Latest Inspection
This is the latest available inspection report for this service, carried out on 6th October 2009. CQC found this care home to be providing an Good service.
The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
For extracts, read the latest CQC inspection for Cleveland Lodge.
What the care home does well People have any risks with continence management regularly assessed. Care plans identify how people are supported with managing continence. Any concerns about people`s continence are promptly referred to their GP. Although a book is kept for monitoring continence not everyone is included. This means that people`s care is individualised and people are supported to remain independent. People`s risk of developing pressure damage is well managed. If people`s nutrition and fluid intake is compromised they are given food supplements and protein enriched drinks. Systems are in place for safe handling of people`s medication. Staff`s competence for administering medication is regularly monitored. We did not look at the requirements and recommendations of our Key inspection of 17th August 2009 at this Random inspection, but the home has told us what they have done to addresss each area. What the care home could do better: The home`s medication policy should be reviewed and revised so that it is clear that people must not be left with any medication that is administered to them. Random inspection report
Care homes for older people
Name: Address: Cleveland Lodge Cleveland Lodge Church Lane Figheldean Salisbury Wiltshire SP4 8JL 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: Sally Walker Date: 0 6 1 0 2 0 0 9 Information about the care home
Name of care home: Address: Cleveland Lodge Cleveland Lodge Church Lane Figheldean Salisbury Wiltshire SP4 8JL 01980670584 01980670584 clevelandlodge@dementiacarehome.freeserve.co. uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Cleveland Lodge Ltd care home 29 Number of places (if applicable): Under 65 Over 65 29 dementia Conditions of registration: Date of last inspection Brief description of the care home 6 Cleveland Lodge is a private care home registered to provide care and accommodation to 29 older people with dementia. The home has been extended to provide extra accommodation. The property is a former Victorian vicarage situated in the small village of Figheldean near Amesbury. The home is accessed via a private drive and has large enclosed gardens for peoples safety. The accommodation is all single bedrooms to the first and ground floors accessed via a passenger lift or staircase. There are two sitting rooms and two dining rooms, one in each of the newer and older parts of the building. The staffing rota provided for a minimum of a senior carer leading the shift of 4 carers during the waking day. At night there are 2 waking night staff with Mr
Care Homes for Older People Page 2 of 8 Brief description of the care home Foreman or his wife carrying out the sleeping in duty from their adjacent house. The last Key inspection was on 17th August 2009. Care Homes for Older People Page 3 of 8 What we found:
We carried out this Random inspection because we had received the following information: people were often left in wet clothing and not being changed regularly enough; the manager did not help people or staff; the manager recorded that she had worked when she had not and the manager was not giving medication correctly, often leaving it for people to deal with themselves. We noted a slight smell of urine in the entrance hall when we first arrived at the home. There were however, no smells in any of the bedrooms, or any other part of the home we went to. The home kept a record of when they supported people with continence management. Risk assessments showed which people needed support. The records showed that people were being checked at least five times during the day and a minimum of once during the night. We saw that if people needed extra support, for example if they had a period of time being cared for in bed, there were immediate care charts in place. These charts identified where people needed extra drinks. We saw that people were given extra drinks throughout the day. Some people received food supplement drinks and drinks made with full cream milk. We saw that any concerns about peoples continence management were immediately referred to their GP. If people were spending some time being cared for in bed, we saw evidence that they were regularly checked and made comfortable, with regular washing and changes of clothing and bedding if needed. People had their risk of developing pressure damaged assessed and regularly reviewed. Care plans showed action taken to reduce any risks and regular monitoring. We saw that strategies were in place to support people who may be resistant to have personal care or refused a regular bath. One of the senior staff gave us an example of positive encouragement used, so that people would have a bath. Mrs Foreman told us that only those staff who had been trained could administer medication. This was mainly the senior carers or staff who had worked at the home for some time. Mrs Foreman showed us the records for regular monitoring of staffs competence to administer medication. She said that she would observe staff administering medication as part of her assessment. Mrs Foreman told us that neither her or Mrs Mason administered medication. We saw that the homes medication policy did not state that people must never be left with medication that is administered to them. Mrs Foreman told us she would amend the policy immediately and inform the outsourced trainer to include this in the training programme. None of the people currently using the service administered their own medication. We looked at the duty rotas. Only Mrs Foreman was identified on the rota; for four days staff training. Mrs Foreman told us that Mr Foreman, registered manager and Mrs Mason, responsible individual, were not on the rota because they did not provide personal care, only in an emergency. Mrs Foreman told us that the managers worked set days each week and showed us the exceptions written in the homes diary. Mr Foreman showed us the administrators payroll records. Mr Foreman and Mrs Mason were not included as they
Care Homes for Older People Page 4 of 8 received an annual salary. We asked about staff supervision and any other means for staff to bring concerns to management. Staff received regular supervision as evidenced by the records. Mr Foreman told us that staff regularly brought concerns to each of the managers. 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 5 of 8 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 17 The home must keep their own records of healing of wounds and not rely on those kept by the district nurse. For the homes own monitoring of healing. 30/10/2009 2 7 13 Medication with specific 30/10/2009 prescribing instructions, for example to be taken weekly, must be detailed in peoples care plans. So that staff know how it is to be given. 3 38 13 The home must make sure 30/09/2009 that staff are putting the moving and handling training into practice and not use unsafe lifting. So that people and staff are not injured by poor moving and handling. Care Homes for Older People Page 6 of 8 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 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 9 The homes medication policy should be reviewed and revised to ensure staff know that they never leave people with medication that they are administering. Care Homes for Older People Page 7 of 8 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 8 of 8 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
