Care Home: Epsom Lodge

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What the care home does well Residents live in a clean and homely environment, which is decorated to a good standard. Resident`s private accommodation is personalised, safe and comfortable. Several residents stated that they liked their rooms. Ample communal space provides residents with the opportunity to socialise in groups. Residents said that they can enjoy a glass of wine or sherry in the evenings and watch their favoutite television programmes in the lounge together. Residents are supported to maintain relationships with their families and friends, and visitors are welcome in the home at any time. The home follows a good admission procedure with all prospective residents having a needs assessmnet undertaken prior to admission. Trial visits will be offered whenever possible. Care plans are well written and outline in detail the care to be undertaken and the method and frequency for this care to be delivered. The cook who has been in post for several years provides residents with fresh, wholesome, and nutritious home cooked food. Residents and relatives stated that the food was excellent and "we can choose what we want". The staff team employed is sufficient to meet the assessed needs of the residents and the size and layout of the home. Staff are trained and competent to undertake their roles and responsibilities. The home is well managed by an experienced manager who undertakes a "hands on" role. Systems are in place to monitor quality assurance for a home of its size. The health, safety and welfare of the residets and staff are observed and promoted. What has improved since the last inspection? The requirements made at the last inspection have been assessed as met. The management team have now identified a selection of staff that can be realied on in an emergency. This will ensure that if staff heve to leave the home while on duty that there will be staff to call on to ensure the minimum staffing levels are maintained. There is a programme of maintenance and refurbishment in place. The shower room on the ground floor has been refurbished and a new floor is now in place. What the care home could do better: The home follows Surrey`s Multi Disciplinary Policies and Procedures on Safeguarding Vulnerable Adults. This document is out of date and needs to be replaced with the most recent revised version. It was also advised that the manager or one of the providers attends the revised local authority training in these procedures. A requirement has been made accordingly relating to Standard 18 Older People. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Epsom Lodge 1 Burgh Heath Road Epsom Surrey KT17 4LW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary Williamson     Date: 0 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Epsom Lodge 1 Burgh Heath Road Epsom Surrey KT17 4LW 01372724722 Telephone number: Fax number: Email address: Provider web address: kevin@epsomlodge.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Helen Pugh Type of registration: Number of places registered: Mr Kevin John Middleton,Ms Ninawatie Seepaul care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Three of the ten service users may also have a sensory impairment SI(E) Date of last inspection Brief description of the care home Epsom Lodge is a large detached house, situated close to the local amenities of Epsom. The home provides accommodation and personal care for up to ten service users in the category of older people, three of who may in the category of dementia. The accommodation consists of eight single rooms and one for double occupancy, a dining room/ lounge and appropriate laundry and kitchen facilities. Service users? bedrooms are on the ground and first floors of the building, the proprietors live on the second floor. A passenger lift enables service users on the first floor to access their bedrooms at all times. A garden is situated to the rear of the home, and a small parking area is Care Homes for Older People Page 4 of 26 Over 65 3 7 0 0 Brief description of the care home available at the front of the property. The fees charged range from £550 to £650 per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The overall rating for this service is two star. This means the people who use the service experience good quality outcomes. This was the first site visit of a key inspection and was unannounced. The inspection was carried out by Mary Williamson Regulation Inspector. The Registered Manager Helen Pugh represented the service for the duration of the inspection. The providers were also involved in part of the inspection. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were seen. Records seen included care plans, medication records, menus, risk assessments, staff training profiles, and employment Care Homes for Older People Page 6 of 26 records. This is a small family run home and the manager and both providers were the staff team on duty. Residents were being well cared for and appeared relaxed and comfortable. Activity was mainly centred around the lounge with residents sitting in groups chatting amongst themselves. It was posible to talk with residents in a group and individually and gain their views about living at Epsom Lodge. They were very complimentary about the care received and the staff team. The kitchen was visited and the catering arrangements discussed with the cook. The standared of food is very good and residents had positive feedback regarding the meals offered, and lovely home made cakes. Relatives visiting the home were spoken to and supported the views of the residents that the standard of care is received is very good. The home completed an Annual Quality Assurance Assessment (AQAA) prior to the inspection, and the information provided in this document has been used to support this inspection report. The Commission for Social Care Inspection would like to thank the residents, relatives and staff for their assistance and