Care Home: Lodge The

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What the care home does well This home is clean and well decorated with very pleasant grounds. The manager finds out what each person needs help with before they move into the home. This is written down in an assessment of care. She tells each person whether the home can offer the care needed and gives out information so that people can decide for themselves if it is a suitable place. Once a person has moved in, the staff regularly talk with them about what help they need and write this down in a plan of care. The plan is changed whenever needed. The home asks doctors and other health care people to contribute to the plan of care. Service users are treated with dignity and respect. The home looks after medication well and the staff who give out medication are well trained. A health care professional said: "The Lodge is the place I would like to go if I found I needed care, I think that says it all." The home provides activities to suit the preferences of those living there, visitors are made welcome and the food is very good. One person said: "The meals are excellent. I couldn`t fault them." Any complaints are listened to and acted on and staff are trained in how to keep people safe and recognise if any person is not being treated properly. There is a good number of staff. This makes sure care can be given in a relaxed, unhurried way. One service user said: "`There is always time to chat." Staff are well trained and are happy to learn more. The manager and deputy are very well qualified. The home regularly asks service users what they think about the care they receive. All comments are gathered together and a plan is drawn up to improve the service based on this. The home also carries out its own quality checks across all areas of care and the building. All health and safety checks are up to date which makes sure service users stay safe. What has improved since the last inspection? The Lodge has continued to improve the environment with planned redecoration and re-carpeting. A new quality assurance questionnaire has been devised, which will give more detail about what people think of the home and what they want to improve. What the care home could do better: The home is looking into improving care plans further by increasing the quality of medical information gathered when a person is admitted. Any improvements required are identified by the home through the quality assurance process. This report has generated no requirements or recommendations. CARE HOMES FOR OLDER PEOPLE Lodge The Westbourne Road Scarborough North Yorkshire YO11 2SP Lead Inspector Karen Ritson Key Unannounced Inspection 09:30 9th January 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 Lodge The DS0000007827.V353805.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. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lodge The Address Westbourne Road Scarborough North Yorkshire YO11 2SP 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) 01723 374800 01723 507343 Hamilton Care Limited Mrs Julia Anderson Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2007 Brief Description of the Service: The Lodge is a large detached property situated in a pleasant residential area of Scarborough close to local shops with easy access to public transport. The building stands in spacious partly wooded grounds with large landscaped gardens to the rear and front of the home. The Lodge offers personal care and accommodation for a maximum of 38 older people. Nursing care or specialist care is not provided. The accommodation consists of 36 single and one shared room. A passenger lift provides access to all floors. Respite and holiday stays are offered if accommodation is available and a day care service if this can be accommodated within the homes registered capacity. All the bedrooms are equipped with emergency call alarms and washing facilities and the majority of the rooms have en-suite toilets. The communal areas in the home comprise the following: a sun lounge looking out onto the rear garden which has a direct ramp access to assist mobility, a lounge with a large screen television/video, an organ and a stereo music system; a second lounge where service users can socialise or quietly read from the range of books available and a third lounge where service users can meet with relatives and friends. The home provides a full laundry service, personal care and all meals. Information about what services the home provides is supplied to service users and their relatives in the form of a ‘Service User Guide’. The last Commission for Social Care Inspection report is also available in the home. The range of fees charged is between £329.50 and £400 per week. Hairdressing, dry cleaning, newspapers and outings are not included in the cost, although transport to hospital is. Some of the cost for outings is met through fundraising events. This information was provided on 9th January 2008. Lodge The DS0000007827.V353805.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 3 star. This means the people who use this service experience excellent quality outcomes. The inspection for this service took 14 hours. This includes time spent gathering information and examining documentation before and after an unannounced site visit and in writing the report. The site visit took place on 09/01/08 between 9:30 hours and 13:30 hours. Information for this inspection was gathered from the following: • • • • • • • • • • A tour of the premises Observations of care throughout the day of the site visit. Speaking with service users. Speaking with the manager and proprietors. Case tracking service users on the day of the site visit. Looking at information provided by the home in the AQAA pre inspection information. Notifications sent to the Commission from the home since the last inspection. Examining policies, procedures and records kept at the home. Examining information regarding the home on the file kept by CSCI. Considering comments made by relatives, health care and social services staff. All key standards were looked at during this inspection. The manager and deputy were present throughout the day of the site visit. What the service does well: This home is clean and well decorated with very pleasant grounds. The manager finds out what each person needs help with before they move into the home. This is written down in an assessment of care. She tells each person whether the home can offer the care needed and gives out information so that people can decide for themselves if it is a suitable place. Once a person has moved in, the staff regularly talk with them about what help they need and write this down in a plan of care. The plan is changed whenever needed. The home asks doctors and other health care people to contribute to the plan of care. Service users are treated with dignity and respect. The home looks after medication well and the staff who give out medication are well trained. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 6 A health care professional said: “The Lodge is the place I would like to go if I found I needed care, I think that says it all.” The home provides activities to suit the preferences of those living there, visitors are made welcome and the food is very good. One person said: “The meals are excellent. I couldn’t fault them.” Any complaints are listened to and acted on and staff are trained in how to keep people safe and recognise if any person is not being treated properly. There is a good number of staff. This makes sure care can be given in a relaxed, unhurried way. One service user said: “‘There is always time to chat.” Staff are well trained and are happy to learn more. The manager and deputy are very well qualified. The home regularly asks service users what they think about the care they receive. All comments are gathered together and a plan is drawn up to improve the service based on this. The home also carries out its own quality checks across all areas of care and the building. All health and safety checks are up to date which makes sure service users stay safe. