Care Home: Egerton Lodge Care Home

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What the care home does well What has improved since the last inspection? Egerton Lodge continues to provide high standards of care for residents. They have implemented the requirements regarding medication administration, staff recruitment and health and safety issues, made at the previous inspection in January 2007, to improve and consolidate these processes, thereby ensuring that the health and safety of residents are fully protected. The home continues to maintain and improve the environment such as the recently installed wet room in basement, also used by the beautician and hairdresser. What the care home could do better: No requirements or recommendations were made following this inspection. CARE HOMES FOR OLDER PEOPLE Egerton Lodge Care Home Wilton Road Melton Mowbray Leicestershire LE13 0UJ Lead Inspector Mrs Carole Burgess Unannounced Inspection 22nd November 2007 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 Egerton Lodge Care Home DS0000001779.V354735.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. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Egerton Lodge Care Home Address Wilton Road Melton Mowbray Leicestershire LE13 0UJ 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) 01664 410202 01664 482124 elaine@egertonlodge.co.uk Egerton Lodge Limited Ms Joyce Wells Care Home 46 Category(ies) of Dementia - over 65 years of age (12), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (3), Old age, not falling within any other category (46), Physical disability over 65 years of age (10) Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service User Numbers (PD(E)) No-one falling within category PD(E) may be admitted into the home when there are 10 service users of category PD(E) already accommodated within the home. Service User Numbers (DE(E)) No-one falling within category DE(E) may be admitted into the home when there are 12 service users of category DE(E) already accommodated within the home. Service User Numbers (MD(E)) No-one falling within category MD(E) may be admitted into the home when there are 3 service users of category MD(E) already accommodated within the home. Service User Numbers (Total) The total number of service users does not exceed forty-six (46). Admission of KP: The home is able to admit the person of category LD/DE as named specifically in variation application number V16081 30th January 2007 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Egerton Lodge provides care for forty-six older people including those with dementia, mental disorder and physical disability. Edgerton Lodge aims to provide a homely environment where residents can exercise choice, enjoy companionship, and feel secure. The home is located in the centre of Melton Mowbray, next to Egerton Park, with all of the expected amenities of a market town. There are two lounges and a dining room on the ground floor and a large hallway, which also has comfortable seating. On the first floor there is a further lounge/dining room. The home is well furnished and decorated to a high standard throughout. Residents’ rooms are located on three floors, including the ground floor and are accessible by lift and stairs. All of the rooms have en suite facilities. The Statement of Purpose, Residents’ Guide & Inspection Report are available on request (these provide information on how the home is organised and what services they provide). The Statement of Purpose and Residents’ Guide are provided for all new residents. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 5 At the time of the inspection, fees ranged from £400 to £575 per week. This includes chiropody, beautician, newspapers and toiletries (hairdressing is extra). Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. The site visit was unannounced and took place over five and a half hours. The Inspector selected three residents and tracked the care they receive through a review of their records, discussion with them (where possible), other residents, the care staff, and observation of care practices. The inspector spoke with staff members regarding training and support. Planning for the Inspection included assessing notifications of significant events sent to the CSCI by the home. There have been no complaints received by the CSCI regarding the home. Registered Provider/Manager (a person registered with the CSCI), assistant manager and other staff spoken with were positive and helpful during the inspection. What the service does well: Egerton Lodge provides an excellent standard of care within a bright, spacious, and homely environment. The home and the attractive gardens are well maintained and provide a safe environment in which residents can be supported to maintain as much independence as possible. The home maintains a very high standard of décor and cleanliness throughout. Food is nutritious and well-presented, individual diets and preferences are catered for, and the chef and staff are very flexible to ensure that residents’ requests are accommodated. Visitors are made very welcome and are able to dine with their relatives if they wish, with prior notice to the chef and for a small charge. There is an excellent activities programme for residents. Levels of staffing ensure that the residents’ health and welfare needs are fully met, including ‘one to one’ time to ensure that residents receive individualised care and support. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 7 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Egerton Lodge Care Home DS0000001779.V354735.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 Egerton Lodge Care Home DS0000001779.V354735.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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with detailed information about the home, and have their health, welfare and social care needs assessed, so that they can be fully met once they move into the home. EVIDENCE: The home provides prospective residents and their relatives with a Statement of Purpose and Service Users Guide (both give information about the home) to help them decide if the home is the right one for them. Both documents are in the process of being revised to provide all residents with up to date information about the home. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 10 Signed copies of residents’ Terms and Conditions are kept in residents’ files. The three residents’ care plans reviewed contained a detailed pre-admission assessment to show that the home could meet their specific health, welfare, and social care needs. It included personal details, relative and GP contact numbers, past and present medical history, current health care requirements and medications, personal preferences, social interests and hobbies to ensure that the home could meet all of a prospective resident’s needs. A resident who had recently moved to the home said that he had been well supported by the caring staff ‘who were champion and lovely girls’, and that he did not want to go back to living on his own. The home does not provide intermediate care. Egerton Lodge Care Home DS0000001779.V354735.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 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health, personal and social care needs. EVIDENCE: Residents’ care plans are very detailed and give carers thorough information about the health, personal and social care needs of the residents: every possible requirement was recorded to ensure that residents receive a high level of individualised care. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 12 All care plans had been signed and dated by the residents and/or their representatives to demonstrate that residents are fully involved and agreed with their personal plan of care. The care staff review all care plans at least monthly so that residents’ care needs continue to be met. Contact with healthcare professionals such as GP’s, District Nurses, hospitals, and Chiropodists were recorded to ensure that healthcare needs and treatments were addressed. Medication policies and procedures are sound. The home has a Controlled Drugs book that is double signed, as are the Medication Administration Records (MAR sheets), when controlled medication is required. Medications is administered by senior carers who receive annually updated training to safeguard the residents, and ensure that they receive their medication as prescribed. Residents are able to continue to self medicate following a risk assessment to ensure that they are safe to do so. Locked cabinets are provided in all residents’ rooms for the storage of these medicines and other valuables which a resident may wish to keep with them. It was recommended that the new medicines fridge should have a thermometer and daily recordings kept to ensure that medicines requiring refrigeration were kept at the correct temperature. This was promptly attended to on the day of inspection. Observation during the inspection showed that staff have a good awareness of how to protect residents privacy and dignity and always knocked on a resident door before entering their room. Staff spoke to residents and visitors in a respectful, friendly, quiet and supportive way. Five residents, spoken with during the inspection, said that they were very well looked after and that staff were kind, caring and respectful. Residents’ said that staff were ‘very good and helpful’, ‘I have everything I need’, and ‘there is nothing to complain about, we are well looked after’. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 13 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff work hard to ensure that residents experience a safe, stimulating and homely life style. EVIDENCE: There is an activity co-ordinator and a choice of planned activities every morning and afternoon, which are displayed on a blackboard in one of the seating areas. On the day of the inspection, residents were enjoying 1-1 activities, exercises and board games. There is a monthly residents meeting to consult residents about the forthcoming months activities. The co-ordinator takes every opportunity to celebrate any special occasions. One resident had had a hundredth birthday Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 14 celebration with a cake, party and the local press invited and another resident had had a buffet in his room for visiting friends. There are many competitions, including a monthly word search and crossword competition, and skittles and bowls competitions. A quarterly newsletter is produced for residents and their families, which contains many photographs of recent events. Residents preferences are outlined in their care plans, and they said that staff offer them choices, and consult them about their daily routines. Religious and spiritual need are supported; birthdays and festive days are celebrated and residents who are able take part in external activities and go into town shopping, with the assistance of a carer, to ensure that they are able to remain fully engaged with community life. There is a hairdressing salon and the hairdresser visits twice a week. The home also has a visiting beauty therapist and chiropodist to enable residents to maintain their appearance and wellbeing. Residents are able to have their own television and telephone in their room should they choose to do so. Residents said that they are able to have visitors at any time. Staff support residents with making choices in their everyday life. All residents spoken with said they got up and went to bed when they wished, are able to choose what they wanted for their meals, breakfast in their rooms if they wished, and are well supported by very caring staff. All meals are prepared in the home’s kitchen by an enthusiastic chef. A cooked breakfast is available every day and there are choices at all main meal times. Breakfast was still being served to late risers at 10:30 on the day of inspection. Drinks are available throughout the day. Special diets such as diabetic and soft diets are catered for. Residents have a nutritional assessment in their care plan, are weighed regularly where necessary, and additional healthcare advice and supplements provided when required to ensure that their dietary needs are met. Residents said that ‘food was very nice’ and that there were always choices. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are sound resulting in satisfactory protection of residents’ rights. EVIDENCE: Residents and staff comments showed that people feel at ease discussing any concerns with the staff. Information regarding advocacy services is available if residents require independent support and advice. Neither the home nor the CSCI have received any complaints about the home. The home’s complaints process reflects the Safeguarding Adults policies and procedures and staff are provided with appropriate training and are able to demonstrate the correct procedures for safeguarding the residents from harm. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A comfortable, clean, safe and high standard of accommodation is provided for the residents. EVIDENCE: The home is clean, safe and well maintained with adaptations to suit residents’ specific needs. It is decorated and furnished to a high standard that creates a comfortable, light, spacious but homely environment. There are usually three cleaners on duty during the day. All residents spoken with said that standards Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 17 of cleanliness are excellent, and this was confirmed during a tour of the building. All residents’ rooms have en suite facilities and all have a ‘nurse call’, and were clean and well decorated. Residents are able to bring items of their own furniture and possessions with them to personalise their rooms. All residents’ rooms were highly personalised with some of the resident’s home furnishings. Residents also have access to attractive safe gardens. There are sufficient additional toilets, bathing and assisted bathing facilities, including a ‘wet room’ in the basement to enable residents to have a choice of bathing facilities. The home’s health and safety arrangements such as regular maintenance and servicing of equipment, regular fire drills and monitoring heat control valves on hot water taps throughout the home show that the Registered Provider/Manager (owner) is mindful of her responsibilities to make sure that residents live in a safe environment. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 18 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are well trained and sufficient in number to meet the residents’ needs. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 19 EVIDENCE: There were forty-four residents at the time of the inspection. Staffing levels, at the point of inspection, were above that suggested by the Department of Health Residential Forum Guidelines and were sufficient to meet the residents’ needs, including providing one-to-one time. During the day there are eight or nine carers, a laundry person, three kitchen staff, three domestic staff, a maintenance person and two activities organisers; in the afternoon there are seven carers, a tea lady and a laundry person in the evening, and there are three waking night staff plus an ‘on call’ for emergencies. On the first floor is a small sitting room for highly dependant residents and there is a carer with them all of the time and a second carer who can be called upon should help be needed. Staffing levels ensures that care staff are free the entire time to provide care for the residents. Residents said that there was always sufficient staff on duty. Four staff files were checked during the inspection and showed that there is a satisfactory recruitment process to ensure that residents are well protected. The process has been improved to ensure that all staff are checked against the Protection of Vulnerable Adults (PoVAFirst) Register before starting supervised induction and work in the home, as required following the previous inspection. The home has a trainer who is responsible for ensuring that staff are fully equipped with the knowledge they require to care for the residents. All staff are required to complete comprehensive training during their first year of service. New staff carry out an induction programme and have mandatory, annual updates. Staff undertake training in specific areas such as Personal Care, Dementia, Emergency First Aid, Moving and Handling, Food Hygiene, and safeguarding adults. Additional training this year will include Falls Prevention, Continence Care and Diversity. The list is not exhaustive. The trainer said that 75 of staff had completed National Vocational Qualification (NVQ) in Care and that the remaining care staff will also undertaking NVQ training. Ancillary staff are also supported to completed NVQ training in their relevant sphere of work. Training appears to be excellent. This ensures that staff have all the necessary skills to give safe and effective care to the residents. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 20 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Provider/Manager provides good, supportive leadership to staff, ensuring that residents receive a high standard of care. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 21 EVIDENCE: The Registered Provider/Manager is a qualified dietician and an experienced carer working in a supervisory and management role in addition to care staff numbers. She is assisted by the assistant manager, who is in the process of applying to be the Registered Manager for the home. Excellent interaction between staff, residents and residents’ relatives was observed during the inspection and ensures that there is a culture of openness and friendliness in the home. The home conducts a yearly quality audit (satisfaction survey) for residents and relatives. The results are collated and actioned and presented as a graph with the Statement of Purpose so that comments from residents and visitors can help to improve the service. Staff are well supervised by the Registered Manager and assistant manager in performing their care tasks. Staff receive regular, recorded supervision (regular review of staff’s personal and training needs in relation to their work) and appraisals to ensure that they have the necessary skills to provide a good service for the residents. A carer said she received supervision at least monthly and was well supported by the managers. Health and Safety Policy and Procedures, such as regular recorded fire drills and fire alarm tests are completed. All of the Health & Safety concerns highlighted during the previous inspection had been attended to, to ensure the health and safety of the residents and staff. Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 22 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 4 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 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 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Egerton Lodge Care Home DS0000001779.V354735.R01.S.doc Version 5.2 Page 25 - 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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