Care Home: Kathleens Lodge

What the care home does well Kathleen`s Lodge provide a homely and comfortable place for people to live in. The atmosphere in the home was relaxed and members of staff were cheerful and very helpful. The home meets the needs of the people living in the home. A relative said, "They understand her needs very well and update her care plans when her needs change." Another said, "They are considerate, flexible, caring, very friendly, it has a cosy warm environment. It feels more like a guest house than a care home." Care plans and all documentation were well presented, organised and up to date. The health needs of people living in the home are monitored and appropriate advice and treatment is sought. A District Nurse said that the staff are very good and everyone people appear well cared for. There is a good training programme for staff. Members of staff have received training in understanding dementia. Staff said that they are well supported and that the manager and the providers are available and encouraging. Members of staff said, "the service has a good reputation of welcoming the elderly who are poorly and they improve dramatically from the care and support they get." "There is a good rapport with relatives and communication is good."The food is of a good standard and there is plenty of home baking. There is a variety of entertainment coming into the home. What has improved since the last inspection? Care plans and staff files have been better organised and include all relevant information. The complaints procedure has been well publicised. A controlled drug register has been obtained. A Quality Assurance system has been devised. A number of bedrooms have been redecorated and new carpets laid. New washing machines have been installed. What the care home could do better: Some matters relating to the safety and general repair and upkeep of the home that required attention: The flooring in one of the en-suite toilets had been damaged through wear and tear and was a trip hazard. The window restricting mechanisms in two bedrooms were broken. The Provider and care manager were informed and action was taken to address these. The fire risk assessment should be reviewed and should include the use of stair gates. The toilets on each floor require refreshing or upgrading due to wear and tear. The assisted bath on the ground floor required a deep clean and ultimately replacing due to wear and tear and hard lime scale damage. The laundry floor finish must be impermeable and wall finishes are readily cleanable. A requirement was made at the last inspection for a sink to be fitted into the laundry. This has not been undertaken and as the laundry floor requires replacing a further requirement has been made. Recommendations have been made in the body of the report in respect of providing a photograph of each person receiving medication within the recording documents and for the manager to ensure that all members of staff who administer medication have been trained to do so. The Provider or care manager could undertake research or obtain information about how to enhance the environment for those people who have a dementia. CARE HOMES FOR OLDER PEOPLE Kathleens Lodge 416 Upper Shoreham Road Shoreham by Sea West Sussex BN43 5NE Lead Inspector Jan Aston Key Unannounced Inspection 09:30 13th March 2008 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 Kathleens Lodge DS0000062113.V359368.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. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kathleens Lodge Address 416 Upper Shoreham Road Shoreham by Sea West Sussex BN43 5NE 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) 01273 452905 01273 453617 kathleenslodge@aol.com Mr Anthony Robert Brown Miss Angela Louise Brown Mr Anthony Robert Brown Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th August 2006 Brief Description of the Service: Kathleens Lodge is a care establishment registered to provide care and accommodation for up to 20 residents. The home’s category of registration has recently changed to dementia, over the age of sixty-five years (DE (E)). Kathleen’s Lodge is a detached property located on a main road in Shoreham, accommodation is provided over three floors, consisting of 14 single bedrooms, and 3 double bedrooms. Kathleens Lodge has three lounge areas and a dining area located on the ground floor. The dining area has patio doors leading to a patio area and garden to the rear of the property. Spaces for parking are provided at the front of the home. The current range of fees is £389-£500 and additional charges are made for hairdressing, chiropody, toiletries, magazines, newspapers and transport. Miss. Angela and Mr. Anthony Brown are the registered providers. Mr. Anthony Brown is the registered manager in day-to-day control of Kathleen’s Lodge. Kathleens Lodge DS0000062113.V359368.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 is 2 Star. This means that people who use this service experience good quality outcomes. Prior to the inspection surveys were sent to people living in the home, relatives, members of staff, Health Professionals and a number of G.P’s. Eleven were received from people living in the home; all had been completed with assistance, five from relatives and three from members of staff. An Annual Quality Assurance Assessment form (AQAA) was completed and sent to the Commission prior to the inspection. A visit to the home was made on Thursday 13th March 2008 and just over six hours were spent in the home. The Inspector looked around the home, examined a sample of records in relation to care plans, training, staff, complaints, accidents and Health and safety checks. Three members of staff and three people living in the home were spoken to privately during the visit. The Registered Manager was not present during the inspection so the care manager facilitated the inspection. Miss Brown one of the Registered Providers called in during the inspection. What the service does well: Kathleen’s Lodge provide a homely and comfortable place for people to live in. The atmosphere in the home was relaxed and members of staff were cheerful and very helpful. The home meets the needs of the people living in the home. A relative said, “They understand her needs very well and update her care plans when her needs change.” Another said, “They are considerate, flexible, caring, very friendly, it has a cosy warm environment. It feels more like a guest house than a care home.” Care plans and all documentation were well presented, organised and up to date. The health needs of people living in the home are monitored and appropriate advice and treatment is sought. A District Nurse said that the staff are very good and everyone people appear well cared for. There is a good training programme for staff. Members of staff have received training in understanding dementia. Staff said that they are well supported and that the manager and the providers are available and encouraging. Members of staff said, “the service has a good reputation of welcoming the elderly who are poorly and they improve dramatically from the care and support they get.” “There is a good rapport with relatives and communication is good.” Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 6 The food is of a good standard and there is plenty of home baking. There is a variety of entertainment coming into the home. What has improved since the last inspection? What they could do better: Some matters relating to the safety and general repair and upkeep of the home that required attention: The flooring in one of the en-suite toilets had been damaged through wear and tear and was a trip hazard. The window restricting mechanisms in two bedrooms were broken. The Provider and care manager were informed and action was taken to address these. The fire risk assessment should be reviewed and should include the use of stair gates. The toilets on each floor require refreshing or upgrading due to wear and tear. The assisted bath on the ground floor required a deep clean and ultimately replacing due to wear and tear and hard lime scale damage. The laundry floor finish must be impermeable and wall finishes are readily cleanable. A requirement was made at the last inspection for a sink to be fitted into the laundry. This has not been undertaken and as the laundry floor requires replacing a further requirement has been made. Recommendations have been made in the body of the report in respect of providing a photograph of each person receiving medication within the recording documents and for the manager to ensure that all members of staff who administer medication have been trained to do so. The Provider or care manager could undertake research or obtain information about how to enhance the environment for those people who have a dementia. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 7 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. Kathleens Lodge DS0000062113.V359368.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 Kathleens Lodge DS0000062113.V359368.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): Standards 1, 3, 5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information that they need to make an informed choice about where to live. People have their needs assessed before a decision is made about them moving to the home. People have the opportunity to visit the home before they make a decision to move in. Intermediate care is not provided in the home. EVIDENCE: The home has a Statement of Purpose that is specific to the home and includes all the information about the service that a prospective resident or their relatives would need before they moved into the home. The home also has a service user guide that is given to all new residents and copies are kept in the entrance to the home. Both documents had been reviewed in January 2008 to ensure that up to date information is provided. Five surveys were received from relatives that indicated that they had received enough information about the home before their relative moved in. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 10 From the sample of care records examined it was demonstrated that the registered manager or care manager undertakes an assessment of a person’s needs prior to their admission to the home. This includes discussions with their relatives and obtaining information from a Social Worker or other professional. It was noted from the sample that where a person is referred to the home through Social Services a copy of the Social Worker’s assessment is also in place. The AQAA stated, “We complete a family history of the resident so we can know as much about their life as possible, which helps when reminiscing and holding conversations with residents. There was evidence from the care records that life histories were in place. From the assessments that are undertaken prior to admission a care plan is compiled that states the person’s needs and wishes and how the service will meet those needs. Prospective residents also have an opportunity to visit the home with their relatives or spend time in the home before agreeing to stay permanently. This process ensures that members of staff have sufficient information about how to support a person on admission to the home. The Care manager confirmed that intermediate care is not provided in this setting. Kathleens Lodge DS0000062113.V359368.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): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A person’s health, personal and social care needs are set out in an individual plan of care that demonstrates the health and personal care that people receive is based on their individual needs and met well. The principles of respect, dignity and privacy are put into practice. EVIDENCE: A sample of five care records was examined. Contained in the care records is a basic information sheet, monthly assessment review, moving and handling risk assessment, general risk assessement, a record of GP visits, notes about changes in medication, weight record, daily activitiy record, property register, care plan and a pen picture of a person’s day. The care plans were detailed and covered all aspects of a person’s needs including whether they preferred female of male carers to assist them and the frequency of night time checks. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 12 The information provided in the “A day in the life of..pen picture” gave staff a good idea of the person’s wishes and routines in respect of personal care and how they like to spend their day. All care plans were well presented and organised and provided good information for members of staff to know how to support each person. The monitoring of a person’s health and well being is also documented in the care records. G.P. and district nurse visits are recorded with advice and treatment given noted also regular checks are undertaken on a person’s weight and sugar levels where needed. Where possible people living in the home are encouraged to visit a Chiropodist, Dentist and Optician of their choice. However for those people who cannot access their own the Provider has made arrangements for those Health Professionals to visit the home. The care plans examined recorded chiropody visits every six to eight weeks. The training provided for new members of staff ensures that they receive a good induction that covers all aspects of supporting a person with personal care. Members of staff spoken with confirmed that they had received an induction training programme when first starting work in the home and this had provided the necessary information and guidance and they felt well supported. Three members of staff who returned surveys indicated that they had received and induction programme. The storage and administration of medicines in the home was examined and was organised and in good order. The Inspector observed the administration of medication that was undertaken according to guidelines and safely. The person that was observed administering medication had been trained and this had been recorded on the person’s file. There are no people living in the home who are able to take their own medication. The documents used for recording whether a person has taken medication were seen and had been completed appropriately. It is recommended that a photograph of each person receiving medication be placed in the file with each person’s recording documents to ensure that medication is given to the correct person. It was confirmed that new members of staff are not involved in the administration of medication straight away and must be trained before doing so. A separate training record is kept that provides evidence of staff having received training in the safe handling of medication. The people who were spoken with said that members of staff were polite, caring, friendly and respectful. A relative who was spoken with said, “This home is fantastic, all of the staff are really welcoming and friendly and are polite to residents.” A relative who returned a survey said, “The manager and staff are kind and caring to my relative, the care that she receives is very good.” Kathleens Lodge DS0000062113.V359368.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): Standards 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to make choices about their life style. A varied programme of activities ensures that people have opportunities to satisfy their social, cultural, religious and recreational interests and needs. The nutritional needs and choices of people living in the home are catered for well. EVIDENCE: The service has arranged a daily activity programme that provides a variety of activities over the course of the week. This includes cards, board games, bingo, skittles, reminiscence games, film afternoons and card making. Celebrations are held for Easter, Christmas and Halloween and other special days throughout the year are recognised for example pancake day. There are quarterly cabaret parties held. A relative who was spoken with said that he had come along to a party, there was a lot of food provided and he really enjoyed it. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 14 Local community groups visit such as the blind association, religious worshippers and Alzheimer’s association. People who were spoken with said that they enjoyed the activities and were able to choose which ones that interested them. Members of staff said that they provide some of the activities and have time to sit and talk with people. The Inspector was informed that people living in the home prefer to have organised activities in the afternoon. It was observed that in the afternoon members of staff sat chatting with people in the lounge and were seen to have a good rapport with people. People living in the home may not always be able to make decisions or choices due to the level of their disability. Where a person cannot make decisions relatives or an advocate will be contacted. Relatives who returned surveys said, “There is excellent communication between the home and the family from the manager.” “They always keep us up to date of any changes.” There are advocacy leaflets available in the entrance hall and the manager arranges advocacy services where this is felt necessary. People living in the home said they liked the food. There is a four-week menu that provides a variety of food with a choice at breakfast, lunch and tea. It was noted that jugs of water or squash were available around the home to encourage people to drink plenty. The Inspector observed the lunch time period. This was well organised, calm and unrushed. Where people ate in their rooms they received their meals in good time and members of staff had sufficient time to assist them where necessary. The Inspector ate the main meal of chicken pie and apple pie and custard for desert. This was cooked and presented well. It was noted that the chef had made cakes for tea. The chef told the Inspector that he works seven days a week and sometimes stays on to cook the tea. He said he has trained members of staff in food handling so they can cook the tea when he is not in the home. Kathleens Lodge DS0000062113.V359368.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): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home and their relatives can be confident that their concerns and complaints will be listened to and acted upon. There are measures in place to ensure that people are protected from abuse. EVIDENCE: The complaints policy and procedure is provided in the Statement of Purpose and service user guide and is given to people living in the home and their relatives. The complaints procedure is displayed in the entrance hall, with a complaints form and suggestion box and also in people’s rooms. People living in the home said they knew who to speak to if they were worried. All of the relatives who returned surveys said that they knew how to make a complaint to the home. A relative said, “We were given this information immediately when our relative was admitted to the home.” There is a system for recording complaints to show the detail of the complaint, the timescales of the response and the outcome. The Annual Quality Assurance Assessment form that was completed by the Manager prior to the inspection recorded that no complaints had been received. The Commission has not received any complaints about this service. The service has a policy and procedure in place in respect of safeguarding adults. The care manager is aware of the West Sussex Social and Caring Services Safeguarding Adults Procedures and follows this. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 16 All newly appointed members of staff receive information about safeguarding procedures as part of their induction and there is an ongoing programme of training in recognising and reporting signs of abuse. Members of staff spoken with during the visit to the home confirmed that they have received training in safeguarding adult procedures. There has been a recent safeguarding adult referral in respect of the service. The safeguarding adult team from Social Services investigated but found inconclusive evidence and had no concerns about the care provided at Kathleen’s Lodge. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 17 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, 20, 21, 22, 23, 24, 25 and 26. Adequate. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and homely environment for people to live in. Improvements are required in the general maintenance and upkeep of the home to ensure that all areas are kept in a good state of repair and are clean and hygienic. People with a dementia living in the home would benefit from the environment being enhanced to specifically meet their needs. EVIDENCE: The accommodation for people living in the home is provided over three floors and there is a passenger lift to each floor. As there are a number of steps around the home and a slope in the bar area the home is not suitable for those people with mobility difficulties. There are two lounge areas, dining/bar area, 14 single bedrooms and 3 double rooms. Only one room is currently used as a double. There was evidence that the people living in this room have been consulted about sharing a room and screens are available in order that the privacy and dignity of each person is respected. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 18 Peoples’ rooms have been personalised with their personal possessions and some of their furniture and all rooms looked different. A number of rooms have been redecorated and new carpet laid. Locks on bedroom doors have been removed for safety reasons. The home was generally clean apart and there were no offensive odours anywhere in the home. There are five rooms that have en-suite facilities of a toilet and sink; two rooms have an en-suite toilet, sink and full bath. There is a separate toilet on each floor and one is situated near the rear lounge area. There is an assisted bath on the ground floor. There is a garden at the rear of the property with easy access from the rear lounge. The communal space in the home looked clean, comfortable and homely. There are two lounges for people to use and a dining area. There is a tropical fish tank in the bar area and there are two cats living in the home. The safety of people living in the home and of members of staff working in the home has been considered. All radiators in the home have been covered to prevent any risk of burning. Hot water outlets have been fitted with thermostatic valves to prevent any risk of scalding. The hot water temperatures are checked on a weekly basis and a plumber called to replace valves where they are faulty. The opening of windows on the first floor and second floors had been restricted. From training records it could be seen that members of staff have received fire training on the 22nd January 2008. The fire alarm, means of escape, fire fighting equipment and emergency lighting are all checked regularly and have received safety inspections. Due to the nature of the disability of people living in the home a stair gate has been fitted to the top and bottom of the stairs by the front door and a coded lock has been fitted on the front door for security. Any necessary equipment that a person may need is provided. It was noted that pressure relieving cushions, raised toilet seats, grab rails, hoists, wheelchairs and continence supplies are obtained. The hoists in the home have been checked for safety. There are sufficient numbers of domestic staff to keep the home clean. All members of staff receive training in the prevention of infection. Disinfecting hand gel is kept in the entrance hall for any visitors to use to prevent the spread of infection. New washing machines have been purchased and fitted. Some matters relating to the safety and general repair and upkeep of the home that required attention: - Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 19 A fire risk assessment had been undertaken on the premises but this had not been reviewed and did not include the use of stair gates. The risk assessment must therefore be reviewed and the fire officer consulted about use of stair gates. The flooring in one of the en-suite toilets had been damaged through wear and tear and was a trip hazard. This was mentioned to the Provider and action taken straightaway to make this safe. The toilets on each floor require refreshing or upgrading due to wear and tear. The assisted bath on the ground floor required a deep clean and ultimately replacing due to wear and tear and hard lime scale damage. Regular checks should be made to ensure that the standard of cleanliness and hygiene in this bath is maintained at all times. At the last inspection in June 2006 it was reported that, “The registered provider/manager has confirmed that a plan is in place to convert two bathrooms to wet rooms in order to provide additional assisted facilities for residents.” As this has not been undertaken a requirement has been made at this inspection for communal toilets and bathrooms to be upgraded. The window restricting mechanisms in two bedrooms were broken. The care manager was informed and this was to be addressed. The laundry floor needs replacing to ensure that it the finish is impermeable and wall finishes are readily cleanable. A requirement was made at the last inspection for a sink to be fitted into the laundry. This has not been undertaken and as the laundry floor requires replacing a requirement has been made. Kathleens Lodge DS0000062113.V359368.