Care Home: Country Lodge Nursing Home

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What the care home does well The home welcomes people who will use the service and their families or representatives, to visit the home and look at the facilities of the home. The manager seeks information from external healthcare professionals as part of the assessment where necessary, to ensure that the home is able to meet assessed needs. People moving into the home are assured that the home that they are entering will meet their needs. For example, staff are trained and show perception and professionalism in the way they deliver care, which enables people who live at the home to feel safe and enjoy a varied and companionable way of life. Staff treat people who live at the home with respect; they share their companionship and give support sensitively. Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that individuals need.Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. People who live at the home were positive about the food that the home provided and were pleased with the activities in which they could participate and the condition of the accommodation that they occupied. People at the home, relatives and staff had confidence in the effectiveness of the home`s manager. Systems and procedures in the home worked well including, dealing with complaints, quality monitoring, and health and safety. What has improved since the last inspection? The environment continues to be improved through a planned refurbishment. The AQAA from the home listed the changes at the home since the last visit: Several changes to food and presentation, for example individuals have requested smaller portions, roast for lunch twice a week, dietary preferences. Individual moved to room with garden view when it became available. New TV aerial installed for better reception. New, large flat screen TV in the lounge. New Queen Anne chair supplied to resident to support her back (suffers from osteoporosis). Regular outings offered to garden centres, coffee and shopping. Installation of more ensuite bathrooms. What the care home could do better: There are a few carpets that must be replaced as they are threadbare and torn which pose a trip hazard comments have been received from people who live at the home and visitors. Fire training for staff must be carried out at a frequency as recommended under guidelines. CARE HOMES FOR OLDER PEOPLE Country Lodge Nursing Home Cote Street Worthing West Sussex BN13 3EX Lead Inspector Val Sevier Key Unannounced Inspection 7th March 2008 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 Country Lodge Nursing Home DS0000024171.V359276.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. Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Country Lodge Nursing Home Address Cote Street Worthing West Sussex BN13 3EX 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) 01903 830600 01903 693696 enquiries@countrylodgenursing.co.uk www.countrylodgenursing.co.uk Mr John Patrick Wright Mrs M Wright Mrs Deborah Susan Spokes Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th November 2006 Brief Description of the Service: Country Lodge is a care home, which is registered to accommodate up to twenty five individuals in the category (OP) old age, not falling within any other category. It provides personal and nursing care. Country Lodge is a detached two storey property which provides accommodation in one double and twenty one single bedrooms located on the ground and first floors. A vertical passenger lift provides access to all floors. A dining room and lounge are located on the ground floor. There is also a small sitting area on the first floor. The property is located on the outskirts of Worthing. The fee levels range from £615 to £850 per week and is dependent on the type of accommodation available. The service is privately owned by Mr and Mrs John Wright and the registered manager, who is responsible for the day to day running of the care home, is Mrs Debbie Spokes. Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service 2 star. This means the people that use this service experience good quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These included: the Annual Quality Assurance Assessment (AQAA) completed by the home, and an unannounced visit to the home, which was carried out on the 7th March 2008, during we were able to have discussions with staff and have interaction with the people who use the service. During the visit we looked around the inside and outside of the home, which included a sample of bedrooms and bathrooms. Staff and care records were sampled and in addition to speaking with staff and people who use the service, their day-to-day interaction was observed. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. What the service does well: The home welcomes people who will use the service and their families or representatives, to visit the home and look at the facilities of the home. The manager seeks information from external healthcare professionals as part of the assessment where necessary, to ensure that the home is able to meet assessed needs. People moving into the home are assured that the home that they are entering will meet their needs. For example, staff are trained and show perception and professionalism in the way they deliver care, which enables people who live at the home to feel safe and enjoy a varied and companionable way of life. Staff treat people who live at the home with respect; they share their companionship and give support sensitively. Detailed records were in place that gave nursing and care staff information that enabled them to provide the help that individuals need. Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 6 Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. People who live at the home were positive about the food that the home provided and were pleased with the activities in which they could participate and the condition of the accommodation that they occupied. People at the home, relatives and staff had confidence in the effectiveness of the home’s manager. Systems and procedures in the home worked well including, dealing with complaints, quality monitoring, and health and safety. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Country Lodge Nursing Home DS0000024171.V359276.