records for people who require assistance with managing their finances show that the necessary improvements have since been made. When looking at health and safety, the inspector looked at a sample of health and safety records. These show that the home is effectively safeguarding the people who live here, staff and visitors from fire and other health and safety hazards. Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 13(4)(c) Requirement The registered person must ensure that risk assessments encompass all known health and welfare needs of the people who use this service. All relevant risks must be recorded and this must include responses and risk reduction measures. The registered person must improve the recruitment procedure to ensure that he is satisfied as to the authenticity of references before any person is employed. (The previous timescale of 30/03/07 has not been achieved) The registered person must ensure that the manager applies for registration with the Commission without further undue delay. Timescale for action 31/03/08 2. OP29 19 (1)(c) 31/03/08 3. OP31 8&9 31/03/08 Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Camden Lodge Residential Care Home DS0000010654.V338353.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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