Care Home: Natal Lodge

What the care home does well Natal Lodge provides a homely environment for people to live in. People are able to choose how they spend their day and are involved in decision making about their lives. People are supported to maintain contact with family and friends and to develop and maintain independent living skills. What has improved since the last inspection? A recommendation for appropriate checks to be made on potential employees has been actioned. CARE HOMES FOR OLDER PEOPLE Natal Lodge 19 Natal Road Thornton Heath Croydon Surrey CR7 8QH Lead Inspector Janet Pitt Key Unannounced Inspection 15th February 2008 09:05 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 Natal Lodge DS0000025816.V359993.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. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Natal Lodge Address 19 Natal Road Thornton Heath Croydon Surrey CR7 8QH 020 8771 4595 020 8251 2785 vijayen@hotmail.co.uk 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) Mr Goinsamy Anenden Mrs Jayamane Anenden Mrs Jayamane Anenden Care Home 3 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (0) of places Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow one specified service user under the age of 65 to be accommodated subject to: (1) a minimum annual review of the service user’s health needs (2) staff continuing to have the necessary skills and training to meet the service user’s needs (3) alternative arrangements being sought should the home no longer be able to meet the service user’s assessed needs. 15th January 2007 Date of last inspection Brief Description of the Service: Mr & Mrs Anenden own Natal Lodge and also work in the home. It is registered with the Commission for Social Care Inspection to provide care and accommodation for three elderly service users with mental health needs. A variation has also been granted for one service user to live there who is under the age of 65 years. The home is a residential terraced house situated in Thornton Heath, approximately 10 to 15 minutes walk from the main town centre. The home is well placed to access local transport links and amenities. All service users have the benefit of a single room and plenty of communal space that includes a lounge, dining area, conservatory room and pleasant garden. There is also a well-equipped kitchen and separate laundry facilities in the conservatory area. Fees at the time of the site visit are from £411 to £535 and additional charges will be negotiated with funding authority of additional care is required. Natal Lodge DS0000025816.V359993.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 two stars. This means the people who use this service experience good quality outcomes. One inspector undertook this unannounced inspection. Records relating to care and staff files were examined. A site visit was made which lasted two hours. During that time the inspector was able to speak with people who live in the home. Due to the small number of people direct quotes have not been used to preserved anonymity. A tour of the premises was undertaken and both the owners were spoken with. Information from the home’s Annual Quality Assurance Assessment (AQAA) was also used to inform this report. What the service does well: 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. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 6 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 Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 7 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 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who chose to live at Natal Lodge can be confident that their needs will be appropriately assessed and a plan of care drawn up to meet these needs. EVIDENCE: The home’s AQAA indicates that assessments are carried out prior to a person moving into the home. People are able to visit Natal lodge and stay over night, so that they can experience what the home is like. Individual’s files had comprehensive assessments in them. The assessments included information from other health professionals and clearly showed that the person had been included in the process. Both of the people who were living in the home at the time of the site visit had been there for many years. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 8 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, 10 and 11 People who use the service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in the home are involved in the care planning process and their privacy and dignity is respected. People are able to make choices about their life and maintain contact with significant others. Medications are handled safely this makes sure that people are protected from harm. End of life care is discussed with the person and their wishes are recorded. EVIDENCE: We noted that people’s plans lead from assessments and involved the individual in the process. Plans were person centred and detailed specific need. Information was available on food preferences, hygiene needs, healthy eating and interaction with others. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 9 Social needs are addressed and people are supported to maintain contact with their family and friends. If a person wishes to develop a significant relationship, support is given. We found evidence of involvement by other health professionals when necessary, for example visits by the general practitioner and dietician were recorded. It was evident that people had a choice whether to access other health professionals and if they chose not to then this decision was respected. We found good procedures in place for safely handling medication, with a clear audit trail in place. Individualised risk assessments were in place, covering aspects such as walking, going out alone and shaving. Each plan was reviewed and updated regularly. People wishes on end of life care and death were recorded sensitively. