Care Home: Lodge Lane Nursing Home

What the care home does well The information that tells people how the service works (the statement of purpose and service users guide) is clear and gives people the information they would need to help them decide whether Lodge Lane was the right home for them. People had received checks of their individual needs before they moved into the home. This meant that they and the staff of the home had the information they needed to decide if the person`s needs can be met at the home. The home has an established staff team who were keen for high standards to be maintained. Residents` plans of care and individual case notes were well written and reflected each person`s needs. This helps to make sure that each person receives the care and support they need in the way they prefer. Lodge Lane provides a wide variety of activities and entertainments for the people who live there. Each person had their own individual programme of activities and a diary detailing activities that people had undertaken. These activities help to keep people busy and given them a chance to join in on social occasions. People who live at Lodge Lane commented, "I like to listen to my radio in my room", "Once or twice a week we go out for lunch and that is good" and "The home looks after everything". An excellent standard of hygiene was seen throughout the home and the standard of decor and furnishings throughout the home was very good. People`s bedrooms had been individualised with their own personal choice of wallpaper, furniture and soft furnishings. Thought has also been given to make sure that there is enough light and heating throughout the home. People who live at the home said, "The home is always fresh and clean", "They keep my room tidy" and "They look after my clothes in the laundry". Staff commented, "The staff and domestics are very good at their jobs making the home really clean and fresh" and "Cleaning, tidying and the laundry is done very well". People who live at Lodge Lane commented, "They make me happy and care for me well", "They keep me busy and provide me with a home. The staff and manager always treat me well", "I know who to speak to if I am unhappy" and "I am well care for and we have good cooks and nice meals. Someone is here day and night and I feel safe". Other comments included, "They get me up in the morning and the food is very good with meals always on time", "The home looks after everything. Staff are good and so is the manager. I wouldn`t change anything" and "The do a lot of things well, menus, cleaning, tidying and the laundry. They don`t need any improvement". Staff commented, "It is an excellent nursing home for residents and staff", "Always the residents are clean and well cared for, they make you welcome and there is a good feeling of well being with the residents", "There are always enough staff on to meet residents needs. My manager regularly gives me support" and "The home is very well run by the manager and they keep us informed about things that are going on". Other comments included, "I like the idea that the manager informs everybody on what is happening in the home. Staff and residents have regular meetings", "We are very good at care plans, good training, good socialising for residents. Very good manager and good team of staff" and "They listen to the individual needs of each resident and try to keep the residents occupied". What has improved since the last inspection? The home has maintained its hygiene and environmental standards. The staff team continue to strive for high standards to be maintained. What the care home could do better: Lodge Lane provides an excellent service to the people who live there. This is confirmed by the people themselves and the staff. The home has a good reputation in the local community and it is important for them to maintain the high standards that they are currently achieving. We would expect Lodge Lane to continue to review its practice in order to ensure that the very high standard of care provided at the time of this inspection is maintained and where possible improved upon. Key inspection report Care homes for older people Name: Address: Lodge Lane Nursing Home 10a Lodge Lane Bewsey Warrington Cheshire WA5 0AG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Maureen Brown     Date: 2 5 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Lodge Lane Nursing Home 10a Lodge Lane Bewsey Warrington Cheshire WA5 0AG 01925418501 01925638768 harvey147461027@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Warrington Community Care Name of registered manager (if applicable) Miss Jacqueline Harvey Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD. The maximum number of service users who can be accommodated is: 20. Date of last inspection Brief description of the care home Lodge Lane care home is registered to accommodate twenty service users diagnosed with a history of enduring mental health needs. The care home comprises of a modern two storey building on the outskirts of Warrington Town Centre and in the local community of Bewsey. There are car parking spaces to the side of the builiding. The home is situated close to local shops and is in close proximity to other community facilities and public transport. There are two railway stations in the centre of Care Homes for Older People Page 4 of 29 Over 65 0 20 Brief description of the care home Warrington. The home is operated by a voluntary organisation, Warrington Community Care. Fees range from 428 pound to 454 pounds per week. Care Homes for Older People Page 5 of 29 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: three star excellent 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: We carried out an unannounced visit to the home on 25 March 2010 and the visit lasted seven and a half hours. It was done by one inspector. The report will say we when referring to what was done and found at the visit, as it is written on behalf of the Care Quality Commission. