Care Home: Palmtree Lodge

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What the care home does well The manager makes a pre-admission assessment, with a visit to the prospective resident at home or hospital. Clear care plans show staff the best way to look after each person.Routines are flexible in the home. One resident enjoyed a `lie in`, and chose to eat his cooked lunch at a later time than the planned one. His meal was kept for him until he was ready and he was happy to sit in the dining room and eat at his chosen time. Meals are home-cooked, with varied choices, and mealtimes are unrushed. Residents said they usually liked the food. Staff are welcoming and friendly, and all of the residents said that staff were happy to do what they wanted them to. There is a good mix of long-term staff and new staff making up the team. "The care team on the floor work very well to try and meet the needs of the residents" was a positive comment from a staff survey. Training of staff is ongoing, and 66% of care staff hold National Vocational Qualifications (NVQ). The home holds the Investors In People Award, showing commitment to the development of its` staff. Relatives commented, "The staff all seem very nice and helpful". Records were clear, up to date, and easy to find. What has improved since the last inspection? CARE HOMES FOR OLDER PEOPLE Palmtree Lodge 20/28 Nutter Road Cleveleys Blackpool Lancashire FY5 1BG Lead Inspector Ms Jenny Hughes Unannounced Inspection 28th August 2008 10:00 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 Palmtree Lodge DS0000063455.V365844.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. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Palmtree Lodge Address 20/28 Nutter Road Cleveleys Blackpool Lancashire FY5 1BG 01253 852092 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) palmtreelodge@tiscali.co.uk Mr Naveed Yousaf Muhammad Fayyaz Chauhdry Mrs Isabel Janet Robinson Care Home 22 Category(ies) of Old age, not falling within any other category registration, with number (22) of places Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 22 Date of last inspection 14th August 2007 Brief Description of the Service: Palmtree Lodge care home is situated within Cleveleys town centre, only a short walk from shops and close to the sea front. The home provides residential care for twenty-two persons on ground and first floor levels. All bedrooms have ensuite facilities and comply with minimum space requirements. There are two lounges and a dining room. The home has been fitted to suit the needs of older people, with, for example, a passenger lift, grab rails and ramps. There is a small front patio area with seating, where residents can enjoy watching the daily comings and goings in the town. There is very limited car parking to the rear of the home, although cars can be parked in nearby roads, and a public car park is nearby. Information about the service the home provides is available in the form of written guides, which try to cover everything a resident needs to know about life in the home. Copies of these can be found in the entrance hall of the home, or are available on request from the manager. The latest report from the Commission for Social Care Inspection is also available in the entrance hall. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 5 As at August 2008, the fee scale ranged from £385 to £412 a week, with additional charges for chiropodist and hairdresser visits, and any extra newspapers and toiletries requested. Further details regarding fees are available from the manager. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means that the people who use this service experience good quality outcomes. This was an unannounced site visit to the home, in that the owners were not aware that it was to take place. The site visit was part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. The length of the visit was for 6 hours. Every year the registered persons are asked to provide us (CSCI) with written information about the quality of the service they provide, and to make an assessment of the quality of their service. We use this information, in part, to focus our assessment activity. This document is called the Annual Quality Assurance Assessment (AQAA) Surveys were sent and received from residents, and staff from the home. During the site visit, staff records and resident care records were viewed, alongside the policies and procedures of the home. The manager, residents and care staff were spoken to, along with any visitors who called during the day. Their responses are reflected in the body of this report. A tour of the home was made, viewing lounges, dining room, bedrooms and bathrooms. Everyone was friendly and cooperative during the visit. What the service does well: The manager makes a pre-admission assessment, with a visit to the prospective resident at home or hospital. Clear care plans show staff the best way to look after each person. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 7 Routines are flexible in the home. One resident enjoyed a ‘lie in’, and chose to eat his cooked lunch at a later time than the planned one. His meal was kept for him until he was ready and he was happy to sit in the dining room and eat at his chosen time. Meals are home-cooked, with varied choices, and mealtimes are unrushed. Residents said they usually liked the food. Staff are welcoming and friendly, and all of the residents said that staff were happy to do what they wanted them to. There is a good mix of long-term staff and new staff making up the team. “The care team on the floor work very well to try and meet the needs of the residents” was a positive comment from a staff survey. Training of staff is ongoing, and 66 of care staff hold National Vocational Qualifications (NVQ). The home holds the Investors In People Award, showing commitment to the development of its’ staff. Relatives commented, “The staff all seem very nice and helpful”. Records were clear, up to date, and easy to find. What has improved since the last inspection? Information about the home is more detailed, giving people a good idea about the home they may wish to live in. Detailed pre-admission assessments are carried