Care Home: Faldonside Lodge Residential Home

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What the care home does well Due to ongoing medical treatment, the proprietor, manager has not been able to physically be in the home on a regular basis. However, the deputy manager has been in day to day charge of the running of the home with the manager visiting at least once a week and in constant telephone contact. There is an ongoing improvement plan in place and the deputy manager explained what development stage the home is currently at. Further details can be obtained in the body of this report. New staff are appropriately inducted into their role following an induction programme. Staff confirmed this and also said they are fully supported by the manager and the deputy manager. Regular supervision and training is also undertaken. Observations at this time did show that staff consider the dignity of people living in the home. Staff asked for individual preferences and were asked and people chatted with staff in a relaxed and confident manner. All previous recommendations and one requirement have been met. On the day of the inspection the meal consisted of steak and kidney pie with boiled potatoes and a variety of vegetables and the kitchen provides choices for those with individual preferences. What has improved since the last inspection? The home has met the previous requirement and good practice areas identified in the last inspection report. There is continued refurbishment and redecoration that maintains the homely environment within the building. New carpet is in place, radiator covers are in place, the lounge has been decorated and some new signage is in place to support residents. New mobility equipment has been purchased as has some new bedside furniture and a chair scale. What the care home could do better: While care plans do contain individual support plans and some good direction for staff, the detailing needs to be extended. This would provide a fully person centred care plan that reflects the abilities and support needs of the individual. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Faldonside Lodge Residential Home 25 Cliff Avenue Cromer Norfolk NR27 0AN     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: Brenda Pears     Date: 1 8 0 6 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. that people have said are important to them: They reflect the things 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 25 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Faldonside Lodge Residential Home 25 Cliff Avenue Cromer Norfolk NR27 0AN 01263512838 01263515950 faldonside@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Janeghee Soobrayen care home 11 Number of places (if applicable): Under 65 Over 65 11 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Faldonside Lodge is a care home providing personal care and accommodation for up to 11 older people. The home is owned and managed by Mrs Janeghee Soobrayen. Faldonside Lodge was built around the turn of the century and is a large, adapted house in a residential area not too far from the town and sea in Cromer. The home is close to all local amenities. Accommodation is provided on the ground and upper floors in two shared and seven single rooms. Two of the single bedrooms have en-suite facilities. There is a stair lift and the home has pleasant gardens to the rear that provide sheltered seating areas. People are advised verbally of the fees payable before the resident moves into the home. Additional costs are shown in the Statement of Purpose and Service User Guide that can be obtained from the home. Care Homes for Older People Page 4 of 25 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 quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced inspection undertaken on the 18th June 2009 and started at 10.00am. The focus of this inspection was on the previous requirements, on the core national minimum standards and on the quality of life for people who receive support in the home. The methods used to complete this inspection consisted of looking at the care a resident receives and the records that support this. Information was provided to us by the home on an assessment form known as an Annual Quality Assurance Assessment (AQAA). During the visit to the home we spoke to the deputy manager, with members of staff and also with five residents. These methods and previous Care Homes for Older People Page 5 of 25 findings all inform the outcomes of this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 7 of 25 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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. The manager and deputy manager do assess the needs of any new client to make sure individuals can be fully supported before an agreement is undertaken. Evidence: A full assessment is undertaken before support is agreed with appropriate staffing levels and this was seen on care plans at this time. One resident confirmed that information and full discussions were carried out prior to agreements being completed. People are welcome to stay for a day or short trial period before deciding if they wish to move into the home. Care Homes for Older People Page 10 of 25 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. The care plans contain information that enables staff to meet individual needs, but some fuller explanation would ensure needs are completely clear at all times. Medication is handled and stored correctly for the safety and well being of those living in the home. Evidence: We looked at three care plans and these confirmed the information in the AQAA that stated care plans and risk assessments are regularly reviewed. A new care plan format has been implemented by the home. Files contain detailed sections of information that shows both doctors and district nurses provide support and other healthcare services are accessed when necessary. One referral has also been made to an audiologist. Pressure areas needing attention are recorded and the district nurse contacted to make sure these skin areas are dealt with before they become a problem. Pressure relieving mattresses and cushions are also ordered to assist in this area. One care plan clearly directs staff to make sure the dynamic cushion is working and correctly placed. Care Homes for Older People Page 11 of 25 Evidence: While healthcare needs are being met, staff would benefit from having some more detail included with directions on the care plan. For example, one file contained information for staff to use the communication tool. This statement did not have any clarification as to how or when this should be used or explanation as to exactly what this is. While communication is supported, this care plan did not clearly state that the person very rarely communicates verbally. Full information was seen when we looked at daily records. These contained detailed information about how the person had spent their day. When the accident book was checked, we found these details on the daily record and on the medical sheet when a health check had been necessary, showing that staff had clearly recorded all areas of this information. Other comments on care pans include direction for staff to check the temperature in one room, a reminder to allow privacy and dignity for certain routines and another states that extra blankets must be made available at stated times. Care plans show that people are regularly weighed and this is recorded on care plans. A new chair scale has been purchased to support regular weight checks and to inform nutrition monitoring. The medication trolley was found fixed to the wall and locked at this inspection. Records of the administration of medication were clearly completed, up to date and medication was in date and stored in an orderly way. The deputy manager said that regular audits are carried out to make sure medication is stored and handled correctly. The home has also obtained advice to ensure they deal with medication appropriately in all areas. Care Homes for Older People Page 12 of 25 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. Residents are supported to take part in a range of leisure activities and to maintain contact with family and