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): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff meets the needs of people living in the home. People are safeguarded by the home’s recruitment policy and practices. Members of staff are trained and competent to do their jobs. EVIDENCE: The Annual Quality Assurance Assessment form that was completed by the Provider confirmed the number, ages, gender and ethnicity of staff employed to work in the home. In relating this information to the number, gender and ethnicity of people living in the home the mix of people in the staff team is appropriate to meet their needs. The staffing levels on the day of the inspection were appropriate and members of staff spoken with confirmed that the staffing levels allowed them to provide support at a resident’s own pace and to have time to talk with them. The amount of training that has been undertaken by the staff team ensures that the staff team have the skills and experience to meet the needs of people well. Members of staff spoken with confirmed that they have received a good level of training from induction through to working to National Vocational Qualifications (NVQ). So far three members of staff have achieved NVQ 2 and four members of staff are currently working towards this. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 21 A sample of staff records was examined. The records were organised and included all the relevant information about each person. Included in the sample were two new members of staff who were working through an induction programme. A new member of staff spoken with said that she found this really helpful as well as working along side more experienced members of staff; she felt she was supported well. Surveys received from staff confirmed that they had received an induction. The three remaining staff had undertaken training since the last inspection in understanding dementia; this was seen to be a three unit training course so was more in depth than just a day or afternoon training session, fire, moving and handling, first aid, risk assessment, awareness of abuse and reporting procedures and two had received training in infection control. The chef told the Inspector that he had trained staff in food handling and hygiene but there was no record of this on staff files. It is recommended that if this has taken place then this be recorded on staff files or a more formal training session in food hygiene should be arranged as staff do pre-pare and handle food at tea and supper time. Members of staff spoken with told the Inspector about the recruitment process that confirmed that an application form is completed, an interview is undertaken and all the necessary checks such as references are taken up. The sample of recruitment records showed that out of the three members of staff in the sample that have been employed since the last inspection all three had references taken up and there was evidence of their identity however only two had criminal record checks in place before they started working in the home. Kathleens Lodge DS0000062113.V359368.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): Standards 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a person with the knowledge and experience to do so. The quality monitoring systems ensure that all areas of the home are run in the best interests of people living there. People’s financial interests are safeguarded. All areas of the environment must be checked regularly to identify any areas that may put a person at risk. EVIDENCE: Mr Anthony Brown is the registered manager for the home. The Providers have appointed a care manager to run the home and it was confirmed that a registration application for this person would be submitted shortly. Currently the care manager is undertaking NVQ 4 and the Registered Managers Award. Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 23 The evidence obtained through the inspection confirmed that the home is being managed well on a day-to-day basis. There have been improvements in care planning and all records seen were well presented, organised and up to date. A relative said, “There is excellent communication between the home and family from the care manager.” Members of staff spoken with confirmed that they meet with the manager regularly through staff meetings and supervision meetings. They confirmed that they found the manager and providers approachable and felt they could easily raise any issue with them and they were always available on call in the evening and weekends. There was evidence that the care manager has obtained feedback about the service through sending questionnaires to relatives and health professionals. This had been done in January 2008. Meetings are held with residents to obtain their views of the service. People living in the home are encouraged to manage their own finances and where they lack capacity to do this relatives or legal advisors assist with financial matters. The Provider and Manager do not act as Appointee’s or hold Power of Attorney for anyone living in the home. The Manager assists one person with small amounts of money for additional services and personal expenses; all transactions are recorded and moneys accounted for. As there were a number of matters raised in the environment section of the report in relation to Health and safety in the home; window restricting mechanisms, fire risk assessment, cracked lino on an en-suite toilet floor and the laundry flooring it is recommended that the person responsible for maintenance in the home undertakes regular checks on all areas of the home and care staff report any health and safety issue immediately. Kathleens Lodge DS0000062113.V359368.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 3 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 2 3 3 3 2 2 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 Kathleens Lodge DS0000062113.V359368.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 Requirement That a sink be installed in the laundry room to enable staff members to wash their hands. Previous timescale of 14/11/06 not met. Laundry floor finishes are impermeable and wall finishes are readily cleanable. The assisted bath is kept clean and hygienic. The toilet and bathing facilities must be kept in good repair and decorative order. Timescale for action 30/06/08 2. 3. 4. OP26 OP26 OP21 16 (2) (j). 23 (2) (d) 23 (1) (a) 30/06/08 13/03/08 30/09/08 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 Kathleens Lodge DS0000062113.V359368.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 Kathleens Lodge DS0000062113.V359368.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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