Care Home: Corrina Lodge Nursing Home

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What the care home does well People who are thinking of moving into the home are encouraged to visit and are provided with information about the home to help them decide if it will be right for them. The needs of prospective residents have been assessed before they moved into the home to ensure these can be met. The home provides "hotel style" accommodation and services, which includes serving wine with meals and providing an in-house bar. A wide range of activities are available both in the home and in the community. These include music therapy sessions, painting classes, in-house cinema, woodwork, quizzes and outings. The home has it`s own wheelchair accessible minibus to transport residents to activities in the community. Residents are offered choices wherever possible, such as in the activities to take part in, the food they wish to eat and how and where to spend their time. Support is provided to enable residents to maintain their independence, such as to vote, and information about advocacy services are made available to residents. Very few complaints have been received, but those received have been looked into and responded to, in an appropriate way. The home is attractively decorated and is furnished to meet the needs of residents. Specialist equipment is provided to help residents to maintain their independence, or to help staff in the care and support of residents. The home is well maintained and there is an on-going plan of improvements, to ensure residents have the space and facilities they need. People who use the service are supported by a stable team of well-trained staff, many of whom have worked at the home for a number years. The home is well managed by an experienced and suitably qualified manager, who is supported by a management team. The management team run the home in an open and accessible way and were freely available to people who use the service, to visitors and staff. What has improved since the last inspection? A full employment history has been obtained for people applying to work in the home. A system of assessing the quality of the service provided has been developed and carried out. This has taken into account the wishes of the people who use the service and other visitors to the home, and the results were made available. What the care home could do better: The receipt of all medication received into the home must be recorded and the amount of medication held must accurately match the record held, to ensure all medication is accounted for and an audit trail can be followed. It is good practice to record any stock of medication held, to enable an audit trail to be followed. Confirmation was provided before this report was written, of the actions taken to ensure all medication is accounted for and an audit trail can be followed. The amount of money held for safekeeping on behalf of residents, must accurately match the record held. It is good practice to keep accurate and up to date records regarding residents` monies and for two people to record each transaction of resident`s monies. Confirmation was provided before this report was written, of changes that have been made in the home regarding the management of residents` monies. Doors designed to close automatically to prevent the spread of smoke or fire, must not be wedged or propped open. It is recommended that advice is obtained from the local fire service about the current practice of holding these doors open. CARE HOMES FOR OLDER PEOPLE Corrina Lodge Nursing Home 79 The Avenue Camberley Surrey GU15 3NQ Lead Inspector Sandra Holland Unannounced Inspection 17th January 2008 10:00 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 Corrina Lodge Nursing Home DS0000017600.V355845.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. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Corrina Lodge Nursing Home Address 79 The Avenue Camberley Surrey GU15 3NQ 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) 01276 686202 corrina@barchester.com www.barchester.com/oulton Barchester Healthcare Homes Limited Mrs Jayne Louise Holloway Care Home 51 Category(ies) of Old age, not falling within any other category registration, with number (51), Physical disability (10), Physical disability of places over 65 years of age (10) Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. In respect of this service persons accommodated falling within the category OP, may be admitted from the age of 60 years and over. One named service user under the age of fifty (50) may be accommodated. 30th May 2006 Date of last inspection Brief Description of the Service: Corrina Lodge is a purpose built care home, which can provide accommodation and nursing care for up to fifty-one service users. The home is located on the outskirts of Camberley in a residential area. The town centre, railway, and other amenities are within easy walking distance. Accommodation is provided on two floors, with stairs and a passenger lift providing access to the first floor. There are fifty-one single rooms, fortyseven of which have en-suite facilities including either a bath or shower. There is an attractive communal lounge and dining room on each floor. The home stands in well-maintained gardens that have sheltered terraced areas and raised flowerbeds. Parking is available at the side and front of the building. The fees at this service range from £500.23 per week to £1252.36 per week. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection site visit was carried out by the Commission for Social Care Inspection (CSCI) under the Inspecting for Better Lives process. A full analysis of all information held about the home was carried out prior to the site visit. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Mrs Sandra Holland, Regulatory Inspector carried out the inspection visit over eight hours. Ms Jayne Holloway, Registered Manager was present representing the service. Most areas of the premises were seen and a number of records and documents were sampled, including medication administration records, residents’ individual care plans, records of residents’ monies held for safekeeping and staff recruitment and training records. Twelve people who use the service, nine members of staff and one visitor were spoken with during the course of the visit. An Annual Quality Assurance Assessment (AQAA) was supplied to the home and this was completed and returned. Information supplied in the AQAA will be referred to in this report. The people who use this service prefer to be known as residents, so that is the term that will be used throughout this report. The inspector would like to thank residents and staff for their hospitality, time and assistance. What the service does well: People who are thinking of moving into the home are encouraged to visit and are provided with information about the home to help them decide if it will be right for them. The needs of prospective residents have been assessed before they moved into the home to ensure these can be met. The home provides “hotel style” accommodation and services, which includes serving wine with meals and providing an in-house bar. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 6 A wide range of activities are available both in the home and in the community. These include music therapy sessions, painting classes, in-house cinema, woodwork, quizzes and outings. The home has it’s own wheelchair accessible minibus to transport residents to activities in the community. Residents are offered choices wherever possible, such as in the activities to take part in, the food they wish to eat and how and where to spend their time. Support is provided to enable residents to maintain their independence, such as to vote, and information about advocacy services are made available to residents. Very few complaints have been received, but those received have been looked into and responded to, in an appropriate way. The home is attractively decorated and is furnished to meet the needs of residents. Specialist equipment is provided to help residents to maintain their independence, or to help staff in the care and support of residents. The home is well maintained and there is an on-going plan of improvements, to ensure residents have the space and facilities they need. People who use the service are supported by a stable team of well-trained staff, many of whom have worked at the home for a number years. The home is well managed by an experienced and suitably qualified manager, who is supported by a management team. The management team run the home in an open and accessible way and were freely available to people who use the service, to visitors and staff. What has improved since the last inspection? What they could do better: Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 7 The receipt of all medication received into the home must be recorded and the amount of medication held must accurately match the record held, to ensure all medication is accounted for and an audit trail can be followed. It is good practice to record any stock of medication held, to enable an audit trail to be followed. Confirmation was provided before this report was written, of the actions taken to ensure all medication is accounted for and an audit trail can be followed. The amount of money held for safekeeping on behalf of residents, must accurately match the record held. It is good practice to keep accurate and up to date records regarding residents’ monies and for two people to record each transaction of resident’s monies. Confirmation was provided before this report was written, of changes that have been made in the home regarding the management of residents’ monies. Doors designed to close automatically to prevent the spread of smoke or fire, must not be wedged or propped open. It is recommended that advice is obtained from the local fire service about the current practice of holding these doors open. 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. Corrina Lodge Nursing Home DS0000017600.V355845.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 Corrina Lodge Nursing Home DS0000017600.V355845.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): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with information to enable them to decide if they wish to move into the home and are welcomed to visit. The needs of residents have been assessed before they moved into the home to ensure they can be met. Intermediate care is not provided so this standard is not applicable. EVIDENCE: Information supplied in the AQAA stated that all literature about the home is provided to prospective residents, including a statement of the terms and conditions for living at the home, a copy of the service user’s guide and the home’s statement of purpose. Prospective residents are also invited to visit the home and, or, stay for a meal, so they can meet other residents and staff and see if it suits them. This was observed on the day of the inspection visit, Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 10 as a prospective resident was looking around the home. It was noted that they were made very welcome, had the opportunity to speak with the manager and staff and were offered refreshments. A detailed assessment of the needs of prospective residents is carried out before they move into the home, to ensure these can be met the manager stated. The files of a number of residents were seen, including those of residents who had recently moved in, and it was clear that their needs had been assessed. It was noted that two of the pre-admission assessments had not been signed or dated. It is recommended that these are signed and dated at the time they are carried out, as this confirms who carried them out and when. Corrina Lodge Nursing Home DS0000017600.V355845.