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about the home. We sent out questionnaires to the people who live in the home and the staff team to find out their views about Lodge Lane. Other information about the home was also reviewed. During our visit we looked at various records and the premises. We looked at the care records of three people who live at the home, to see how their needs were being met. We also looked at four staff files to ensure that thorough recruitment processes had Care Homes for Older People Page 6 of 29 taken place and that people who live in the home were safeguarded from harm and supported safely. We spoke with some of the people who live at Lodge Lane and the manager and other staff who were on duty at the time of this visit. They all gave their views about the home. Care Homes for Older People Page 7 of 29 What the care home does well: The information that tells people how the service works (the statement of purpose and service users guide) is clear and gives people the information they would need to help them decide whether Lodge Lane was the right home for them. People had received checks of their individual needs before they moved into the home. This meant that they and the staff of the home had the information they needed to decide if the persons needs can be met at the home. The home has an established staff team who were keen for high standards to be maintained. Residents plans of care and individual case notes were well written and reflected each persons needs. This helps to make sure that each person receives the care and support they need in the way they prefer. Lodge Lane provides a wide variety of activities and entertainments for the people who live there. Each person had their own individual programme of activities and a diary detailing activities that people had undertaken. These activities help to keep people busy and given them a chance to join in on social occasions. People who live at Lodge Lane commented, I like to listen to my radio in my room, Once or twice a week we go out for lunch and that is good and The home looks after everything. An excellent standard of hygiene was seen throughout the home and the standard of decor and furnishings throughout the home was very good. Peoples bedrooms had been individualised with their own personal choice of wallpaper, furniture and soft furnishings. Thought has also been given to make sure that there is enough light and heating throughout the home. People who live at the home said, The home is always fresh and clean, They keep my room tidy and They look after my clothes in the laundry. Staff commented, The staff and domestics are very good at their jobs making the home really clean and fresh and Cleaning, tidying and the laundry is done very well. People who live at Lodge Lane commented, They make me happy and care for me well, They keep me busy and provide me with a home. The staff and manager always treat me well, I know who to speak to if I am unhappy and I am well care for and we have good cooks and nice meals. Someone is here day and night and I feel safe. Other comments included, They get me up in the morning and the food is very good with meals always on time, The home looks after everything. Staff are good and so is the manager. I wouldnt change anything and The do a lot of things well, menus, cleaning, tidying and the laundry. They dont need any improvement. Staff commented, It is an excellent nursing home for residents and staff, Always the residents are clean and well cared for, they make you welcome and there is a good feeling of well being with the residents, There are always enough staff on to meet residents needs. My manager regularly gives me support and The home is very well run by the manager and they keep us informed about things that are going on. Other comments included, I like the idea that the manager informs everybody on what is happening in the home. Staff and residents have regular meetings, We are very good at care plans, good training, good socialising for residents. Very good manager and good team of staff and They listen to the individual needs of each resident and try to keep the residents occupied. Care Homes for Older People Page 8 of 29 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 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 7535. Care Homes for Older People Page 9 of 29 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 29 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. People received information about the home to help them decide about moving in and their needs are checked before they move in so they know that these can be met at Lodge Lane. Evidence: We saw a copy of the information that tells people how the home works, the service users guide and statement of purpose. These were produced in plain English and mostly in standard print format. The statement of purpose contained aims and objectives, philosophy of care and residents charter. The residents charter was written in script and it was suggested that this be changed to standard print for ease of reading. It was recommended that a review date be included on this document so that people who read it know when it was last reviewed. The service users guide contained information on accommodation, services provided, staffing, care plans and care programme, Warrington Community Care and the Care Homes for Older People Page 11 of 29 Evidence: complaints procedure for the home. It was recommended this document be brought up to date, as the registered managers name, the commission details and staff information need updating. It was also recommended that a review date is included so that people know when this document was last reviewed. The manager confirmed that intermediate care was not provided at Lodge Lane. A document was available for staff to use with people before they move into the home to check on what their needs are. This covers personal details, next of kin, GP, mental health assessment, mental capacity assessment and best interests checklist. Prospective residents have the opportunity to visit the home for gradually extended periods of time starting with being shown around the home, then spending time with residents and sharing a meal, to overnight or weekend stays before people have to make a decision to move in. Care Homes for Older People Page 12 of 29 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 health, personal care and social needs of the people living in the home are met by the staff team in a way that enables them to maintain their privacy and dignity. Evidence: We looked at the care plans of three people who live at Lodge Lane, to check the care they receive. These were well written and the language used was person centred. It was noted that acknowledgment to privacy and dignity was included in the care plans. Each file contained personal details, licence agreement, care plans, personal programmes, daily sheets, assessment forms, personal physical statement and body checks, observation