out for all prospective residents, to check the home is the right place for them, and their needs can be met there. Care plans are clearer and linked to assessments and regular reviews of care needs. The daily notes made by staff are more detailed, giving a picture of each person’s life and events at Palmtree Lodge. Medicines are now being given to people correctly, which helps make sure their health and wellbeing is maintained. Records of the receipt and disposal of medicines were accurate, so medicines can now be fully accounted for. Paperwork and procedures have improved to help make sure people receive the right amount of support when looking after their own medicines. Care staff have received more medicines handling training and have been supervised by the manager to make sure they handle medicines safely. The manager now controls staff recruitment, and she has access to all of the records, which are held securely. The recruitment records are up to date and complete prior to employment. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 8 There has been some redecoration and updating of furnishings in some rooms. The dining room décor has been updated, and new tables and chairs, cutlery and crockery provided. One of the lounges has been redecorated, and new beds and bedding have improved the appearance of people’s rooms. The home now has a carpet shampooer, and has been used to help keep the home as fresh and clean as possible. There are more activities in the home for residents, and the manager plans to further develop the programme. The quality assurance system is slowly developing, with staff and residents’ meetings. Residents also receive surveys to respond to. All means of escape in an emergency are now accessible. What they could do better: The information provided to prospective residents about the home needs to be regularly reviewed to make sure it is up to date and correct. Some information about what takes place in the home, and the fees, was out of date in the documents. The manager needs to make sure records are made of regular audits of the medicines in the home. This helps to make sure medicines are handled and recorded correctly and helps make sure staff remain competent. Staff are making detailed notes about individuals needs and progress, and the manager needs to ensure it is clear that these have been followed up when required. For example one entry in the daily notes mentioned a resident had a sore knee. There was no further mention of this in subsequent records to show if any action had been taken, or if the problem had improved. Activities have improved, but these need to continue to be developed. Staff were seen around the home working together, and need to be encouraged to spend some of their time helping to motivate and stimulate the residents, using the background information held on each person. Staff were seen arriving at work for the start of their shift, walking through the dining room with their coat on, when residents were eating lunch, and not acknowledging the residents they passed. Staff need to remember to recognise and respect that this is the residents’ home. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 9 There has been a fair amount of re decoration and cleaning around the home, and this needs to continue to be addressed to maintain the level of improvements to the environment. There are still areas that appear tired and worn, and old and mismatched bedroom furniture needs replacing. The manager needs to continue to monitor the appearance of the home, to make sure it is a welcoming and homely place to be. For example creased net curtains at the windows, although clean, give an uncared for impression. The kitchen floor needs repair to meet health and safety needs. There has been no improvement to this since the last inspection. As at the last inspection, the laundry room needs complete refurbishment to have readily cleanable wall and floor finishes. As at the last inspection, the water temperature at the point of delivery to residents is too hot in some of the rooms, and could cause scalding. The manager said that a plumber is in the process of dealing with this, and staff monitor the residents safety in those rooms. We discussed how to further develop the monitoring of the service quality by having an overview of events in the home, giving a picture of what is happening. This can be done by auditing, for example: falls, accidents, complaints and concerns, activities attendance and meal preferences. The manager said that this is done informally, but plans to develop a formal system. 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. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 10 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 Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 11 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the home is freely available for service users. The home has a clear assessment procedure, which is carried out for all residents. This means that the service provided is tailored to an individual’s needs and preferences. EVIDENCE: A copy of the Statement of Purpose for the home is available in the entrance hall. This informs on who the owners and manager are, and what services the home provides. A copy of the Service User Guide is also available, which gives more detail as to the day to day running of the home for the people who live there. Anyone interested in staying at the home is sent this information. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 12 The information held in these two documents had improved since our last visit, and they held all the information required by the Care Homes Regulations 2001. The manager needs to regularly review these documents to ensure the information is as up to date as possible. For example the Service User Guide stated there was a ‘Daily Activities Programme’, which is not how the activities are organised, and also ‘monthly flower arranging’, which does not happen. The information held on ‘Cost and Funding’, states a fee that is out of date. An Information Pack also states out of date fees, and holds an incorrect telephone number for the Commission for Social Care Inspection (CSCI). Individual records are kept for each of the residents, and there is a set procedure for admitting someone to the home, with a pre-admission assessment form being seen on three selected files. The manager uses these assessments to check that staff can give suitable care to each person, before the manager agrees that the home is the right place for them to live. The decision made on what help is required is discussed with the resident and their families, and they sign the documents in agreement. The manager told us that people are welcome to have trial visits to the home to help them decide. Staff we spoke to were aware of the needs of the residents, and generally how to meet those needs. Staff stated in surveys that they received up to date information about residents, and that communication in the home was good. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 13 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good care planning system in place meaning that the health and personal care needs of the residents are met. EVIDENCE: As part of the visit a pharmacist inspector looked at how medicines were being handled because previous visits had identified serious shortfalls. We looked at a sample of medicines stock and records and found significant improvements in how medicines were given and recorded. Our checks found medicines were usually given to people correctly and accurate records of this were made. Records of medicines receipt and disposal were accurate so medicines could now be fully accounted for. Further checks on the medicines records showed that staff were now more careful when giving and recording medicines and the type of mistakes seen at previous visits had now stopped. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 14 We saw some evidence of staff being watched by the manager whilst giving and recording medicines and she said that this would be repeated on a regular basis along with further ‘formal’ medicines handling training to make sure staff continue to do it correctly. We looked at the times medicines were given and found they were now given at the best time, notably any medicines that needed to be given before food were given correctly and this was clearly recorded on the medicines records. Giving medicines at the right time helps make sure they work properly. We looked at a sample of care plans and the daily records to make sure medicines were correctly reflected in them. We found medicines prescribed as ‘when required’ had enough information to help make sure they were given correctly and we checked how new medicines and medicine dose changes were recorded and saw significant improvements. Records of when nurses and doctors had involvement with people were recorded and other information about their health and medicines issues were recorded as part of a ‘medicines care plan’. Having detailed information about medicines helps make sure they are handled safely. We looked at the arrangements for medicines storage and found these clean, tidy and secure and a suitable lockable fridge was used for storing medicines that required cold storage. Storing medicines securely helps keep them safe. We looked at how medicines were checked and audited. Suitable paperwork and procedures were in place but no formal audit had been done. The manager said that she had carried out checks but none had been recorded. Having detailed regular audits helps make sure medicines are handled and recorded correctly and helps make sure staff remain competent. There is a standard format for the care plans covering areas that clearly identify the needs of each individual, so staff know how best to look after people. The care plans were signed and dated by the resident, or their representative if the resident was unable to, to show that they were involved in deciding what their care needs were. We saw risk assessments on moving and handling, and falls, which were carried out as needed. There were checklists to prompt staff when reviews of the areas in the care plan were to be completed. These reviews were done every month, or more as required. Staff surveys and staff spoken to indicated that they were kept up to date with the needs of the people living at the home. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 15 Selected files showed us that all changes in need are fully recorded. Daily records are made twice a day by staff, and we saw these were detailed and gave a good picture of the daily events in people’s lives. They also prompted contact with other professionals, such as GP’s or district nurses, where needed. On occasion we saw that an entry was made when staff had noticed a possible health need of a resident. For example, bath records had noted a possible sore on a resident, and no further comment was made about it to indicate what help was required and given, or if it had improved. Staff are making detailed notes, and the manager needs to ensure it is clear that these have been followed up when required. “The care team on the floor work very well to try and meet the needs of the residents” was a positive comment from a staff survey. Staff care for people with diverse needs, for example there are residents from different cultural and social backgrounds. Records hold information about the differing needs, and in speaking to staff they were aware of how they should care for the individuals. Residents are allocated named key workers. They have responsibility for more individual needs, and is someone the resident can feel a closer relationship with. However one staff spoken to was not sure whom she was a key worker for. If this system is used the manager needs to ensure staff are clear on their roles, and who with. We saw and heard staff chatting with residents who clearly felt able to say how they felt and what they wanted. Residents can choose to go where they wish in the home, and may see visitors in the lounges or dining room, or in their own room. Some residents prefer to stay in their own room, where staff were seen to knock and wait for an answer before entering. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 16 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Meals are nutritious, and residents are encouraged to enjoy food and mealtimes. There are some social activities, meaning that people are sometimes being provided with stimulation. EVIDENCE: There is good information in the care plans about the social history of people, their religious needs, and what hobbies and activities they prefer. Planned activities are listed on the notice-board in the entrance hall. The manager said activities take place three or four times a week. The list we saw noted a male singer visits the home every two weeks. The manager told us that this entertainer encourages residents to join in, and the residents told us they liked the singing sessions they had. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 17 The list noted that a female general entertainer calls every two weeks. She provides Bingo, reminiscence sessions, sing-a-longs, and other games such as Play Your Cards Right. Individual stimulation needs to be developed using the information held on the social history of each person. This could be done by the key-worker for the individual. One resident, who was able to get out on her own, was waiting for her taxi when we arrived at the home. During our visit a staff member led a prize Bingo session. Several residents sat in the lounge quietly, with the television on. The manager said that they do not get involved with residents’ finances, which remain the responsibility of each individual’s family. The dining room has been refurbished, and there are new tables and chairs and new wall lights. There is also fluorescent strip lighting in this room, which detracts from the more homely and clean feel the redecoration has created. The sample meal taken was ham and pineapple with fresh vegetables and potatoes, followed by bread and butter pudding. It was well cooked and tasty, and all the residents seemed to enjoy their meal. Residents surveys all responded that they usually liked the meals. Those needing help were assisted tactfully, with carers chatting all the time. The day’s menu is on display in the entrance hall. A couple of people ate their lunch in their room, which was their choice. The cook said she tried to respect peoples choices and different tastes. She said she had a set menu to follow, but sometimes changed it to what was available. The manager confirmed that alternatives would be offered if residents did not want the menu choice. “You can’t complain about the food here”, said a resident. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident their concerns will be listened to and acted upon. Staff have an understanding of Safeguarding issues, which protect residents from abuse. EVIDENCE: There is a complaints procedure in place, with a complaints book to record any complaints, which may come to the manager’s attention. We saw there were no complaints recorded in the last 12 months. We discussed ways to develop the quality assurance procedures of the home by recording ‘minor dissatisfactions’, and how they have been dealt with. This record would give a complete overview of the events in the home, and any patterns emerging. It also helps towards improving the overall service delivered. Residents spoken to said they would “tell any of the staff” if they were not happy with something. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 19 Staff spoken to knew about the Adult Protection procedure, now known as the Safeguarding Procedure, and what to do if they had any concerns. They said they would always act if they thought a resident was at risk. Also if it were a member of staff causing concern they would inform the management. All staff attend abuse awareness training. The manager said that she planned to refresh this training during staff meetings and individual 1:1’s. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 20 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): Standards 19, 25 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is generally comfortable and safe, providing people with a fairly pleasant place to live. EVIDENCE: The refurbishment of the home is an ongoing project, and since the last visit one of the lounges has been decorated, and the dining room has had a complete uplift with new decoration, new tables and chairs and soft wall lights. There are also fluorescent strip lights in the dining room, which detract from the homely feel of the rest of the room. We saw that some of the bedrooms had been decorated, and the manager confirmed that the aim was to eventually replace the older, worn, and mismatched furniture, which was still in place in a lot of the rooms. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 21 We noted that there were areas that were tired and worn, such as the downstairs bathroom, which had flaking and marked woodwork, and a worn bath-seat on the hoist. The manager said the home now had its’ own carpet cleaner, and some carpets were due for cleaning. A domestic is employed to ensure the home maintains standards of cleanliness and hygiene, and generally most of the rooms were clean and smelt fresh. The manager said that she carries out spot checks on work carried out, and she needs to ensure staff are thorough in their work, as we noted some areas in bedrooms that had been missed. Residents and relatives told us that sometimes requests for help in cleaning something take a while to be responded to. The majority of beds have been replaced, and look more homely with valances and pleasant bedding. Around the home net curtains are at windows. These have been cleaned, but replaced creased and unsightly, giving an unkempt look to what could be a nice room. The manager was aware of this and said she was to address the problem. Staff complete a maintenance record if they note any minor jobs, for example broken drawers, or a bulb to replace, and a maintenance man completes the task. This is signed and dated to confirm it has been done, and when. The kitchen floor needs repair to meet health and safety needs. There has been no improvement to this since the last inspection. As at the last inspection, the laundry room needs complete refurbishment to have readily cleanable wall and floor finishes. The manager confirmed that the plan is to completely upgrade this area. As at the last inspection, the water temperature at the point of delivery to residents is too hot in some of the rooms, and could cause scalding. The manager said that a plumber is in the process of dealing with this, and staff monitor the residents safety in those rooms. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home operates a good recruitment policy, which ensures that only people who are suitable for this type of work are appointed. The residents are supported by trained staff, who are generally in sufficient numbers. EVIDENCE: The records of three staff were viewed. Since the last inspection the manager has taken over the recruitment of new staff, and keeps all records structured, available, and stored securely. The files showed that the recruitment policy of the home is followed, with references and CRB and POVA checks obtained for staff prior to starting work. There is a core of long term staff at the home, who help guide new staff, and retain consistency for residents. The manager said that the staff team work well together and support each other, which helps to develop and improve the service. One staff said, “I love working here, I can’t say much more than that can I?” Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 23 Staff surveys stated that there is a good induction to the home for new staff, and good training provided. They also commented that communication within the home was good. Examples of courses staff attend are Caring for Confusion, Infection Control, Skills for Care, Medication Awareness, Health and Safety, Food Hygiene and Moving and Handling. 66 of staff hold National Vocational Qualifications (NVQ), with a further 22 working towards them. Residents said that staff usually listened to them and acted on what they asked for. The rota showed appropriate levels of staff on time of the visit there was a manager and three and a domestic. This should allow for staff residents, and the manager should ensure this key-workers of residents. duty through the day. At the care staff on duty, plus a cook to provide quality time with happens, particularly with the Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 24 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service protects the health, welfare and safety of the residents. EVIDENCE: The registered manager has obtained the registered managers award, and also holds nursing qualifications. She has several years experience of care work, and of working in a supervisory capacity in care home environments. She has worked at this home for over two years, and been the registered manager for about a year and a half. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 25 The information we asked from the manager regarding the service was sent back to us when we asked for it. It gave is basic information about the service, and we discussed the need for the manager to provide more specific detail about Palmtree Lodge, in order for us to have a complete picture on how the home was running, and any planned developments. Some of the information sent to us was incomplete, but the manager was able to fill in the details during the inspection visit. She said she would address these issues when she next updates this information for us. Generally staff felt well supported by management at the home. We discussed with the manager the need to maintain the good communication in the home and make sure all staff feel supported at all times. All staff receive regular 1:1 supervision sessions, and annual appraisals. The home holds the Investors In People award, showing a commitment to developing staff. The manager has started developing the quality assurance system in the home to gain feedback from people involved with the service. We saw records from residents meetings, which relatives were welcome to attend. Very relevant issues were raised, and addressed by the manager and staff. Staff meetings are also held to both pass on information, and to receive feedback from staff. Surveys are given to residents for them to complete, with their relative’s help where necessary. Very few were returned, but those we saw held positive responses. The manager confirmed there is no involvement with personal finances, and invoices are issued for payments due on items such as the hairdresser or chiropodist. If family leave a small amount of money due to their absence for a while, records and signatures are kept. Records were clear, up to date, and easy to find. The manager had recorded that the equipment used in the home had been correctly serviced or tested as required. Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 26 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 27 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. 3. Refer to Standard OP1 OP7 OP9 Good Practice Recommendations Information about the home provided to prospective residents should be up to date and correct It should be ensured that the care records include any action taken by staff to meet the changing needs they have noted. Regular recorded audits of the medicines should be carried out to help make sure they are handled safely and to make sure staff are competent. Staff should always be aware that they should respect the fact that Palmtree Lodge is the residents’ home. They should be able to show they are aware of the need to stimulate and motivate individuals linked to their background information. 4. OP10 OP12 Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 28 5. OP19 OP26 The provider should continue to refurbish and update the environment to provide a nice place to live. The kitchen floor needs to be repaired to meet health and safety requirements. The laundry room needs to be upgraded in order to be readily cleanable and help control risk of infection. The work to address the water temperature to ensure residents are not at risk of scalding should be completed. The Quality Assurance system should be further developed to provide information that will help improve service delivery, content and quality. 6. 7. OP25 OP33 Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Portway Preston PR2 2YQ 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 Palmtree Lodge DS0000063455.V365844.R01.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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