hospitality during this inspection What the care home does well: What has improved since the last inspection? What they could do better: The home follows Surreys Multi Disciplinary Policies and Procedures on Safeguarding Vulnerable Adults. This document is out of date and needs to be replaced with the most recent revised version. It was also advised that the manager or one of the providers attends the revised local authority training in these procedures. A requirement has been made accordingly relating to Standard 18 Older People. Care Homes for Older People Page 8 of 26 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents are provided with sufficient information in oredr for them to make a choice about living in the home. Pre admission needs assessments and contracts of occupancy are in place. Intermediate care is not provided in this service. Evidence: The home has a statement of purpose and service user guide in place. This is available to all prospective residents and their relatives, and provides sufficient information for them to be able to make an informed choice about choosing to live in the home. A copy of this document is located in individual bedrooms for information. All prospective residents have a needs assessment carried out prior to being admitted to the home. This is undertaken by the manager to establish if the home can meet the specific assessed need of the residents. Three needs assessments were seen and these are informative. A new resident was being admitted during the inspection and had all the Care Homes for Older People Page 11 of 26 Evidence: required documentation in place. Contracts of occupancy are in place. A selection of these were sampled and outilne the accommodation offered, the care provided, the fees charged and the method and frequency of payment. The home does not provide intermediate care. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate arrangements are in place to meet the health, personal, and social care needs of residents, which are outlined in individual well maintained care plans. Privacy and dignity are observed and residents are treated with respect. The medication policy in place protects residents living in the home. Evidence: Individual care plans are in place, and three of these were seen during the inspection. Care plans are written with information gathered from the pre admission needs assessment, input from the residents, additional information from relatives, any medical or care management reports, and assessmnets available. Care plans are well maintained and reviewed regularly, and when needs change. Risk assessments are in pace and form part of the care plan. All the residents are registered with two local GPs. They visit the home when necessary and residents stated that they were happy with the service provided. There is also good support from the district nurses who currently visit the home weekly to Care Homes for Older People Page 13 of 26 Evidence: undertake dressings. The chiropodist was visiting the home during the inspection and said that she visits residents every six weeks. A domiciliary dentist and optician also visit the home regularly. The home has a medication administration policy in place and all staff who administer medication are familar with this policy. The medication is supplied to the home by Anachem Pharmacy, who also undertake regular audits of medication and provide staff training. The medication recording charts were seen and are well maintained. Currently there are no residents in the home who self medicate, but this would be risk assessed and facilitated if required. Privacy and dignity are observed. Staff knock on bedroom doors prior to entering residents rooms. Locks are provided on toilet and bathroom doors, and keys would be provided for bedrooms if requested. Staff interact with residents in a professional and polite manner. Residents are addressed by their preferred title in a respectful way. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this 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 activity programme in place meets the individual and collective needs of residents. Family and community links are maintained and spiritual needs of residentss are observed. The catering arrangements in place provide residents with a well balanced, nutritious and wholesome diet. Evidence: The home has an activities programme in place and includes bingo, dominoes, reminiscence, quiz, music, and exercice. The home employs an activity coordinator who provides weekly music and movement sessions and group games. Some residents enjoy a daily newspaper, some like to listen to music while others sit and chat. A resident stated that she enjoyed a glass of wine or sherry in the lounge every evening watching television with other residnets. Outside entertainment is provided for special events for example birthdays, and Christmas. Family links are maintained and relatives can visit the home at any reasonable time. Relatives are encouraged to participate in the care planning process, attend reviews of care, home functions, and take residents out for trips and meals. Spiritual needs are Care Homes for Older People Page 15 of 26 Evidence: supported and a church service takes place in the home every two weeks followed by coffee and a chat. Visits from various clergy are arranged on request. The menus are planned over a four week period by the cook, who has been in post for eleven years. She has a sound knowledge of residents likes and dislikes, and has a good understaningg of nutritional needs of the elderly. The food offered for lunch was appetising, whilesome and nutritious. Fresh produce is used, and residents were very complimentary about the standatd of food in general. Drinks and snacks are available throughout the day and home made caked are provided daily. It was good to observe residents having lunch in the dining room in a relaxed and homely atmosphere. The kitchen is clean and well managed. Food hygiene certificates are in place. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this 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 complaints procedure protects residents living in the home. The home observes the local authoritys safeguarding procedures, however the service needs to obtain a revised copy of these procedures and the manager needs to access training in this. Evidence: The home has a complaints procedure in place, which is also included in the service user guide. Both residents and relatives stated that they were aware of this procedure and felt confident thet if it was necessary to make a complaint that this would be managed efficiently. The home maintaines a complaints log and there have been no complaints since the last inspection. There is a whistle blowing policy in place. The home has a copy of Surreys Multi Agency policies and procedures on Safeguarding Vulnerable Adults, however this needs to be replaced by the up to date version, and the manager needs to attend updated training on safeguarding. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 location and layout of the home is suitable for its stated purpose. Residents live in a safe and well maintained environment that is clean and hygenic. Evidence: Residents have access to comfortable communal facilities including an open plan lounge and dining room. This overlooks a well maintained garden. Ample toilet and bathroom facilities are located over both floors and have been adapted to meet mobility needs of residents. The shower room has been refurbished and a new floor provided as a requirement form the last inspection. There is a lift available to provide access to the first floor. The second floor is privare for provider accommodation. Bedrooms are single occupancy, which are well decorated and comfortably furnished. Residents are encouraged to presonalise their rooms and can bring items of furniture with them on admission. A shared room currently provides accommodation for a married couple. The home is clean and well maintained. The care staff undertake the cleaning duties and the manager stated that the home employs a cleaner twice a week to undertake more heavy cleaning duties. There is an infection control policy in place and all staff receive training in this. Care Homes for Older People Page 18 of 26 Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by the number and skill mix of staff working in the home. The recruitment procedure protects residents living in the home. Staff are trained to undertake their specific roles. Evidence: On the day of the inspection the manager and both providers were the staff team on duty. This was appropriate for the assessed needs of the residents, and the size and layout of the home. The staff duty rota demonstrated the allocated staff to each shift and hours worked. The residents were keen to give feedback on the good standard of care received and this was also supported by the relatives visiting the home. The home also employs a cook, and a cleaner partime. A record of staff training is retained in staff files. All staff undertake induction training specific to Epsom Lodge and have attend training coordinated by ALPHA Vocational Training Centre. Most of the staff employed are partime and hold other posts. They have portable NVQ awards at level 2 and level3. The recruitment procedure in place protect the residents living in the home. Three staff employment files seen included written references, and CRB reference numbers. No staff have been employed in the home since the last inspection. Care Homes for Older People Page 20 of 26 Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home which is well managed in their best interests. Procedures are in place to safeguard residents financial affairs. The health, safety and welfare of the residents and staff are promoted and protected. Evidence: The home is well managed by an experienced manager with several years experience in the provision of care for older people. She has almost completed her NVQ level 4 in management. Her role is a hands on manager and she has a sound understanding of the needs of the residents in her care. Both providers also work as part of the staff team. One has an NVQ level 2 and the other has an NVQ level4. They live in private accommodation on the second floor and provide management support to the team when the manager is off duty. One of the providers undertakes the administration of the business, and is responsible for overseeing the management of records, booking training, managing budgets and financial records. Care Homes for Older People Page 22 of 26 Evidence: There is a procedure in place for the safeguarding of residents financial affairs. The home does not handle any money on behalf of residents and charges for hairdressing, nespapers, chiropody and sundreis are invoiced to the designated representative. Fees are paid by direct debit or other approved arramgements. Quality assurance is monitored by daily contact with residents and talking to relatives during visits. Residents meetings are held monthly and relatives are also welcome to attend these. Feedback is also peovided by the GPs, district nurses and other health care professionals. The cook also recieves regular feedback on catering issues. Health, safety and welfare of the residents and staff are observed and promoted. All staff receive health and safety training, and a wide range of health and safety policies and procedures are in place. Risk assessments are in place for all identified risks to protect residents and staff, and to promote safe working practice. Fire safety is observed and all staff unertake fire safety training. Accident and incidents are recorded appropriately. COSHH procedures are in place. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 The registered person shall make arrangements to access training and an updated copy of the local authority safeguarding procedures. To ensure residents safety and protect them from abuse. 16/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!