Care Home: Portelet Lodge

What the care home does well Prior to moving into the home, residents and their families can be assured that it is a suitable place to live where their needs can be met as Portelet Lodge ensures that each persons needs are assessed and the home is an appropriate place for those needs to be met. Following assessments, a plan of care is written with input from the resident (where able), their representative and other relevant parties, this care plan informs staff of action needed to meet assessed needs. Residents can be assured that heir needs will be met respectfully and that care practices support their dignity. Recreational and leisure activities in Portelet Lodge meet individual requirements, those residents less able to go out are supported in their social relationships within the home; residents families and friends are able to visit freely. Appropriate procedures are in place to ensure any complaints or concerns are managed appropriately and staff are trained in issues relating to adult protection.Residents in the home have a comfortable, relaxed environment in which to feel at home where cleanliness, maintenance and health and safety are programmed. Residents benefit from appropriate numbers of well trained staff at the home and can be secure in the knowledge that good management practices are in place. What has improved since the last inspection? One requirement was made as a result of the last inspection relating to staff training in adult protection, this has been addressed for the safety and protection of residents. Recommendations of the last inspection have also been addressed in relation to refurbishment and redecoration of bathroom and shower areas of the home and staff training in relation to health and safety issues. What the care home could do better: This was a very positive inspection where no requirements are made, a recommendation of the last report is however repeated regarding an assessment of the premises to ensure suitable access around the home and a recommendation is made concerning formulation of policies. Although there is no first aid policy in the home, staff have received appropriate training in this area but guidance should be available to inform and remind staff of their responsibilities and duties in relation to first aid. Similarly, there are no residents in the home with pressure ulcers although there should be a policy available for staff reference regarding pressure relief and management of nay pressure wounds should they occur, guidance on this can be taken from the tissue viability service. CARE HOMES FOR OLDER PEOPLE Portelet Lodge 42 Westby Road Boscombe Bournemouth Dorset BH5 1HD Lead Inspector Jo Palmer Key Unannounced Inspection 12th November 2007 12:00 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 Portelet Lodge DS0000053933.V353483.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. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Portelet Lodge Address 42 Westby Road Boscombe Bournemouth Dorset BH5 1HD 01202 398982 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) porteletlodge@tiscali.co.uk Portelet Care Ltd Mrs Sarah Louise Gillman Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (21) Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. In addition to registered places a day care service of up to 7 hours per day may be provided for two people in the categories MD(E) DE(E). 25th May 2006 Date of last inspection Brief Description of the Service: Portelet Lodge is a care home registered with the Commission to provide personal care and accommodation for 21 people over the age of 65 years who have mental health needs. Portelet Lodge is registered under the company name Portelet Care Limited, one of whose directors is the responsible individual for Portelet Lodge. Sarah Gillman is the registered manager. Portelet Lodge is situated in a residential area of Boscombe, Bournemouth, and is a short walk from local shops and amenities and the sea front. Accommodation is provided over three floors; a five-person passenger lift provides access between floors along with a central stairway. There are fifteen single rooms, eleven of which have en-suite facilities, and three shared rooms all with en-suites. On the ground floor there is a communal lounge and dining area and a conservatory opening up to the rear garden. The gardens are secure and provide seating for residents. The front of the home provides off road parking for five or six cars, parking on Westby Road is available although limited. Current fees are £471 to £525. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_c hoos.aspx Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 12th November 2007 between 12.00 and 16.15. Mr David Lallana, joint owner of Portelet Care Ltd and responsible individual for Portelet Lodge was present along with Sarah Gillman, the registered manager. The main purpose of this key inspection was to check that the residents living in the home were safe and properly cared for and to review progress in meeting the requirement and recommendations made at the previous inspection. The inspector spoke with four residents, one staff member, took a tour of the premises and examined relevant records. The Commission for Social Care Inspection sends questionnaires to service users, their relatives, staff and visiting professionals in order to obtain feedback about the services provided, an Annual Quality Assurance Assessment (AQAA) is also sent for completion by the manager/responsible person, the completed AQAA was used to inform parts of this inspection visit although no surveys had been returned, the manager confirmed that these were to be used as part of the homes own quality assurance audit. What the service does well: Prior to moving into the home, residents and their families can be assured that it is a suitable place to live where their needs can be met as Portelet Lodge ensures that each persons needs are assessed and the home is an appropriate place for those needs to be met. Following assessments, a plan of care is written with input from the resident (where able), their representative and other relevant parties, this care plan informs staff of action needed to meet assessed needs. Residents can be assured that heir needs will be met respectfully and that care practices support their dignity. Recreational and leisure activities in Portelet Lodge meet individual requirements, those residents less able to go out are supported in their social relationships within the home; residents families and friends are able to visit freely. Appropriate procedures are in place to ensure any complaints or concerns are managed appropriately and staff are trained in issues relating to adult protection. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 6 Residents in the home have a comfortable, relaxed environment in which to feel at home where cleanliness, maintenance and health and safety are programmed. Residents benefit from appropriate numbers of well trained staff at the home and can be secure in the knowledge that good management practices are in place. 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. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (Standard 6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A thorough pre admission procedure is in place and assessments are routinely undertaken to ensure that only residents whose needs can be met by the home are offered places there. EVIDENCE: A completed pre admission assessment was seen for a resident who had recently moved to the home. The needs of the resident are assessed prior to them agreeing to move into the home using a set format that has been developed to take into consideration their health and welfare needs. The records indicated that the needs and circumstances of the people had been properly taken into account. The assessment indicated that other relevant people had been consulted with regard to this persons care needs and the local authority care plan for the placement at Portelet Lodge was available for staff reference. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to provide staff with the information they need to meet the health, personal care and social needs of residents. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The information contained in pre-admission assessments, and any assessments supplied by funding authorities, is used to help compile a detailed plan of care. A series of assessments carried out on arrival at the home (risk assessment, personal care, mental and physical health, social care and communication) also feed into the care plan. Care files were well organised, easy to read and accessible to staff to provide up to date information about the needs of the resident and how the home was to meet these needs. It was clear that reviews were being undertaken and plans updated with changes. One care plan looked at was for a resident who Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 10 had a supra-pubic catheter in place, the care plan did not provide instruction for staff on how to manage the catheter site and it was evident from records held that staff had been changing the dressing frequently. The manager is advised to ensure that when a resident has need of any form of nursing attention, that clear instruction is provided by the district nursing service as to the correct care procedures in order to prevent any cross infection and to ensure the resident is receiving the proper care. No requirement is made in respect of this at this time, as it was evident that the resident no longer required this care at the time of inspection. Staff complete daily records which support and evidence the delivery of care to residents and feed into the regular reviews of care plans. Reviews are carried out with the staff and manager at monthly staff meetings. Evidence was available on file and through discussion with management that GPs, district nurses, opticians and chiropodists are available to residents. There is no first aid, or pressure relief policies in the home providing procedural guidelines for staff. Medication records are well kept and evidenced that residents are in receipt of any medication as prescribed by their GP, storage of medicines in the home was safe and in order. A monitored dosage system is in place administered by the dispensing pharmacist, the system provides medication administration records (MAR) for completion by the home. These were seen to be in order, well kept and with clear instruction. A record is kept of the safe return to the pharmacy of any medication that is no longer required. Most medicines are issued from the supplying pharmacist in blister packs (MDS), those that are not suitable for this type of dispensing are issued in their original containers, the container is dated when opened to ensure an accurate audit trail can be maintained. Residents spoken with said that they were treated well and that staff were kind and friendly. Staff were seen to treat residents with courtesy, patience, kindness and respect. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A range of activities is available for residents to participate in should they choose to. People are generally encouraged to make choices about their life style and to maintain contact with their family and friends. The meals in this home are wholesome and varied and are served in a pleasant environment EVIDENCE: Residents spoken with confirmed that the activities they are able to engage in suit their lifestyles. Portelet Lodge does not offer many group activities as staff have been concentrating on individual, one to one pursuits whether this be through conversation, trips to the local shops or engaging in activities of each residents personal choice, in doing so, residents confirmed that they are able to maintain relationships with friends and families and the local community. Mini-bus trips are arranged once or twice each week which residents confirmed they enjoyed. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 12 Meals in the home are produced from a central kitchen, records of meals provided demonstrate a varied diet is available, it was evident that fresh fruit and vegetables are used and many dishes are homemade. A cook is employed to prepare the main, midday meal and care staff prepare the afternoon tea and suppers. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and staff training programmes are in place to protect the residents living at the home; residents can be reassured that they can express any concerns they may have and that any incidents will be managed appropriately. EVIDENCE: A complaints procedure is available to residents and visitors to the home. The registered manager confirmed that no complaints have been received. This homes history shows that when any concerns are raised, they are fully investigated and resolved to a satisfactory conclusion. An adult protection policy is in place with procedures detailed for contacting the appropriate authorities should any concerns or allegations be made. Since the last inspection, one such incident was raised, was investigated by the appropriate personnel and resolved, the allegations were proved to be unfounded. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 14 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, 20, 21, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Portelet Lodge provides residents with a comfortable environment in which to live where they are safe, warm and have suitable facilities to meet their needs. EVIDENCE: Since the last inspection, much work has been done to improve the environment, new floor covering has been laid in all bedrooms, several rooms have been redecorated and bathrooms and shower rooms have been upgraded. Residents spoken with confirmed that they are comfortable in their rooms and are able to bring personal effects to make their space more homely, some residents have taken greater advantage of this than others. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 15 Bathrooms, showers and toilets are sited around the home, these provide suitable facilities, are clean and recent redecoration has improved the appeal of these areas. A recommendation of the last inspection is repeated with regard to an assessment of the premises by a qualified Occupational Therapist to establish the extent of any disability access equipment or adaptations that could benefit residents. Radiators and hot surfaces in communal areas of the home have been guarded and in resident’s rooms, have been assessed with regard to any risk posed of accidental scalding. The home was clean and well maintained at the time of inspection with no unpleasant odours, infection control procedures are in place. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff are on duty to meet resident’s needs. Training is provided to staff in order that they have the skills and are competent to do their jobs. Safe staff recruitment practice is used. EVIDENCE: Staff rotas seen demonstrate that there are sufficient numbers of staff on duty to meet residents needs; residents confirmed that staff are available when they need them. There are 4 care staff on duty each morning and afternoon and two each night. Additionally, there is a housekeeper and cook and Sarah Gillman, registered manager is also shown on the rota as being available in the home throughout the week. Two staff employed are currently undertaking the NVQ level 3 award and one is on her way to completing level 4. One member of staff has attained level 4 NVQ and two staff have NVQ level 3 equivalent (overseas nursing qualifications) Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 17 Staff files seen demonstrated the extent of training courses attended by staff. Those seen included certificates in the following: • Emergency Aid • Food hygiene • Medication management • Adult protection • Moving and handling • Health and safety Sarah Gillman, registered manager confirmed that all staff have attended these training course except two new staff who are booked onto adult protection and medication courses in the next month. Staff files seen demonstrated appropriate recruitment. Application forms are used to recruit into vacant posts, applicants provide personal details as required in Schedule 4 (Care Homes Regulations) including work history and qualification, provide names of referees and sign a Rehabilitation of Offenders statement. References, POVA (Adult Protection) and Criminal Records checks are made before an applicant is successful and starts employment at the home. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 18 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, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are can be confident that the home is well managed and that systems are in place that centre around their care needs. Management practices and records kept, confirm the health and safety of people in the home. EVIDENCE: Sarah Gillman, registered manager completed an NVQ level 4 in care with a company that then went into liquidation before she obtained her certificate to evidence completion of the course. Ms Gillman unfortunately therefore has to re-take the course with a different training provider. Ms Gillman is a competent manager who is able to efficiently run the home with the support of Mr Lallana, Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 19 responsible individual for Portelet Lodge, Mr Lallana takes an active role with Ms Gillman in the management of the home. Residents spoken with confirmed they were happy with the management arrangements stating that Ms Gillman and Mr Lallana were always available and active in the home The Commission for Social Care Inspection send all care homes an AQAA (Annual Quality Assurance Assessment) to complete prior to inspection. A completed AQAA which provided detail of the home’s intention to continue to monitor and evaluate quality of service provided was submitted which identifies what the home feels they do well and sets out their plans for improvement over the next twelve months. It is strongly advised that the significant points of the AQAA are used to formulate the homes Quality Assurance report that is available for residents. Residents can be assured of effective management of their personal finances, where a resident requires assistance with their allowances; the home ensures that procedures are in place for their protection. Records seen demonstrate that income, expenses and balances are recorded ; receipts for expenditure are numbered and logged to ensure a clear audit is kept. Staff files seen demonstrate regular supervision and matters discussed. Mr Lallana and Ms Gillman confirmed that each staff member has an appointed supervision session six times each year. Any accident in the home is appropriately reported using the correct reporting format, caution is needed to ensure the home keeps a supply of current forms on which to report any accidents or events in the home which fall under Regulation 37 particularly in respect of RIDDOR (Reporting Injuries, Diseases and Dangerous Occurrences Regulations) The home has a fire risk assessment that was reviewed in October 2007, Dorset Fire and Rescue Service last visited the home in June 2007 and recommendations made from their visit have been addressed. Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 20 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 2 9 3 10 3 11 x 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 3 3 X 3 3 3 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 3 3 X 3 3 X 3 Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 21 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. Refer to Standard OP22 Good Practice Recommendations It is recommended that the Portelet Lodge premises be assessed by suitably qualified persons including an Occupational Therapist. Policies should be available with procedural guidance for staff relating to first aid and pressure relief. 2. OP8 Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Portelet Lodge DS0000053933.V353483.R01.S.doc Version 5.2 Page 23 - 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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