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. Comprehensive plans of care have been drawn up to guide staff to the needs of residents and residents’ healthcare needs are well met. Some aspects of the administration of medication need to be more robust to ensure residents receive their medication as prescribed and all medication is fully recorded and accounted for. EVIDENCE: A comprehensive, individual plan of the care and support needs of each resident has been drawn up, and these are used to guide staff in meeting each residents’ needs. These have been drawn up from information gathered at the pre-admission assessment and from a further assessment, which is usually carried out on the day the resident moves into the home. This ensures that any changes in the resident’s needs between the pre-admission assessment and moving in are recorded. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 12 The care plans that were seen included residents’ needs in relation to personal care, communication, mobility, pain, relationships, nutrition, sleeping and social interests. The plans identified the resident’s needs in these areas and what action was required by staff or others to ensure these needs were met. Daily records by qualified nursing staff and by care staff, indicated what care and support had been provided to meet residents’ health, personal and social care needs. It was positive to note that care plans had been reviewed each month to ensure they accurately reflected residents’ current needs. It was observed that although space is provided in the care plans for residents to sign to show they have been involved, the care plans which were seen had not been signed. It is recommended that residents are asked to sign their care plans if they are able, to show that they have been involved in drawing it up, are aware of the contents, and agree with the information it contains. If a resident is unable to sign, it is good practice to ask their representative to sign on their behalf. From the speaking to residents and from the records seen, it was clear that residents’ healthcare needs are well met. A number of healthcare professionals are involved in the support of residents including general practitioners (GP’s), podiatrist, physiotherapist, wheelchair services, optician, dentist and cancer nurse specialists. Where they are able, residents attend community healthcare facilities, including the hearing aid clinic at the local hospital. CSCI feedback forms offer the choice of “always, usually, sometimes or never” as a response to the questions asked. Those completed by residents indicated that they always, or usually, get the medical support they need, that staff are usually available when they need them and that staff listen and act on what residents say. Positive feedback was provided by healthcare professionals who are involved in the support of residents. One healthcare professional responded on the CSCI feedback forms that they were “in general very satisfied with all aspects of the care” that they have seen provided in the home, and another responded, “patients appear to be contented with a fulfilled day”. Medication and printed medication administration record (MAR) charts are supplied to the home by a local pharmacy. Medication is stored appropriately and securely, and only authorised staff are allowed access. A medication fridge is available for items that require chilled storage, and the temperatures of this are regularly checked and recorded. The manager stated that only qualified nursing staff are involved in the administration of medication and that each nurse has an annual medication competency assessment. Weekly checks of medication are carried out in the home and twice a year the Barchester organisation carry out an in-depth medication audit, the manager advised. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 13 The majority of medications are supplied in “blister” packs, with individual doses of differing medications contained in each blister. This system is designed to make the administration of medication safer and to make monitoring of medication stock more effective. When a number of blister pack medications were checked randomly, the amounts present accurately matched the record held. Other medications that were stocked in their original packaging were also checked at random. It was noted that for two of these, the amount present did not accurately match the record held. The medication for one resident was supplied as loose tablets in a bottle, but when these were counted, there were two tablets more than the record accounted for, so it was not clear if the resident had received their medication as prescribed. For another resident, tablets had been supplied in the original packaging and the recently arrived new stock had been recorded on the MAR chart. Although three doses had been recorded on the MAR as being administered, the new stock of medication was still full. When staff checked, they found that the medication had been administered from a stock that had been supplied many months ago. It is recommended for safety and ease of monitoring, that the total stock of each medication that is held is recorded on each MAR chart. It was also noted that a stock of a controlled medication had been received in the home, but this had not been recorded. Staff advised that this was due