records, appointment records, medication administration record sheets and correspondence. All the information was up to date. The previous recommendation regarding personal plan audits has been met. Each person has a personal programme that shows their individual activities over the week. This was divided in morning, afternoon and evening activities and was reviewed annually. All seen were up to date. Care Homes for Older People Page 13 of 29 Evidence: The daily record sheets were well written and gave details of the activities undertaken and the wellbeing of the service user. Risk assessments were included in the care plans. There was a review sheet at the front of these showing when they had been reviewed and the next review date. This was good practice as it gave a view of the current situation at a glance. The risk assessments included moving and handling, nutritional, skin viability, environmental, hip fracture, dependency, risk factors and MUST (Malnutrition Universal Screening Tool). All the risk assessments seen were up to date. Visits to and from healthcare professionals were recorded in each persons file and it was seen that these included visits to GPs, district nurse, diabetic clinic, foot clinic, breast screening, chiropody, opticians and the dentist. They were easy to read and the date of the last visit each person had made to the various clinics was clearly identified. The medication for people living in the home is stored safely in a separate room. A monitored dosage system is used in the home, prepared by the chemist in blister packs. There is also a fridge to enable the home to store medication that needs to be kept chilled and records are kept of the fridge temperatures. Medication is administered from this room to the people who live at the home and it is completed by a nurse and a member of the care staff. Medication administration record sheets are completed to confirm that that people have received their medication as prescribed by their doctors. The staff have completed training in mediation awareness and this helps to make sure that staff who give out medication know how to do it safely so that errors do not happen. Staff also have access to policies on ordering of medications, homely remedies, waste medication, giving injections and the Nursing and Midwifery Councils guidelines for administering medication. The manager confirmed that no controlled drugs were being used at this time, although they had appropriate storage for these if needed. Care Homes for Older People Page 14 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities and meals are both well managed so they provide daily variation and interest for the people living at Lodge Lane. Evidence: Lodge Lane provides a wide range of activities for people who live at the home. These included activities within the home such as playing cards, bingo, watching TV, quizzes, reading, baking, reminiscence, gardening, karaoke, church services, card making, Julies heath and beauty group and individual time spent with care staff. Also entertainers visit the home on a regular basis. Activities outside the home included shopping trips to local supermarkets, local pub lunches, going out for a drive, other lunches out and Chinese meals out. Other activities included visits to Warrington and Birchwood shopping, trips to Parr Hall and Blackpool and Creative Remedies at the Pyramid. Each person has their own individual weekly programme showing what they do over each day and this is reviewed on an yearly basis. Each person also has a progress diary which contains information on what the person has been doing, the date and is signed by the care staff. This helps to show the range of activities each individual has undertaken and to plan for future activities that people will enjoy. The home also has Care Homes for Older People Page 15 of 29 Evidence: produced several photograph albums to show what they have been doing and these included ones on the baking sessions, reminiscence groups, music group and one showing general activities being enjoyed by the people who live at Lodge Lane. All the main festivals are celebrated within the home and these include Christmas, Easter, Halloween, Valentines day and each persons birthday. People from the local church visit on a weekly basis and people who live at the home can join in this service if they wish to. The manager commented this was usually attended regularly by about eight people. People who live at Lodge Lane commented that, I like to listen to the radio in my room, Once or twice a week we go out for lunch and that is good, I enjoy the activities. Although it is acknowledged that people have access to a wide range of activities, three people said that they would like some more days out and possibly evening trips out. There is a four weekly menu plan in place, which the people who live at the home were involved in producing. If the menu is changed then these changes are noted in the kitchen book. Temperatures of the fridges and freezers are noted throughout the day to ensure that food is kept at the correct temperature. The kitchen was seen during this visit and was very clean and tidy. The cook on duty confirmed that the cooks keep the kitchen clean between them and this was evident during this visit. There are a wide range of meals available with fresh fruit and vegetables available each day. Alternative meals are also available and usually include salads or sandwiches. A choice of sweets is available including a hot sweet, fruit, biscuits, yogurt, jelly or ice cream. There are usually two sittings for lunch to enable people who need more support to have this during a second sitting. The manager confirmed that this worked very well for the people who preferred this. Care Homes for Older People Page 16 of 29 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 homes procedures for complaints and safeguarding are effective so that the concerns of people who live at Lodge Lane are listened to and they are protected from abuse or harm. Evidence: We looked at staff files during our visit and these showed that staff had completed training about safeguarding adults. The manager confirmed this and showed that she was aware of the policy, procedure and guidance on safeguarding. There were also policies available in the home including the Warrington Borough Council No Secrets document, and policies on adult abuse, break away techniques, bullying, harassment, violence towards staff, restraint, racial