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 Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3 (6 is not applicable to this service) People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering using the service are given appropriate information about the service to enable them to make an informed choice. People that use the service can feel assured that their needs will be assessed and that the home has an understanding of their needs using the assessment process. EVIDENCE: The statement of purpose and service users guide is in the form of a brochure and contains information about the home and its facilities. The guide also comments on the values of the home, on privacy, dignity, independence, civil rights, choice, fulfilment, and ethnic and cultural diversity and security. We received the AQAA for the home, which stated that: “We complete a preadmission assessment for all residents. We obtain a copy of the care management plan from local authorities or other care services. Residents Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 10 receive a written contract setting out their rights and responsibilities. We give advance notice of any changes in payments. We ensure that the resident is assessed for their Nursing Care Contribution”. This was supported by evidence in the records at the home and with talking with relatives of individuals who had moved to the home in the last year. The assessment includes the following areas: personal hygiene and dressing; safe environment; eating and drinking and swallowing; working and leisure; sleeping and aids to ability. Examples of the individual’s abilities within these areas were seen for example able to express needs, needs spectacles for long and short distance”. It was also noted that there was information gathered from others who are involved in caring and supporting the individual, including the family and other health professionals. Country Lodge Nursing Home DS0000024171.V359276.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 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The records and systems within the home that ensure that the personal and healthcare needs of people who use the service are met safely and effectively. Staff working practice helped to ensure that the privacy and dignity of people who use the service is promoted. EVIDENCE: The manager stated in the AQAA returned to us that: “We have a well-evolved care plan for all our residents, including end of life, which is updated monthly or earlier as required. Risk assessments to identify risks of pressure damage, malnutrition and falls, and action being taken to prevent these situations. We respect the dignity, choice, independence and privacy of all residents Our residents can register with their GP of choice as long as the GP is in agreement, and we identify health problems so they can be dealt with promptly. We ensure the correct receipt, storage, handling, administration and disposal of medication”. Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 12 We sampled four care plans of people who use the service that had moved to the home in the last year. The care plans sampled were being used in conjunction with medication records and other health-monitoring tools that are used as part of the care planning for individuals. The care plans that have been developed were seen to be a working tool, with records of daily life and regular evaluations by the key worker. The documents seen and the plans were based on the assessments the home carried out in order to identify what help individuals needed. Assessments included a range of potential risks to individuals for example: pressure sores; falls; moving and handling and malnutrition. Where a pressure sore assessment indicated that an individual was at risk it was noted that the corresponding plan of care for the person concerned referred to the use a pressure relieving aid. We were able to see that pressure area breakdown had been present when an individual moved to the home and that the care and treatment in support of pressure areas that had broken down had been successful. The plans examined set out clearly the actions and support staff needed to take and what specialist equipment was needed to provide the support and assistance each person required. For example where support with movement was identified instructions on numbers of staff needed, equipment and communication was seen. It was seen in the care plans that physical health needs are also addressed for individuals, with information from health and other specialists; this information has been incorporated into the care plan at this home. It was also seen that individuals have access to opticians and dentists as needed. Notes regarding physical health indicated that other professionals had been involved as necessary for example regular visits from the tissue viability nurses to assist the home in caring for the needs of those individuals with pressure areas. Records indicated that care plans were reviewed regularly and as needs changed and daily notes referred to the actions taken by staff to provide the needs set out in those plans. Care plans are agreed with the person using the service where possible and their relative or representative. The home had written policies and procedures concerned with the management and administration of medication. Medication was kept in locked and secured medicine trolleys, cupboards and where required in a medical refrigerator. Controlled drugs were stored securely and appropriately. The only staff in the home that dispensed and were responsible for the management and administration of medication on a day-to-day basis were trained nursing staff. The manager stated that their local pharmacist called at the home twice a year to assist with monitoring the medication for example storage. It was seen that there were examples of where staff had handwritten the medication administration record however there was no date of when the Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 13 medication came into the home, the amount and no signature to say who had completed it. There were examples of where medication was ‘as required’ and had been administered with no reason or outcome recorded. The manger stated that she had had a meeting with trained staff two weeks prior to the inspection about the medication administration, and would highlight to them the issues raised at our visit. Staff were observed speaking and assisting the individuals with dignity and respect. It had been seen on care plans that the preferred choice of name had been recorded and staff were heard to speak to people who use the service by the name they wished. Country Lodge Nursing Home DS0000024171.V359276.