to be taken home by a resident who was leaving the home on the day the medication arrived, but the medication was not collected for, or supplied to, the resident. As this medication had not been recorded, it was not accounted for and an audit trail could not be followed. The manager supplied confirmation before this report was written, that the stock of all medication was being reviewed and that any stock held would be recorded on the new MAR charts at the start of the next cycle of medication. This system would be continued with each new supply of medication to “enable a more efficient audit trail of the medication in the home”. The written information supplied also confirmed that the controlled medication which had been received, had been fully recorded on the day of inspection, but had now been destroyed as it had not been collected by the resident’s family as requested. Staff were observed to speak to residents in a relaxed, informal manner, whilst maintaining respect. Personal care was offered discreetly and provided in the privacy of each resident’s own bedroom or bathroom, to ensure his or her dignity was maintained. Staff were observed to knock on residents’ bedroom doors and to wait for a response before entering. Corrina Lodge Nursing Home DS0000017600.V355845.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 excellent. This judgement has been made using available evidence including a visit to this service. A wide range of social and leisure activities are offered to residents, both in the home and the community. Residents are supported to maintain contact with their families and friends and to make their own choices and decisions. A selection of well-balanced meals are provided and where necessary, these are adapted to meet the needs of residents. EVIDENCE: A colourful, monthly programme of daily activities is produced and supplied to each resident. This was seen to include resident’s birthdays and regular activities such as visits by the hairdressers, reflexologist and music therapist. The programme offered a wide range of activities including a book club, singing, woodwork, in-house cinema, quizzes and watercolour art class. Information supplied in the AQAA advised of other activities that take place including a bridge club which visits the home each week, a curry evening and a Tea at the Ritz afternoon. Outings are arranged and photographs were seen of a recent boat trip on the Thames, which residents said they had enjoyed. A gardening club which is led by a resident has won, or been a runner up, in the “Best Residents’ garden” in the “Barchester in Bloom” competition for the past Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 15 two years, the AQAA stated. A comment on a CSCI feedback form stated that there is “Plenty of entertainment, social get-togethers involving friends and relations” and there are “various activities that the residents can participate in”. In the “what we could do better” section of the AQAA, the home advised that it has recognised that it needs to provide a more diverse choice of activities for younger residents and to provide access to some activities at the weekend. This was confirmed by residents who mentioned that few activities were available at the weekends, and more would be welcomed. A number of residents have telephones in their rooms and others have computers and internet access, to enable them to maintain contact with their families and friends. It was clear from speaking to residents and a visitor, that visitors to the home are made very welcome. It was positive to note that residents have been encouraged to be actively involved in making decisions about the activities and the meals in the home. A “residents’ activities in-put group” meet each month with the activities organiser to discuss and suggest ideas for activities for the following month. The home promotes the equality and diversity of residents and information supplied in the AQAA stated that “we are happy to vary the way services are delivered to fit individual’s preferences”. A dining committee also meets with the head chef each month to discuss the food and food service. Minutes of the meeting are taken and are made available. The chef advised that he has been undertaking a Chef Academy course to enhance the menus and food service. Information in the AQAA advised that menus are created using residents’ suggestions wherever possible, and seasonal ingredients. Meals are served in a restaurant style, enabling residents to be offered a choice of each course at the table, or at the time of serving. A daily menu is displayed on each table in the dining rooms as well as in the main hall. Wine is served with meals for those residents who enjoy it and whose health permit it. It was clear that residents are encouraged to be as independent as possible and to make their own choices and decisions. This included at mealtimes where residents are offered a choice and are provided with the necessary aids to enable them to manage their meals, including adapted cutlery, cups and dishes. Where required, meals were pureed to ensure they suited the needs of residents. It was positive to note that each food item was pureed individually, making them identifiable and more attractively presented. Staff were available to assist those residents who required it. There are two dining rooms in the home, one on each floor. These are furnished with tables for varying numbers of residents and the tables were attractively laid with tablecloths, napkins, glasses and flowers. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 16 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. Very few complaints have been received, but those received have been appropriately managed. Staff have been trained in the safeguarding of adults and were aware of their responsibilities in this. EVIDENCE: Information supplied in the AQAA indicated that only three complaints had been received in the last year, two of which were upheld. The complaints record was seen and it was clear that all appropriate actions had been taken to ensure any complaint was looked into and responded to. No information has been supplied to CSCI about any complaint made to the home. CSCI feedback forms completed by people who use the service and their representatives, indicated that they knew who to speak to if they were unhappy, knew how to make a complaint, and that the home had responded appropriately if any concerns had been raised. Residents are encouraged to give their views on the service provided and information supplied in the AQAA stated that, “we ensure that no service user or staff member is treated less favourably or victimised, due to him or her exercising his or her rights on the grounds that they have made a complaint or provided information about discrimination or harassment”. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 17 From the staff training record, it was clear that staff have received training in safeguarding adults (formerly known as the protection of vulnerable adults). Members of staff who were spoken with stated that they would report any concerns to the manager or the person in charge, and would have no hesitation in doing so. The manager advised that in the event of a suspicion or allegation of abuse, the home would follow the Surrey Multi-Agency Procedure for Safeguarding adults. An up to date copy of the procedure is kept in the home for staff to refer to if necessary. The Surrey Multi-Agency procedure has been implemented by the home in the past when a concern was raised, and appropriate action was taken. Information in the AQAA stated that the manager and the matron have both attended the Surrey Multi-Agency training for Safeguarding Adults, to ensure they are fully aware of the procedure to follow, and to enable them to provide effective support to residents and staff. The AQAA indicated that staff receive further information to help them in safeguarding the residents in their care. All staff are provided with a Staff Handbook, which clearly explains the home’s “Whistle Blowing” policy, and are given a copy of the “Codes of Practice for Social Care Workers”. Staff responses in the CSCI feedback forms indicated that they are aware of the procedures to follow if they had any concerns about a resident or the home. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 18 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, 22 and 24. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is very attractively decorated and furnished and presents as a comfortable place in which to live, whilst providing residents with the aids and adaptations required to support their independence and care. EVIDENCE: The home is a purpose built property standing in its own gardens and grounds. It is attractively decorated and furnished to a very high, “hotel-style” standard and is well maintained. The spacious communal areas include lounges, two dining rooms and a number of small sitting areas, which enable residents and their visitors to meet more privately. Information supplied in the AQAA stated that all 51 bedrooms are for single occupation and all have an en-suite toilet and basin, and 47 bedrooms also Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 19 have an en-suite shower or bath. There is an on-going programme of improvements to the home. The AQAA recorded that 24 bedrooms have been refurbished during the last year, and more bedrooms will be refurbished during the coming year. Air conditioning has been installed on the first floor to make a more comfortable environment during the hotter months of the year, the AQAA stated. The manager advised that work has recently been started to extend the home by creating seven extra resident bedrooms, a staff training room, a maintenance store, and to refit the kitchen and provide a kitchen storage area. Other plans include the creation of a private dining room so that residents can entertain their friends and families, and a major refurbishment of the reception, ground floor corridors and seating areas. It was positive to note that when prospective residents’ needs are assessed before they move into the home, any specialist equipment required is also assessed. This is to ensure that it will be available in the home, or is obtained before the resident moves in. Specialist equipment that was available in the home included electrically adjustable beds, hoists, easy access baths, shower accessible chairs and specially designed armchairs and wheelchairs. A passenger lift enables residents, visitors and staff to move freely between the two floors of the home. A number of residents who use wheelchairs were spoken with as they moved independently around the home. It was also positive to observe that the appearance of the home gave little indication of the high level of care and support needs of some of the people who live there. A tour of the home was carried out and all areas that were seen were very clean and freshly aired. Hand-washing facilities, including liquid soap and paper towels are provided in all appropriate places to maintain hygiene. Staff advised that personal protective equipment, including gloves and aprons are provided and used to prevent infection or the spread of infection. A laundry room is equipped with machines with appropriate settings and is situated away from food storage and serving areas. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 20 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. A full team of staff are employed to meet the needs of residents. The required recruitment checks have been carried out to safeguard residents, and staff are offered a range of training to develop their knowledge and skills. EVIDENCE: Residents are supported and cared for by a stable team of staff, many of whom said they have been employed at the home for more than two years. The staff team is made up of care staff, qualified nurses, housekeeping staff, catering staff, administrative staff, an activities organiser, a maintenance worker and gardener. Information supplied in the AQAA stated that “residents’ needs are met by the numbers and skill mix of staff, which are dictated by the total care assessments for all residents, staffing skills and generics of the building”. The specific needs of individual residents are also taken into account, such as the need for one to one support for activities, staff advised. The staff rota is planned a month in advance, the manager stated, to enable all shifts to be covered. It was positive to note that no agency staff have been employed at the home for over two years, ensuring continuity and consistency Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 21 of care and support for residents, by staff who know and understand their needs. A number of staff have achieved a National Vocational Qualification (NVQ). Information supplied stated that more than 50 of care staff have achieved an NVQ in care, to level 2 or above, or are working towards this, so the home exceeds the recommended 50 of staff trained to this level. It was positive to note that staff in other departments such as housekeeping, also have the opportunity to undertake these recognised qualifications. The manager advised that a staff training matrix (plan) and individual staff training files are maintained. These were seen to record that staff receive mandatory training, (which is required by law), including fire safety, first aid, food hygiene and moving and handling. Staff also receive other training applicable to their role, to develop their knowledge and skills such as infection control, NVQ’s, person centred care and Control Of Substance Hazardous to Health (COSHH). Staff recruitment files were sampled and the required checks had been carried out including a Criminal Records Bureau (CRB) disclosure and two written references. For qualified nurses, a check had also been carried out to ensure that they were currently registered to practice. In the staff recruitment files seen, the specified recruitment records and documents had been obtained. A requirement had been made following the last inspection that staff files must contain a full employment history and this has been met. A full employment history had been obtained and was held in the staff files seen. Information supplied in the AQAA stated that the equality and diversity of staff are promoted and incorporated into the way that the home is operated. The home ensures “that the recruitment and selection policies and procedures result in no job applicant receiving less favourable treatment on grounds of race, colour, nationality, ethnic origin, religion or sexual orientation”. The AQAA states that staff are selected and promoted on the basis of their aptitudes, skills and abilities. A comment made on a CSCI feedback form advised that “On the whole we find the home and the staff very warm and caring” and that staff “usually” have the right skills and experience to look after people properly, from the choice of responses available. Staff commented on CSCI feedback forms that “I like my work at Corrina Lodge - from the comments of residents’ families, the majority are pleased with what we provide”, “I think I work in a rather good home”, and “staff try their best to make residents happy and contented”. It was positive to note another comment from staff, which said “management and staff support each other and team work is encouraged”. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 22 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, 32, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home if effectively managed by a person who is fit to be in charge and is run in the best interests of the residents, who are actively encouraged to take part in running their home. EVIDENCE: The manager stated that she is an experienced nurse and manager, and has worked in nursing homes for ten years. The manager has a degree in Healthcare and Service Management, maintains an active nursing registration and oversees all aspects of the home’s management, she advised. A deputy manager who takes the role of Matron and head of training, and a team of heads of department provide management support. Information supplied in the AQAA indicated that further management support is provided by the Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 23 regional management team of the Barchester organisation which runs the home. The manager advised that she keeps an “open door” policy and it was clear during the inspection visit, that the manager was freely accessible to the people who use the service, to visitors and to staff. The manager was seen to interact with all, in a friendly, informal and appropriate manner. It was clear that the home is being effectively managed, that the home is run in the best interests of the residents and that the majority of outcomes for residents as assessed at this inspection are good, and one is excellent. A requirement was made following the last inspection, that a quality audit system must be developed, to take into account the views of the people who use the service and other visitors to the home, and make the results available. This requirement has been met. The manager advised that surveys