harassment, violence and violent situations and whistle blowing. The home had reported one referral under the local safeguarding procedures during the twelve months before our visit. Details of the referral we saw showed that it was dealt with appropriately. The complaints procedure for Lodge Lane was satisfactory and contained details of how to contact us; however the commissions details needed updating and a recommendation was made. We had not received any complaints about Lodge Lane in the twelve months before this visit was made. The home had a complaints file and we looked at this. No complaints had been received at Lodge Lane over the last year. People who live at Lodge Lane confirmed they would contact the staff or manager if they had any concerns or problems. Care Homes for Older People Page 17 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lodge Lane is very well maintained and decorated and furnished to an excellent standard so that people living there do so in comfortable, safe surroundings that suit their needs. Evidence: During our visit we toured the building and we saw all the shared (communal) areas as well as a number of bedrooms. The decor was of a high standard with people who live in the home choosing their own decor in their bedrooms. Bedrooms were personalised to each individuals taste and included their own choice of soft furnishings and furniture as well as personal items such as posters, photographs and ornaments. The communal areas were well decorated and furnished. A rolling programme of redecoration and renewal is ongoing to continue to improve the environment for the people who live at Lodge Lane. The home was found to be very clean and free from unpleasant odours. Overall the home is well maintained and of a good standard. People who live at Lodge Lane said, They do a lot of things well here, especially the cleaning, tidying and the laundry, They look after my clothes in the laundry and keep my room tidy and The home is always fresh and clean. Care Homes for Older People Page 18 of 29 Evidence: Staff commented, The staff and domestics are very good at their jobs making the home really clean and fresh and The home is always clean. Care Homes for Older People Page 19 of 29 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 who live at Lodge Lane are supported by trained, effective staff who have gone through a thorough recruitment process, so that peoples needs are met and they are safe from possible harm or poor practice. Evidence: The staff rotas showed the number of staff on duty over the week. The home had a full complement of staff at the time of this visit. They also have a group of people as bank staff for the home which they use during times of sickness and holidays. One of the bank staff said that they enjoyed working at the home and they thought the use of bank staff was good so that people who live in the home have continuity of care. During this visit the manager was showing a new bank staff member around the home and completed an induction with them so that they were aware of the procedures within the home. The manager confirmed that she or a senior member of staff always showed new staff around the home and started the induction process with them before they started working so that they were aware of the basic procedures. Staff hand overs are completed at the end of each shift and during this time the senior staff member discusses each resident and their wellbeing for that shift. Any other useful information is also given at this time. Staff confirmed that it was good to have the hand overs and that important information was given during these times. Staff Care Homes for Older People Page 20 of 29 Evidence: also confirmed that they got good support from the manager and that the interactions between staff and the senior management team were very good. Staff had a good awareness of the needs of the people living at the home and participated well during the handover discussions. We checked three staff files and they all had most of the pre-employment checks in place including terms and conditions of employment, application forms, references, some proof of identity and Pin numbers for qualified nurses. Protection Of Vulnerable Adults (POVA) first and Criminal Record Bureau information is held centrally at head office. During discussions with the manager it was suggested that she should have access to this information. The manager said that it was not held on the staff files at the home. The training that staff had received included an induction course, manual handling, safeguarding adults, mental health awareness, food hygiene, medication awareness, fire awareness, first aid and health and safety. Other courses available included proactive approach to conflict, equality and diversity, COSHH, equal opportunities, MUST training, physical conditions affecting older people, reminiscence work, awareness of the Mental Capacity Act 2005, supervision and appraisals and who cares for the carers? Good progress has been made with the national vocational qualification (NVQ) training. Out of eleven care staff, eight have NVQ level 2 or above. Seven nurses are also employed at the home. This means a good percentage of staff have a nationally recognised qualification in care to help them provide good quality support for the people who live at Lodge Lane. Care Homes for Older People Page 21 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lodge Lane has policies and procedures in place to ensure the health and safety of the people living there are promoted and protected and that the home is run in the best interest of the people who live there. Evidence: The registered manager is well qualified for her role. She is a RMN and SRN, is teacher trained and has thirty years experience as a nurse. She has been the registered manager for eighteen years since 1992 when the home first opened. She has updated her knowledge and skills as required throughout her time as manager. During discussions with her it was evident that she keeps up to date with changes in legislation and was aware of the forthcoming changes following the Health and Social Care Act 2008. She knows the people who live at Lodge Lane and the staff team well. She had completed the information about the home we ask for each year, the annual quality assurance assessment that gave us information about the home and what had been happening there during the twelve months before our visit. This information gave us a good overview of