Care Home: Chapel Lodge

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What the care home does well People completing surveys told us the following on what they felt the home did well: "Nice friendly atmosphere"- "Good food" -"The home is clean, friendly and caring, needs are listened to." - "Everything is clean" - "Staff very nice and good" - "They look after us and are very helpful"- "I always feel better for coming here" - "I always enjoy the food that they give me" - "I always feel at home when I come here" - " I feel happy and safe" -"Home from Home" -" I`m very happy and well looked after and cared for" - "I feel very looked after at all times"- "The home is always ready and keen to supply my needs" "They do everything to make sure I am happy" People were getting attention from health care professionals in response to their individual needs and circumstances. Personal care and support was being provided sensitively, peoples` dignity and privacy was being respected. Residents meetings were being held so people could voice opinions and make suggestions. To help protect people and keep them safe, the home had policies on the prevention of abuse and neglect, and safeguarding training had been arranged. To help make sure people living at Chapel Lodge get effective care and support, staff training and development was ongoing. What the care home could do better: Progress needed to be made with the residents care plans, to make sure people get individual care and attention in the way they prefer. Action needed to be taken to ensure some health care needs are more effectively reviewed, monitored and planned for. To make sure people are properly and safely supported with their medication, attention needed to be given to storage arrangements, some practices and records. To make sure people have clear information about how to go about raising concerns, the complaints procedure needed updating. Some guidelines for managers and staff needed to be improved, to make sure people using the service are properly protected. Random inspection report Care homes for older people Name: Address: Chapel Lodge 11 Hall Street Worsthorne Burnley Lancashire BB10 3NR two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jeffrey Pearson Date: 1 0 0 6 2 0 1 0 Information about the care home Name of care home: Address: Chapel Lodge 11 Hall Street Worsthorne Burnley Lancashire BB10 3NR 01282413901 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Julie Patricia Harrison Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dr Zahid Mahmood Dabir,Mrs Naila Dabir care home 23 Number of places (if applicable): Under 65 Over 65 23 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP. The maximum number of service users who can be accommodated is: 23. Date of last inspection Brief description of the care home Chapel Lodge is a converted chapel with some bedrooms overlooking the cemetery. Chapel Lodge is in a residential area in the village of Worsthorne about two miles from Care Homes for Older People Page 2 of 10 Brief description of the care home Burnley town centre. There are some local facilities nearby such as a general store, post office, public houses and a Church quite close to the home. There is a small parking area to the front of the home, also gardens and a patio area. Garden furniture is provided. A ramp provides access to the front door. The home has inter-connecting sitting rooms and a dinning area. All the bedrooms are single; some have en-suite toilets. Staff are available to provide assistance with personal care and support. The home can provide for recreational activities. The registered providers live next door to the home. Written information about the home was available on request. Care Homes for Older People Page 3 of 10 What we found: An inspection which included an unannounced visit to the service was conducted at Chapel Lodge on the 10th June 2010. The purpose of the inspection was to assess outcomes for people in relation to Health and Personal Care and Complaints and Protection. Prior to the inspection people using the service were invited to complete surveys, to tell the Commission what they think about the support and care provided by the home, 10 were returned to us. Before the visit the manager was asked to complete and return to us an AQAA (Annual Quality Assurance Assessment). This was to enable the service to show how they were performing and provided details about arrangements, practices and procedures at the home. During the visit we spoke with residents, the senior carer, owner and staff. Various documents, including care plans, case files, policies, procedures and records were looked at. Parts of the home were viewed. The residents spoken with made positive comments about life in the home and indicated they were satisfied with the services and care provided at Chapel Lodge. Im very happy and well looked after and cared for was a comment in one survey. The senior carer in charge at the time of the visit said each person had a written care plan. We found care plans included some satisfactory information about peoples individual needs and wishes. However, the plans were lacking in detail on providing good person centered information and instructions for staff to follow, we found some specific needs had not been included, which meant there was potential for care needs not to be appropriately and effectively met. Records showed care plans were being reviewed each month. Care notes seen were mostly reflective of peoples care and circumstances, however, we found one entry did not fully explain the circumstance in respect of a specif matter. Also, one entry read policies and procedures followed which was not descriptive of the persons life, circumstances or the individual support provided. The home had policies and procedures in relation to health and personal