friends. Clients are offered a variety of healthy meals that they have chosen. Evidence: People living in the home told us that there are lots of regular visitors who are made welcome. One regular visitor to the home was enjoying lunch with their friend. We saw staff giving people time, not trying to rush them and regularly going into rooms to check on people who had not come into the lounge areas. Two people did say they could have a different meal and that they enjoy their food. This has also been confirmed at a previous inspection. The lunch time was undertaken in a relaxed way and people were left to enjoy some conversation. Not everyone comes into the dining room for meals; some meals are served in rooms when chosen. Any special diets are catered for including diabetic foods and any pureed food is presented separately on the plate, providing a plate that looks inviting. The Care Homes for Older People Page 13 of 25 Evidence: meal looked and smelt appetizing at this lunch time and people at the dining table said the meal was very good. Residents have the opportunity to attend churches in the local area and links in the community are encouraged. The deputy manager said that a person would be supported to undertake any activity they wished. Records show that there is a review of individual likes and dislikes and a record is kept of all activities undertaken. We talked to a group of residents who said they had enjoyed trips outside the home and they had recently enjoyed tea in the garden. The home has regular fetes, outings, Christmas celebrations and summer barbeques that families attend and assist with. One resident was undertaking sketching in the front garden and it was explained that this was enjoyed as a regular past time. There are regular outings to the coast, trips to the shops and celebrations for birthdays and special events. Care Homes for Older People Page 14 of 25 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. Residents know who to complain to and feel they will be taken seriously. Procedures are in place, including staff training, to provide protection from abuse. Evidence: A copy of the complaints procedure is in every room including the communal areas of the home. When we talked to people living in the home, they did say that they feel comfortable talking to the manager/deputy manager or staff about any problems and that action is taken. We have not received any complaints about the service since the last inspection. There are robust practices used when dealing with money on behalf of a resident. All receipts are kept on file and two signatures are recorded at transactions, providing an audit trail. The deputy manager explained that only management deal with money on behalf of any resident. Residents are regularly consulted and discussions with three people in the home at this inspection confirmed this. Previous discussions and questionnaires have also confirmed Care Homes for Older People Page 15 of 25 Evidence: this. Appropriate recruitment practieces further protect people living in the home. Care Homes for Older People Page 16 of 25 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 home does provide a clean, safe environment that continues to be adapted to meet the needs of people. Evidence: The home continues to offer a clean, odour free and relaxed environment that is as domestic in style as possible. Since the last inspection there have been several improvements in the home that include redecoration and new carpeting, new mobility aids, new bedside tables in rooms and new lounge furniture. An extension to the home is due to be started later this year. This will provide four new rooms, a new lounge area, a ground floor office and also allow an extension to the existing kitchen and laundry areas. An enclosed garden will also be developed for residents to enjoy independently. This will allow the use of some areas for quiet reading or to share with visitors as needed. The management desk and equipment is currently taking up one side of the television lounge. While this enables the manager and staff to be available, this is also taking part of the space that is currently for use by the residents. The previous office was on the upper floor and not so central. However, the new extension will deal with this Care Homes for Older People Page 17 of 25 Evidence: matter and provide an accessible and independent office. The deputy manager pointed out that a hands free phone is currently used to allow for private and confidential matters to be discussed elsewhere. There is an ongoing redecoration programme in place and the first floor corridor and landing were being painted at the time of this inspection. Rooms are individual and provide a comfortable and personal space for residents who are allowed to bring their own furniture that can fit into their room. Care Homes for Older People Page 18 of 25 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. People living in the home have their needs met by a consistent staff team who are well trained and regularly supervised, providing stability and continuity of care. Evidence: At the time of this inspection there were two senior carers, the deputy manager and one cook on duty in the home. There is one waking night staff and a member of the management currently sleeps in during the night period. Staff were seen to be providing support in a calm manner and not rushing anyone and there were relaxed conversations and interaction between residents and staff. We looked at two staff files that showed recruitment procedures are appropriate and these show that criminal record checks are completed plus references obtained before staff start work in the home. Files also contained identification, contracts, job description and other appropriate information. There is a programme of training in place that includes information on the deprivation of liberty, fire training, first aid, infection control and dementia awareness. The care staff who spoke to us said that they receive adequate training that they feel relates to meeting the needs of people in the home. Staff said that they do have Care Homes for Older People Page 19 of 25 Evidence: supervision, minutes of staff meetings were available and staff feel they can discuss matters as they need to. Care Homes for Older People Page 20 of 25 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. The home is managed in an open and inclusive way and in the best interests of people. Evidence: The manager operates an open door policy that means residents or staff are able to discuss any matters with her. This was confirmed through discussions with staff and residents carried out at this time. There is a record of up to date servicing certificates for such items as electrical equipment and all fire extinguishers. Regular checks are undertaken and recorded for hot water temperatures, emergency lighting and on the emergency call system. There are written policies and procedures in place that cover areas including concerns and complaints, bullying, dealing with aggression and missing persons. As previously stated, appropriate systems are in place for dealing with any personal finances. The home gives out satisfaction surveys for the monitoring of quality assurance and to Care Homes for Older People Page 21 of 25 Evidence: encourage comments from family and visitors. There is an induction programme in place to provide staff with information that will assist them in their roles. Staff said that the manager does support them and that she always has time to listen to staff and residents as does the deputy manager. Staff who spoke to us at this time said they enjoy working in the home and they can always ask for training or support when needed. Staff and residents said that they would not worry about having to speak to the manager or the deputy manager about any matters. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 That care plans contain more explanation of how and when support is provided. This will expand on the details already on care plans, to provide more in depth information for staff to give support how and when the resident chooses. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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