how the home was being run. The manager is well Care Homes for Older People Page 22 of 29 Evidence: thought of by the people who live in the home and the staff team. Staff commented, My manager regularly gives me support, I like the idea that the manager informs everybody on what is happening in the home and The staff are very good at their jobs and it is an excellent nursing home. People who live at Lodge Lane told us, I would speak to the manager if I was unhappy, The manager is very good and The manager and staff care for me well. There is a quality assurance process for the home which includes residents meetings, residents meeting with management, staff meetings, anonymous questionnaires for people who live there, the compliments file, monthly visits from the a representative of the organisation that runs the home and annual questionnaires to relatives and visiting professionals. Resident meetings are held every 2 weeks and most recent one before our visit was on 20 March 2010 with fifteen residents and three staff attending. Records are kept of the issues discussed. The residents meetings with the management are held each month and the last one before our visit was 12 February 2010. The manager said that she found these meetings particularly good as they focused on the management of the home and people who live at the home felt involved in this. Staff meetings are held weekly with the staff team on duty at that time. Records are kept and staff are encouraged to pass on information verbally. Those not in attendance read the record and sign to show they have been made aware of issues raised. Anonymous questionnaires are given out to people who live at the home on a monthly basis. The last ones done before our visit were February 2010. Comments included, I like it here very much, Its a very nice place to live, warm and cheerful, I think everything here is good, I like going to the pub for a meal, The food here is good and plentiful and I am happy here. Relatives and visiting professional surveys are carried out each December. However they were not completed in 2009 and a recommendation was made for these to be completed. Survey results from December 2008 were seen and an analysis had been produced. Comments from these surveys included Staff were always very cooperative and helpful and all agreed that they were satisfied with the quality of the care and support to the people who live at the home. Care Homes for Older People Page 23 of 29 Evidence: The compliments file was available at the home and included a range of letters, cards and emails of appreciation from service users and their families. Comments included, Thank you for caring in such a compassionate way, Thank you for your kindness, A very efficient and caring home and I am always made to feel welcome. A representative from Warrington Community Care visits the home each month to check on how it is running. The most recent visit before our visit was in February 2010, and the report of the visit covered meeting with people who live in the home and staff and inspection of the premises and of records. No issues of concern were raised on the last report. Good records were kept of these visits. Day to day supervision of staff was good and regular formal supervision was being undertaken with records kept. Annual appraisals are also undertaken with records kept and these were up to date. This ensures staff have a chance to discuss their work with their manager, so they can provide good quality care of the people who live at Lodge Lane. Safe working practices were in place in the home. There were up to date safety checks on the homes electrical wiring and gas installation. All checks with regard to fire safety were up to date and checks were also completed on the emergency lights, hot water system and call system. There were a wide range of policies and procedures in the home about safe working practices and these included food hygiene, health and safety, MRSA, mobilisation, needs assessment, hand hygiene, lifting and handling, pressure area protocol, contingency plans for pandemic flu, infection control, accidents, break away techniques, COSHH, clinical waste, continence, first aid and fire safety. The home has a policy on smoking. People who live at Lodge Lane and relatives can smoke in the conservatory and staff have a separate smoking area in the garden. The policy on gifts states that generally staff should not accept gifts from service users or relatives. A gift of small monetary value may be accepted providing it is declared to the manager and they will decide if it is appropriate. Gifts of cash or jewellery are not to be accepted. People who live at the home or relatives can give money to the service to be used to the benefit of the home in general. It was noted that no mention of dealing with service users wills was included in this policy or in a separate policy. It was recommended that this issue be addressed. The personal spending money for people who live in the home is dealt with by the manager and each person, with records kept of all transactions. Each resident has Care Homes for Older People Page 24 of 29 Evidence: their own bank account and no residents money is kept on their behalf by the home. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 The service users guide should be brought up to date with relevant information about change of name of the manager, commission details and staff details, so that people who read this document have up to date information. A review date should be included in the service users guide so that people have access to up to date information. A review date should be included in the statement of purpose so that people have access to up to date information. Within the complaints procedure details of the commissions name and address should be updated so that people using this policy have up to date details of how to contact the Care Quality Commission. Questionnaires sent to relatives and visiting professionals should be completed on an annual basis so that people have up to date information about what is thought about Lodge Lane. Information about supporting people who live at the home with their will should be included in a policy so that staff Page 27 of 29 2 3 1 1 4 16 5 33 6 33 Care Homes for Older People 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 are aware of the procedure regarding this. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - 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!