care. Residents completing surveys indicated they always get the medical care and attention they need. Records and discussion showed people were getting attention as necessary from health care professionals such as GPs and District Nurses. Peoples personal safety and mobility risks had been considered and planned for. Specific individual assessments had been carried out in respect of nutritional screening and skin integrity, during the admission process, however, it was not clear that these matters had been effectively re-considered as part of the ongoing reveiw process. Staff responsible for medication administration had received training, which included a competence based assessment. Medication storage was found to be unlocked, which Care Homes for Older People Page 4 of 10 presented as a potential health, safety and security risk, the senior carer took action in respect of this matter at the time of the inspection visit, the owner explained that more suitable storage facilities were due to be obtained. Records showed the temperatures in the storage area were being monitored. Most MAR (Medication Administration Records) seen were clear and up to date. However, we found that hand written entries on MAR charts had not always been verified as correct by two people, which would help promote safe administration practices. Individual instructions were in place for some when necessary and variable dose medication, we found such instructions had not been written up for one item, however, there was some guidance within the persons care notes. It was suggested the Royal Pharmaceutical Guidance, The Handling Of Medicines In Social Care be used for reference, when reviewing and updating the homes medication policies and procedures. The home had a key worker system which links a resident with a particular staff member to provide a more personal service. The residents spoken with did not express any concerns about how they were treated, one comment made was, They look after us and they are very helpful. Observations of care practices, showed peoples privacy needs were respected. Staff were seen to provide support and interact with people in a friendly and courteous manner. People were being supported to take an interest in their appearance, a hairdresser was making regular visits to the home. As there are no staff facilities at Chapel Lodge, we spoke with the senior carer about the arrangements for confidential discussions. Also making sure the dining area caters effectively for the residents needs and wishes as apposed to staff. Most people completing surveys, told us they were aware of how to make a formal complaint. The residents spoken with said they had no complaints about the home. Residents meetings were being held so people could be consulted, voice opinions and make suggestions. The complaints procedure was included in the homes guide, a copy had also be placed in each bedroom. The procedure included instructions for people to follow, but needed updating to include the national contact details of the Care Quality Commission. There had not been any recent complaints at Chapel Lodge, however, systems were in place to record and respond to any issues raised. The senior carer said all staff had recently undertaken safeguarding adults training. We looked at the homes polices and procedures on safeguarding people from abuse, which included some good guidance on looking for potential signs and indicators. However, the procedure needed updating to include the designated contact details of Social Services Safeguarding Adults team and the national contact details of the Care Quality Commission. The senior carer expressed an awareness of the action to be taken in respect of any allegations, suspicions or incidents of abuse and of the relevant agencies to contact. The whistle blowing (reporting bad practice) procedure included some useful guidance for staff, but needed updating to include the national contact details of the Care Quality Commission, it was also suggested details of agencies who deal with employee related Care Homes for Older People Page 5 of 10 matters be included. Policies and guidance in relation to physical intervention and restraint were available. What the care home does well: 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 9 13 Effective action must be taken to ensure suitable arrangements are made for the safe storage of medicines. This will ensure items of medication are kept safe and secure for the protection of the residents. 02/07/2010 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 Action should be taken to ensure individual care plans identify all health and social care needs, with staff being given clear written directions on responding to such needs. Care notes should be reflective of each persons care and circumstances, this will promote good communication, ongoing monitoring and reviews. Health care assessments should be periodically reviewed in respect of each person, this will ensure peoples health care needs are more effectively considered and responded to. Hand written entries on Medication Administration Records, should be checked and signed by two people to make sure Page 8 of 10 2 7 3 8 4 9 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 they are correct. 5 16 Action should be taken to ensure the complaints procedures include the appropriate contact details for the Care Quality Commission. Action should be taken to ensure all safeguarding policies and procedures provide clear instructions for managers and staff to follow in line with agreed Local Authority protocols. Procedures should include all appropriate contact details of the relevant agencies, such as Social Services, the Police (Public Protection Unit) and CQC. 6 18 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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