Care Home: Park Lodge Nursing and Residential Care

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What the care home does well People are provided with good information about the service and are given good opportunities to come and visit before moving in. The care planning system for the home is good. Care plans are detailed and person centered in their approach. Consent for this process is always obtained where possible. People are thoroughly risk assessed and these documents are regularly reviewed and changed when necessary. The standard of medication is good and medication is closely audited. People said they thought the staff were very helpful and kind. They said they respected their privacy and dignity. The home provides people with activities that suit their needs. People are kept well informed of what the activities for each week are. The home provides a suitable and clean environment for people to live in. The training and recruitment process within the home is good. The overall management of the home is excellent. The manager has a good awareness of what her role is and performs this well. What has improved since the last inspection? The Service user guide has been reviewed and improved to ensure all the necessary information needed is contained. People are assisted to self medicate and a risk assessment is in place to assist this task. Menus are prominently displayed within the home. People are involved with the development of the menus. A new call system is now in place. 50% of the staff are now trained to NVQ Level 2 standard or above. All the necessary information needed to ensure a person is safe to work in the home is obtained before employment commences. Environmemtal risk assessments are performed in the home. A full redecoration programme is near completion. A new conservatory has been added to the building. What the care home could do better: Those people unable to eat there meals independently should be provided with suitable support from staff. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Park Lodge Nursing and Residential Care 10 Park Avenue Roundhay Leeds Yorkshire LS8 2JH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sean Cassidy     Date: 0 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Park Lodge Nursing and Residential Care 10 Park Avenue Roundhay Leeds Yorkshire LS8 2JH 01132659353 01132650942 park.lodge@ashbourne-homes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ashbourne Homes Ltd Name of registered manager (if applicable) Louise Elizaberth Taylor Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category terminally ill Additional conditions: The number of service users aged between 55 and 65 years of age should not exceed 3. Date of last inspection Brief description of the care home The home provides both nursing and residential care, and although registered for 51 places, some shared rooms are being used as singles, reducing the number of available places to 48. It is located in a residential area of the suburbs of Leeds and is near Roundhay Park, but still within walking distance of local facilities, which include shops, public transport and a post office. It is a large adapted building and accommodation is mainly in single rooms, many with en-suite facilities. There are gardens, with seating areas, to the front and side of the building. Communal areas are somewhat cramped given the potential number of people who may wish to use them, Care Homes for Older People Page 4 of 26 care home 51 Over 65 51 0 0 6 Brief description of the care home but planning permission is being sought to build a conservatory along the front of the building, which would provide an additional seating area. The fees charged by the home range from £425 to £575 per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The accumulated evidence used in this report has included: A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the AQAA (Annual Quality Assurance Assessment) Surveys received from people who use the service, relatives and staff. An unannounced visit to the home, which lasted eight hours. This included a partial tour of the premises. Care Homes for Older People Page 6 of 26 Evidence gained by direct observation, talking with people who use the service and management. Inspection of records including care plans risk assessments, medication administration records,and the homes policies and procedures. What the care home does well: What has improved since the last inspection? The Service user guide has been reviewed and improved to ensure all the necessary information needed is contained. People are assisted to self medicate and a risk assessment is in place to assist this task. Menus are prominently displayed within the home. People are involved with the development of the menus. A new call system is now in place. 50 of the staff are now trained to NVQ Level 2 standard or above. All the necessary information needed to ensure a person is safe to work in the home is obtained before employment commences. Environmemtal risk assessments are performed in the home. A full redecoration programme is near completion. A new conservatory has been added to the building. Care Homes for Older People Page 8 of 26 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are very well informed about the service before and after they move in. Evidence: Four care files were looked at and all contained evidence that a preassessment took place before each person was admitted to the home. Three people spoken to said they were offered the option of visiting the home but only one person took up the offer. Relatives spoken to also said they were given the option to look around and they all accepted. The Statement of Purpose and Service User Guide were up to date and informative. These documents are on display at the entrance of the home as well as the up to date inspection report. Intermediate care is not offered at this service. Care Homes for Older People Page 11 of 26 Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are assured their healthcare needs are met . Evidence: Four care files were inspected. All files contained evidence that each individual had been assessed when they were admitted. Evidence was also available which showed people are reassessed when their care needs change or when they return from hospital. this is good practice as it enables staff to provide up to date care. Where a care need was identified a care plan was developed. The information contained within the care files was detailed and person centered. This is good practice. Staff spoken to over the course of the day said they were able to read the documentation and involve themselves with the daily records. They also provided a good summary of the care needs of the people they were caring for that day. Evidence was seen to show the staff actively obtain consent for the care they provide. All care plans showed evidence that they were reviewed monthly. This is good Care Homes for Older People Page 13 of 26 Evidence: practice. The files showed good evidence that people are thoroughly risk assessed in areas such as nutrition, falls, tissue viability and continence. Evidence of staff following up identified problems was seen. For example, two people identified as losing weight had been quickly referred to the GP for action. One lady who was experiencing chest problems had this recorded in her daily records and it was also reviewed in a risk assessment. The health professional records showed that this person was referred to the specialist nurse in this area and the care plan reflected this. All risk assements were reviewed monthly and consent was seen to be promoted. The home has an up to date medication policy and procedure. This also includes guidance on medication audits. Overall, a random inspection of the medication administration charts contained evidence that these were completed to a good standard. Regular medication audits of all medications were seen and these were also completed to a good standard. The home does have a self medication risk assessment to use when a person wishes to self medicate. One care file showed evidence that this was appropriately used. One person who was recently admitted to the home was asked if she had been given the opportunity to self medicate. She said she had not but would like to have that opportunity. This was passed on to the manager. Staff were observed performing their roles during the day. They appeared helpful and kind. They knocked on doors before entering and waited for an answer. Good feedback was given from people who lived in the home and relatives. Some comments made were, Staff are very kind. They are cheerful and helpful. I would say my privacy and dignity is respected here. The staff always knock before they enter. They are quick to respond to the buzzer when I call. One concern was highlighted in relation to dignity. During the lunch time meal I went to the top of the house and found a lady on her own in her room. She was visibly struggling to eat her meal and obviously needed assitance with this. This was passed over to the manager during feedback. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to maintain interests and social activities. Evidence: People spoken with said they are informed of what activities are on offer and that they were able to choose which ones they wanted to get involved in. people said they were assisted and supported to get involved with activities outside the home. This involved being accompanied by a member of staff on some occasions. There is an activities coordinator who plans activities for all people in the home. These activities are well displayed around the home and there is also a newsletter that is published monthly. People were able to tell me about activities that they have been involved with. There were many pictures displayed which provided evidence of the activities people have been previously involved with at the home. There are care plans as well that highlight peoples likes and dislikes and the daily records showed evidence of how people spent their day. This was also relevant to people who were unable to leave their rooms. Care Homes for Older People Page 15 of 26 Evidence: Three people spoken to said the home enabled them to attend the church that they enjoyed going to before they came into the home. Other religious people come to the home to provide services. The lunchtime meal was observed and this was seen as a social occasion. People were aware of the menus and said they enjoyed a variety of meals. There is a great choice of food in the home. Im able to ask for something different if I dont like whats on offer. Residents, relatives and friends said they were happy with the visiting arrangements provided by the home and were welcomed whenever they arrived. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People said they feel well protected when living in the home. Evidence: People spoken to during the inspection were aware of the complaint process and how they would go about making a complaint. Evidence was provided that showed complaints are properly investigated by the home manager. The complaints procedure is made available to all in different areas of the home. It is also included in the Statement of Purpose and Service User Guide. All carers spoken to possessed a good understanding of what is meant by the term safeguarding adults and how they would deal with a safeguarding situation if they came across one. the training records showed that all staff have been trained in safeguarding vulnerable adults. there have been no referrals made to the safeguarding team since the last inspection. People who live in the home were very positive about the way they were treated by staff. They said, I feel very safe here. I feel very protected. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides and environment that suits the needs of the people who live there. Evidence: People spoken to said they were happy with the environment of the home. It suits my needs. Its not my own home but it feels comfortable and thats all that matters. Its got nice grounds and a new conservatory. I go out in the warm weather with some of the staff and thats nice. The manager pointed out the new conservatory which provides people with extra space if they want some quieter time. The home was clean and tidy. The house keeping staff were aware of their roles and responsibilities in relation to infection control and COSHH (Control of Substances Harmful to Health) One housekeeper said, I am very proud of where I work. People are very well looked after here. A full refurbishment programme is nearing completion. There are only two rooms left to be decorated. All main corridors have also been redecorated. A new stair lift has also been installed. Care Homes for Older People Page 18 of 26 Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are assured that they recieve their care from a well trained and recruited staff group. Evidence: The home has a staffing rota that highlights what staff are on duty over the course of the day. People told us they felt that the staffing levels for the home were correct. They said, The staff dont rush around as much as they used to. They seem to know what they are doing. The staff are very helpful and they do have time for a little chat with me. They are quick to answer the buzzers, I dont have to wait long. Staff were observed performing their duties. They did not appear to be rushed and had time to sit and chat to people. People also told me that this was normal practice. The training records were inspected. All staff have received the correct basic training for the year and the manager should be commended for this. All staff have had CHESS training. A training plan matrix is in place that highlights what training staff require over the course of the year. Staff spoke very positively about the training they receive in the home. The manager is very supportive regarding training and knows what courses we need to go on. We can also ask to attend courses. Care Homes for Older People Page 20 of 26 Evidence: More than 50 of staff have attained training at NVQ Level 2 and above. The recruitment process was inspected. The recruitment files of the two most recent employees were looked at. Both showed clear evidence that a thorough recruitment process had been followed. Evidence was in place also that showed all the necessary mandatory training had been provided and that they had both completed thorough induction process. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and well managed home. The care provided is regularly audited to ensure the standards are always assessed and improved where needed. Evidence: The manager has attained the Registered Managers Award and has also completed the Advanced Clinical Assessment award. She has many years experience working as a manager and provided evidence that she develops herself professionally. People knew who the manager of the home was and staff found her very approachable and helpful. The manager provided some very good evidence that showed the quality of care was being closely monitored regularly. Regular audits are carried out on the care planning documentation, pressure care, falls and accidents. Evidence was also shown to show what action was taken as a result of trends being identified. This is good practice. Annual surveys are carried out. The information gathered from these surveys is available in the entrance along with the newsletter and up to date CSCI report. Care Homes for Older People Page 22 of 26 Evidence: Regular staff and resident meetings take place. Staff told me they receive regular supervision. The AQAA was fully completed by the manager and this was very informative. It is clear the manager is aware of what they do well and what they could do better at the home. The home has strict guidance on how peoples monies are managed. Transactions are recorded appropriately. The manager supports the maintenance man with all health and safety matters. All health and safety records were checked and up to date. This is commendable. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 10 People who need assistance with all care needs such as eating meals, should receive it in a supportive and dignified manner. Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!