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, & 15 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. Dietary needs are well catered for with a balance and varied selection of food available that meets individual dietary requirements and choices. EVIDENCE: The AQAA from the home said: “We hold residents’ meetings where they are able to make suggestions on menu content, activity programme and housekeeping. We practice person-centred care, treating residents as individuals and trying to make the routine of daily living as flexible as possible. We have completely open visiting arrangements and frequently entertain visiting relatives and friends to lunch and tea. All residents can receive their visitors in private and have their own telephone in their rooms. We encourage residents to participate in activities and entertainment that we provide for them on a frequent and regular basis”. People living at the home and visitors spoken with on the day said that there were televisions in their bedrooms as well the main lounge and they were able Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 15 to watch them as the wished. The visitors spoken with said that visiting was open and they were able to spend as much time with the person at the home as they all wanted and this included having a meal. The home has an activity person who works with small groups or on a one to basis, care staff at the home also carry out activities and there is external entertainment. The home offers an activities programme which includes games, crafts, exercises, puzzles and remiscence. It was seen on care plan that an inidvidual expressed an interest to play cards, it was noted that they had a game of cards during the visit. There are regular visits from the hairdresser and mobile library. There is monthly Holy Communion. People who use the service are encouraged to exercise control over their lives and it is their choice to participate in social activities if they wish. Visitors spoken with said that staff try to help individuals to maintain their rights and for them to be able to make informed choices around daily living. People who use the service that we spoke with, who were able to pass comment were complimentary about the food provided. The meals seen looked nice and were presented in a way that looked appealing. The menus and records of food provided indicated that the food was nutritious and there was a wide range of meals provided with a selection of choices every day. In addition special diets and individual preferences and needs were catered for e.g. soft and pureed meals and diabetics. People who use the service could choose where to eat and some preferred to eat in their rooms. Food preferences, dislikes, food related allergies and nutritional and dietary requirements were recorded in residents care plans and the information was also readily available to catering staff. On the day of the visit the meal was fish or macaroni cheese, the cook however had spoken with several people who had expressed a liking for something else that day one wanted salmon and egg another who was feeling unwell ‘fancied egg and chips’ it was seen on the kitchen records and through observation that the cook had met these individual requests. Country Lodge Nursing Home DS0000024171.V359276.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 & 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected through the open complaints process and the staff’s knowledge and understanding of safeguarding and protection issues. EVIDENCE: The homes complaints procedure was seen to be available in the information given to people who use the service. There have been no complaints received by the home or the commission. The manager advised that the home promotes an open door approach to relatives and people who use the service, to help resolve complaints and issues effectively. Relatives and people who use the service said that they felt able to talk with the staff and that the manager responded to their ‘grumbles’. The home uses West Sussex safeguarding adult policy and staff were seen to have training in adult protection as part of their induction as well as yearly updates. The AQAA from the home said: “The home has a clear and accessible complaints procedure in place, illustrating timescales and how complaints are dealt with. All residents are informed of the complaints procedure and receive support from staff in making their complaint. We keep records of all complaints Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 17 received and what action is taken. We assume that every resident has the capacity to make all their decisions unless proved otherwise, and this is reviewed as required. We offer advocacy service information. All staff are trained in the protection of vulnerable adults and observe the regulations. We have procedures in place to respond to evidence or suspicion of neglect or abuse”. Country Lodge Nursing Home DS0000024171.V359276.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 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have a pleasant and homely environment to live in which also has had adaptations to meet individual needs. EVIDENCE: We looked around some of the home and were able to see communal areas such as the dining room, lounge, bedrooms and bathrooms. The garden is accessible with wheelchairs. All of the bedrooms seen were brightly decorated and had evidence that people who live at the home had been encouraged to furnish the room with personal belongings such as furniture and pictures, to make it feel like home. Consideration is given to the support of needs with the use of equipment. Specialist beds are available at the home for those that are assessed as needing them. There is also specialist seating, a lift and adapted bathing facilities. Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 19 It was noted that in accordance with best practice all communal WCs that were seen were provided with liquid soap dispensers (that were full and working), alcohol gel sanitizers and paper towels. Protective clothing was readily available and staff were observed using gloves and aprons appropriately. The home’s laundry was appropriately sited and equipped and effective procedures were in place for the management of soiled laundry items. The home manages all the laundry with dedicated staff. There was no malodour in the home and it was seen to be clean and tidy. Comments from residents about the condition of the premises included: • “They are particular about keeping it clean, the windows ands so on, I think they also look after the building”. • “It is kept spotless and I like looking out of the window. The trees and plants change colours and I can see the birds”. It was noted that several carpets in the home were worn in places and posed a hazard, it was also seen that residents and visitors had also commented on these carpets. Country Lodge Nursing Home DS0000024171.V359276.