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 10 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 receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Natal Lodge tailors activities to meet the needs of the individuals who live in the home. Meal times are flexible and people are able to choose what they want to eat. Support is given to access the community and to attend places of interest. EVIDENCE: People who live in the home are able to make choices about how they spend their day. On the day of the site visit, plans had been made to visit a day centre and the local shops. People are supported to participate in what the home calls ‘work activities’, this includes meal preparation, cashing benefits, shopping, going for coffee and collecting medicines from the local pharmacy. This enables people to develop and maintain independent living skills. We found that people are able to continue to practice their chosen religion and support is available if they chose to attend services. The manager said that arrangements are in place to make sure people are safe when they go out in the community. These arrangements do not infringe on Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 11 their rights, for example medic alert information is obtained or a person agrees to carry identification. Plans indicate that support is given to keep in contact with family and friends. The AQAA states that menus are planned in accordance with personal preferences. People are encouraged to eat healthily and the menus are flexible dependent on daily activities. The home hopes to organise a summer holiday for individuals and day trips are organised for example to the London Eye. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 12 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 receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People cam be confident that any concerns they may have will be listened to and acted upon. They are protected from harm by good procedures for Safeguarding Adults. EVIDENCE: We have received no concerns or complaints about the home. The AQAA indicated that none have been received by the home. Each person has a copy of the Service User guide, which contains details on how to make a complaint. The manager said that she make sure that people are able to talk with her when they have any concerns and people are involved in the running of the home. People who live in the home are protected from abuse by clear policies and procedures and training given to staff. Both owners demonstrated a good awareness of Safeguarding Adults procedures during discussion and plan to use staff supervision sessions to reinforce good practice. It is recommended that the home obtain a copy of the local authority’s Safeguarding Adult Procedure, as this document has been updated since the home was last inspected. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 13 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 receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Individuals who live in Natal Lodge are able to personalised their rooms and make use of homely communal areas. The home provides a pleasant, clean and safe place to live. EVIDENCE: Natal Lodge provides a homely environment. The house was clean and tidy on the day of the site visit. Plans to redecorate the hallway and one bedroom were in place. Furnishings are domestic in nature and there was sufficient communal and private space for people to live in. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 14 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 receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People are supported by competent and trained staff. There are adequate numbers of staff available. Recruitment procedures make sure that necessary checks are carried out on potential employees. EVIDENCE: People are supported by adequate numbers of staff, who have received appropriate training. Both owners work in the home and employ a small number of part time staff. The owners stated that there is one person who sleeps in at night and they are available if needed. We examined staff files and found that they contained the required information, such as Criminal Records Bureau checks, references and identity checks. Potential employees must be ask for their full employment history to make sure that any gaps in employment can be investigated. Training has been commenced in food hygiene, mental capacity and first aid. The manager reported that she is trying to access a course on diabetic care. The home’s AQAA indicates that training is accessed via distance learning and study days. The training pack was available to view at the site visit. Training given via distance learning is linked to Skills for Care Units. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 15 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 receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who live in the home are able to comment on the running of the home and are supported by the management of the home. Individuals are encouraged to manage their own finances with appropriate help. The home provides a safe, maintained environment for people to live in. EVIDENCE: The home benefits from a stable management system that works in the best interests of people who live in the home. Natal Lodge provides a ‘family type’ of accommodation and care. People who live in the home are able to comment both formally and informally on care they receive. Surveys are sent to their next of kin for comment. The home Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 16 AQAA indicates that results of these surveys are acted upon whenever possible. The AQAA completed by the manager contained good details of how they home plans to continue to meet the needs of the people who live there and how they hope to improve service provision. People are ale to manage their own finances and records are kept. Staff are appropriately supervised and records of supervision are held on their files. No health and safety issues were identified at the time of the site visit. The home has a record of fire drills, fire equipment checks and hot water temperature monitoring. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 17 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 3 9 3 10 3 11 3 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 3 X X X X X X 3 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 3 Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? No 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. 1. 2. Refer to Standard OP18 OP29 Good Practice Recommendations It is recommended that the home obtain an updated copy of the local authority’s Safeguarding Adults procedure. It is recommended that application forms are reviewed to make sure that a person’s full employment history is detailed. Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection 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 Natal Lodge DS0000025816.V359993.R01.S.doc Version 5.2 Page 20 - 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. 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