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 7 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 Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 8 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): 3 and 6 People who use the service experience good quality outcomes in this area. Service users can be assured that their health and social care needs will be met. Their needs are well assessed. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: A thorough pre-admission assessment is carried out for all prospective service users. Information about service users’ needs is gathered from varying sources. This includes GPs, healthcare professionals involved in the individual care of the service user and, where appropriate, social services. Where possible, all service users are visited prior to their admission and, if possible, they are encouraged to visit the home as well. Service users receive good information prior to making a decision about admission. People said they were Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 9 encouraged to ask questions about what the home could offer. One person said: “My family brought me to look around and we took a brochure home. It has definitely lived up to its promises.” The manager intends to gather more information regarding medical history of prospective residents and has a policy of avoiding admissions at weekends and on Fridays if possible. This minimises potential distress to people if an admission is inappropriate. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People who use the service experience excellent quality outcomes in this area. Service users receive health and personal care in a safe way that respects their privacy and promotes dignity and independence. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: All service users have a written care plan that details how their health and social care will be delivered. The plans are based on information received during the pre-admission assessment and reviewed and updated as needed. All activities that the service user may be involved in have been the subject of risk assessment and this ensures that service users are cared for safely whilst maintaining their independence and choice. People said they were encouraged to continue to care for themselves where they had capacity. One person said she handled some of her tablets but was happier for staff to manage the Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 11 others, another person said she preferred to manage her bath unaided, and this was written into her care plan. All staff spoken to said they were aware of the care plans and that these were working documents. One person living at the home said: “The staff know each one of us, they’ve been hand picked to listen to what we want and to make sure things happen for us the way we want them to.” All staff are able to contribute to discussions about service users’ care. The records showed that all service users’ healthcare needs are kept under regular review and, where indicated, relevant healthcare professionals are involved. A person living at the home said: “They understand what help we need and if one of us feels we need the doctor, we have only to tell a member of staff and they sort it out straight away.” All staff are able to contribute to discussions about service users’ care. The records showed that all service users’ healthcare needs are kept under regular review and, where indicated, relevant healthcare professionals are involved. Staff were seen speaking respectfully to service users and giving them the opportunity to express their wishes. At each shift change, all staff receive current and up to date information about the needs and wishes of service users. A district nurse said: “Whenever I go in I can hear staff speaking kindly to the residents.” Another health care professional said: “The Lodge is the place I would like to go if I found I needed care, I think that says it all.” Policies and procedures relating to the administration of medication ensure that service users receive their medications promptly and in a safe way. Medication records that were looked at showed that this was the case. Staff responsible for handling medications have received training in this area. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use the service experience excellent quality outcomes in this area. Activities and daily routines closely match the expectations of those living at the home and the meals are very good. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: Activities provided at the home have been devised following consultation with service users, so ensuring that it meets their wishes and preferences. Residents have had the opportunity to go out for a Christmas lunch, the venue being chosen at the residents’ meeting, this is in addition to the lunch provided at the home on Christmas Day. There was also an outing to a local pantomime, and a show at Bridlington. Over Christmas time, there had been a visit from Gladstone Road school choir, a Christmas party with buffet and entertainment from singers and dancers. A service user said, “They try their best to make Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 13 sure we can carry on with our lives as before. If you have an interest they will go out of their way to make sure you can continue with it.” The activities organiser works for sixteen hours each week. She makes sure that those service users who spend time in their rooms or choose not to join in any group activities are visited in their rooms for a chat. Group activities include countdown, bingo, and board games such as scrabble. There is a mobile shop for sweets and toiletries and Ringtons deliver to the home. Students are welcomed into the home to chat and share experiences. People are enabled to keep their faith and ministers from differing religions visit the home. These include Church of England, Roman Catholic and the Pentecostal Church. In addition to the two main lounges, there are three further lounges where service users may see their relatives and visitors in private. One of these lounges has a fridge and facilities to make snacks and drinks at all times of the day. A visitor said she was always made very welcome and she now regards The Lodge “as my mother’s new home, not a home at all.” Careful consideration is given to the dietary needs of service users. All service users have had a nutritional assessment. There is a four-week menu provided. Fresh local produce is used at all times. At each mealtime there is a choice of food available, and there is always a cooked option at breakfast or tea. A bar facility is available. There are daily home baked cakes and biscuits. The chef was spoken to and he said he was free to offer whatever choices people preferred. A group of people living at the home said the meals were very good indeed. They commented enthusiastically on the quality of the food over Christmas and were particularly complimentary about the salmon they were offered on New Year’s day. Special diets such as diabetics, low fat and high fibre are catered for. Any special diets are recorded in the individual care plans. The cook is aware of his responsibilities in relation to safe handling and preparation of food and this ensures that all service users receive their food safely. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. Their complaints are listened to, acted upon and their welfare is protected. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: Service users and their representatives are aware of the complaints policy in the home and know whom to approach should they have a complaint. They feel confident that any complaint will be taken seriously and acted upon. One service user said, ‘I would talk to Julia or Kath (the manager and deputy) if there was a problem.” A relative said “I would talk with the manager if there was something wrong. She is very approachable and asks if there is anything they can do better.” Regular residents’ meetings are held where people are encouraged to speak out if there any complaints. People commented that they were not shy about saying when something needed attention and that these comments were taken seriously by the home. Details of how to access advocacy arrangements if needed are available in the home. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 15 The adult protection policy and procedure ensures that service users are fully protected. Staff are aware of the whistle blowing policy and their responsibilities. Staff have all received abuse awareness training. They were clear about reporting procedures following any disclosure. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience excellent quality outcomes in this area. They live in a very well maintained and pleasant environment and their clothes are carefully laundered. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: A tour of the premises showed that the home was well maintained and decorated. Those living at the home said they were able to bring in items of furniture and possessions with them when they moved in. One person said she had moved into a downstairs room but, when a larger room became available, she was offered this and was very pleased with it. Some rooms are larger and so people are able to use these as bed sitting rooms and have a separate lounge area. There are four communal lounges including one that smokers can Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 17 use if they wish. There is also a private room on the first floor that has facilities for making snacks and drinks. This is for the use of residents and their relatives and friends. Relatives can also use the still room area for making drinks if they wish. The lounge areas and dining room were furnished and decorated to a high standard. One person said: “Even though I have been very sad to leave my home I can’t fault how clean and pleasant my room is here. I have everything I need.” A handyperson is employed to ensure that repairs and maintenance are carried out and a written record is kept of work carried out following the maintenance plan. Several bedrooms have been redecorated and the landings have been recarpeted since the last inspection. The laundry is sited away from food preparation areas, is large enough and has the appropriate equipment to deal with all the laundry in the home. Service users’ clothes are all clearly labelled. The laundry assistant has had appropriate training for her role and is provided with equipment to help her address infection control and health and safety. These include dissolvable bags for soiled laundry and gloves and aprons for her and staff use. A relative said: ”The laundry service is really excellent. My mother sends her clothes down and they come back beautifully pressed and on hangers the next day.” Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People who use the service experience good quality outcomes in this area. They are cared for by sufficient, well -trained and recruited staff. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: The home encourages staff to undertake training relevant to their roles and currently over 50 of care staff hold an NVQ qualification at level 2 or above. This ensures that staff are competent and confident in their roles. The core group of staff employed at the home have been in post for many years and this means they are familiar with the home’s routines and service users benefit from continuity of care from experienced staff. The home employs staff for each area of work such as caring duties, domestic, laundry and maintenance and this works well. Staff records showed that staff had undertaken mandatory training in health and safety topics and had also had the opportunity to undertake training in other areas of interest, such as bereavement and dementia awareness. Training needs are regularly reviewed in supervision. Recruitment procedures are robust and this means that service users are protected. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 19 Staff rotas showed that staff are deployed in sufficient numbers to ensure that the needs of people living at the home are met at all times of the day. Two waking night care staff are on duty with a manager on call in case of emergency. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 People who use the service experience excellent quality outcomes in this area. They may be assured that their views underpin practice, that they remain safe and that the home is well managed for their benefit. This judgement has been made using a range of evidence including a visit to the service. EVIDENCE: The manager has many years’ experience in care and holds a qualification in Advanced Management in Care and a level 5 qualification in Operational Management. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 21 Service users are encouraged to manage their own finances where possible and are provided with a lockable facility to enable them to do so. The quality assurance system has been developed to ensure that service users are regularly asked what they think of the service and how things can be improved. For example, following admission a survey is sent to ask if they had been given sufficient information about the home and if there was anything else that could have been done to make the move easier. The home holds regular reviews of care which involve the person living at the home, relatives, representative and staff. There are also regular residents’ meetings, which are chaired by the recreational therapist rather than management and people living at the home said this gave them the opportunity to talk freely about things they may wish to change. They said that changes had happened as a result of these meetings. New meals have been added to the menu, some of the activities have been changed. A bird table had been purchased for the garden and a cupboard had been provided for the residents to have easier access to board games. More changes are planned as a result of listening to what people say. The manager ensures that staff receive mandatory training as required. There is a training programme to address this and each member of staff’s training needs are identified. An up to date sample of health and safety records was seen. The home regularly carries out health and safety audits to ensure those living at the home remain safe. Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lodge The DS0000007827.V353805.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. 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