were supplied to people who use the service, their relatives, and visiting healthcare professionals. The results were reviewed by the manager and a letter was sent explaining the responses and advising of an action plan to address any issues arising. It was noted that the majority of the survey responses were positive. The manager advised that another survey had been supplied last autumn and the results are currently being analysed by the Barchester head office. The survey forms had been returned to Barchester to ensure confidentiality. A number of CSCI feedback forms were supplied to people who use the service, their representatives and visiting healthcare professionals. At the time of writing this report, five feedback forms had been completed and returned by residents, three by visiting healthcare professionals, one by a relative and six by staff members. A number of comments from the feedback cards have been referred to earlier in this report, as they relate to specific standards that have been assessed. Overall, responses were very positive about the standard of the service provided. The administrator stated that small amounts of monies are held for safekeeping on behalf of some residents, although the home is planning to change this. Under the new system the home will pay for any expenses on the residents behalf, such as for hairdressing or chiropody, and will send an invoice to the resident or their representative for repayment. This is to be recommended, as it safeguards residents against financial abuse. The monies currently held for four residents were randomly sampled. For three of these, the amounts held accurately matched the record held, but for one resident, the amount of money held exceeded that which was recorded. Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 24 The financial record for this resident had not been updated to show recent transactions. It was also noted that for many transactions of residents’ monies, including deposits and withdrawals, only one member of staff had signed to show they had been involved in the transaction, even though the record sheet provides space for two signatures. The manager supplied written confirmation before this report was written, that the home had balanced all residents’ monies and arranged to repay this to them, so money is no longer held on behalf of residents. A recorded system of supplying small amounts of money to residents has been established and this will ensure that an accurate audit trail can be followed. In future, a witness will sign any transactions, and this will be the resident wherever possible. Information supplied in the AQAA indicated that systems and equipment in the home are maintained, tested and serviced appropriately, to ensure the health and safety of all who live and work in the home. These include electrical equipment, gas appliances, the emergency call system and lifts and hoists. The home’s Health and Safety at Work poster and insurance policy were displayed as required. During the tour of the premises, a number of resident’s bedroom doors were observed to be wedged or propped open. These doors are designed to safeguard residents by closing automatically to prevent the spread of smoke or fire. The manager stated that many residents prefer their door to be kept open, or need to have the door open to enable them to move in and out of their rooms. The home’s fire risk assessment was seen and this referred to propping the bedroom doors open and stated that the doors are closed at night. The manager advised that staff are trained to remove the props from the doors when the fire alarm is activated, and that a new fire alarm system will be fitted as part of the planned building works. It is planned that the new fire alarm system will include fittings that will retain doors open, but allow them to close when the fire alarm is activated, the manager stated. To ensure residents are safeguarded, it is recommended that advice is obtained from the local fire service about the current practice of holding doors open. Corrina Lodge Nursing Home DS0000017600.V355845.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 X X 2 Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13 (2) Requirement Arrangements must be made for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Specifically, the receipt of all medication into the home must be recorded, to ensure all medication is accounted for and an audit trail can be followed. The amounts of money held for safekeeping on behalf of residents must accurately match the record held. An accurate and up to date record must be maintained of the purpose for which any resident’s money is used. Adequate arrangements must be made for detecting, containing and extinguishing fires. Specifically, doors designed to close automatically must not be wedged or propped open. Timescale for action 25/01/08 2 OP35 17 (2) Schedule 4 25/01/08 3 OP38 23 (4) (c) (i) 25/01/08 Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 27 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 Refer to Standard OP9 Good Practice Recommendations It is good practice to carry forward a record of stocks of any medication held, to enable an audit trail to be followed. It is recommended that advice is obtained from the local fire service, regarding the current practice of propping or wedging open doors that are fitted with devices to ensure they close automatically, to prevent the spread of smoke or fire. 2 OP38 Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Office The Oast, Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Corrina Lodge Nursing Home DS0000017600.V355845.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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