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 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the services have their needs met by staff who are trained, supportive and sufficient in numbers. People who use the services are protected by the recruitment procedure. EVIDENCE: The staffing structure provides a broad spread of experience and professionalism: manager, nurses, support workers, kitchen staff, laundry and housekeeping. Other health care professionals support the team from outside the home as needed. Staff spoken with on the day of inspection indicated that they were aware of the needs of the people who live at the home; they also seemed enthusiastic about working at the home. The rotas indicated that there were sufficient staff to meet the needs of the people at the home. There was evidence that staff have received training in all mandatory areas such as food hygiene, first aid and manual handling, health and safety, safeguarding adults and infection control. In addition it was seen that staff have attended training in continence management, management of diabetes, tissues viability, Mental Capacity Act, end of life care, diversity and valuing differences night care for older people and NVQ in cookery. Staff receive at last three days training a year and are enabled to access courses either at the home or externally. Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 21 New staff undertake two-day induction period when mandatory training is undertaken. This is followed by the induction pack, which is supervised by the individual staff members mentor. The time taken to complete this induction pack, which is based on ‘Skills for Life’, depends on the individual member of staff but is usually twelve weeks. Modules covered are: values, understanding the organisation and the role of the worker, health and safety for example fire and incidents, communication for example call bells and methods of communication, abuse and neglect and developing as a worker. After each model there is an exam, which is marked by an outside agency. Staff are expected to pass the exams as part of the evidence of their knowledge and understanding of their role. Records were examined of four staff that had been employed to work in the home since the last fieldwork visit to the home. Records indicated that statutorily required pre-employment checks, intended to ensure that people unsuitable to work with vulnerable adults were not employed, had been completed before the individuals concerned actually started working in the home. The manager explained that after interviewing, references are sent for and the CRB check is requested, a member of staff commences employment after the references are received and under supervision whilst waiting for the CRB check to be completed. The POVA First is included on this check and is returned before employment commences. This supported the statement in the homes AQAA that: “We have a robust recruitment process, with due regard to obtaining CRB checks, references, employment history and work permits where required. Trained nurses are all registered with the NMC. We have an appropriately qualified workforce, with 59 of carers having achieved NVQ2 or above; three carers are working towards their NVQ2 and a further three towards their NVQ3 (health and social care). Two members of housekeeping staff have their NVQ2 in Cleaning and Support, and one member of kitchen staff is taking his NVQ2 in Professional Cookery. All staff receive a job description and handbook. All staff receive formal induction training and regular updates. We display a weekly rota that clearly shows daily staff duties”. Country Lodge Nursing Home DS0000024171.V359276.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, 33, 35 & 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a well run home; with systems and procedures in place which monitor and maintain the quality of the service provided and promotes the safety and welfare of everyone living and working in the home. The home must ensure that all staff receive training in fire safety for the protection of people who use the service and staff. EVIDENCE: The manager – Debbie Spokes has six years management experience and holds the Registered Managers Award. The responsible individual Mr Wright goes to the home daily. There is a clear Management structure with Policy & procedures reviewed annually. There were a range of written policies and procedures available for Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 23 staff to refer to as guidance and to inform their practice. These included the following: • Admission, discharge and transfer of residents • Human Rights • Confidentiality and access to personal records • Abuse of the person • Drug administration • Self administration of medication • Infection control • Complaints procedure • Whistle-blowing • Sexuality • Health and safety at work The people who use the service and their relatives or representatives and the staff, are able to discus all aspects of the running of the home generally or on a personal level. This opportunity is offered in resident, relative and staff meetings, and in questionnaires, which are sent out annually. The manager also carries out an annual audit of the home looking at areas such as health and safety, medication and employment. Individual monies & valuables can be locked in lockable drawers in the resident’s room or in a safe. Records are kept of all valuables and money. It was noted that the home’s equipment, plant and systems were checked and serviced or implemented at appropriate intervals i.e. passenger lift and hoists; fire safety equipment portable electrical equipment; hot water system; etc. There were contracts in place for the disposal of clinical and household waste. Records were kept of accidents The local fire officer had visited the home on 7/1/1/08 and several requirements for action were made. The fire officer will carry out a further visit in April 2008 to monitor compliance. It was further noted that staff have not received training in fire twice a year with some staff not having had training since May 2007. It was seen that the manager had begun to rectify this with 12 staff having had fire training on 20/2/08. Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 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 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 25 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. 2. Standard OP19 OP38 Regulation 23 (2)(d) 23 (4)(d) Requirement The flooring at the home must be made safe to protect the people that use the service. Staff must receive regular training as per guidelines in fire safety to protect the people that use the service. Timescale for action 07/06/08 07/06/08 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 Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 26 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 Country Lodge Nursing Home DS0000024171.V359276.R01.S.doc Version 5.2 Page 27 - 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. 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