Care Home: Saxby Lodge

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What the care home does well The home provides a comfortable, safe and homely environment with a positive, happy atmosphere. The communal space allows for residents to be with company or be on their own if they wish. Staff morale is good and staff were noted to be happy going about their work. They were caring, friendly but respectful to residents. Under Mr and Mrs McCarron`s leadership and support the staff provide an excellent standard of care and staff strive very hard to meet the needs of the residents in a caring, professional and friendly manner. Staff training is being given a high priority and the staff have the training they need to meet needs of residents and the requirements of the legislation. We received complimentary comments from residents and relatives about the staff and the way they care for the residents. The meals served are home cooked and varied and residents said they were happy with the service. What has improved since the last inspection? Since the last inspection Mrs McCarron has completed the Registered Managers Award. At the last inspection it was noted that some of the windows did not have restrictors on them. This has now been rectified, ensuring a safer environment for residents. A new quality assurance system has been implemented by the home to gather the views of relatives and other stakeholders. Staff are now being supervised regularly. CARE HOMES FOR OLDER PEOPLE Saxby Lodge 124 Victoria Drive Bognor Regis West Sussex PO21 2EJ Lead Inspector Jo Hartley Unannounced Inspection 28th April 2008 09:30 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 Saxby Lodge DS0000014703.V363064.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. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Saxby Lodge Address 124 Victoria Drive Bognor Regis West Sussex PO21 2EJ 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) 01243 828615 Mrs Eileen Teresa McCarron Mr Timothy Gerard McCarron Mrs Eileen Teresa McCarron Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th May 2006 Brief Description of the Service: Saxby Lodge is a privately run establishment providing board, accommodation and personal care for up to nineteen people over the age of 65. It is a large detached property set in its own grounds close to local shops and railway station and about two miles from the seafront. Accommodation is provided in single rooms, four of which have an ensuite toilet. The home does not have a vertical lift so only residents that can manage the stairs can be accommodated in any of the four rooms on the first floor. Facilities include a lounge/diner and a conservatory on the ground floor and a lounge on the first floor. There is a small garden for the residents to enjoy. The proprietor/manager is Mrs Eileen McCarron. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on 28th April 2008 over 5 hours. The Providers Mr and Mrs McCarron both take a full and active part in running the home and are committed to providing a very good standard in the home, both were present during the inspection. Mrs McCarron, two staff and six residents were interviewed during the visit to find out how it is to live and work in the home. A general tour of the home was undertaken and the majority of residents’ rooms visited. Case tracking from records to care given was carried out for a number of residents. Staff records and relevant records relating to the management of the home were examined. All records seen were in order. The midday meal was also sampled and found to be very good. Three letters had been sent to the Commission prior to the inspection, the comments in the letters were very positive and complimentary about the standards of care in the home. It was clear from their comments and by observation that residents are encouraged to make choices about their daily lifestyles, for example going to bed and getting up when they wish. Staff training is ongoing and it was noted that the majority of staff were either National Vocational Qualification (NVQ) trained or were awaiting to start the training. Mrs McCarron has now completed the NVQ Registered Managers Award. The home met the requirements of the local fire and environmental health services. There were no requirements made at the time of this inspection. The conclusion of the inspection is that residents enjoy a good quality of life, at the home and are looked after by a committed and dedicated and caring staff team. Fee levels are currently £331 to £495. The overall outcomes for residents are excellent. This has been judged as a three star service. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were made following this inspection. The home should keep up the high standard of care it provides to the residents. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 7 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. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 8 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 Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 9 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): 1, 3, Quality in this outcome area is good. New service users are admitted on the basis of a full assessment. Every service user has a plan of care for daily living. New service users are able to visit the home prior to admission and move in on a trial basis. The home does not provide intermediate care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Saxby Lodge has an up to date Statement of Purpose and Service User Guide. Both documents are written in plain English and contain information to enable prospective residents to make choices about where to live. The Manager told us that prior to admission prospective residents are invited to view the home. She said that she also encourages them to visit other homes so they are able to make an informed choice about where they want to live. The manager then makes a visit to the prospective resident to make an assessment of their needs. Prospective residents are given a copy of the Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 10 home’s Statement of Purpose, Service User Guide and the home’s most recent inspection report. We viewed residents’ files and saw that they all contained a detailed preassessment and risk assessments. It was clear that residents and their families have been involved in drawing up care plans. Privately funded residents receive a contract. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 11 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 excellent. Resident’s needs are reflected in the assessments and care plans. The medication procedure is safe and staff are trained to administer medication. Residents are able with assistance to make choices about their lives and the staff protect their privacy and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were looked at during the visit to the home. They were seen to be well written and contained all the information necessary to meet the needs of residents. They are reviewed every six months or more frequently if needs change, and are updated regularly. We spoke to the residents who confirmed that the staff care for the residents to a good standard. A resident commented, “Everything is wonderful here. I love my room and the staff are lovely”. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 12 General practitioners, district nurses, opticians, dentists and other professionals visit the home when requested and records are kept of all such visits. The manager told us that one resident had a pressure sore when she arrived at the home. The notes of the resident show that the home involved the tissue viability nurse to support them in treating the pressure sore. Resident’s weight is monitored every two months. However, residents whose weight is causing concerns are weighed more regularly. Medication was seen to be stored safely. Records of the administration and disposal of medicines were well kept. Staff training records that were seen during the visit confirmed that the majority of staff have attended an Asset Course on the safe handling of medication. Residents told us that staff treat them with respect and dignity. Since the last inspection we have received three letters from relatives of former residents of the home. All the letters were complimentary about the standard of care provided at Saxby Lodge. A letter from a daughter of a deceased resident, comments on the care and kindness shown to her mother whilst she lived at the home. “Good food, clean home and mother always looked well cared for and was treated with dignity.” Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 13 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. Residents stated that they are happy with their lifestyle, are able to keep in contact with their family and friends and able to have choice and control over their daily tasks. Good home cooked food is provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a varied activity programme that includes; Music and Movement, sing-alongs, bingo, quizzes, parties and shopping trips. Residents told us that they can join in if they wish. There are also fortnightly visits from a local catholic church and a visit by a Church of England vicar every two months. Staff spend time with residents just chatting or playing board games and daily papers are available in the lounge. Two chefs work at the home and cover the seven days. On the day of the visit the main meal was braised beef with peppers, cauliflower, runner beans and mashed potato. The sweet was treacle tart with custard. The inspector sampled the meal and found it to be well presented and very tasty. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 14 The menus indicated that nutritious good home cooked food is served, alternatives are available at all times and the chef was aware of the likes and dislikes of residents. There was a list in the kitchen of the resident’s individual choices for breakfast. Residents have a hot drink and biscuits about 7.30-8pm and also some residents like sandwiches or toast later on. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 15 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. Complaints are handled in accordance with the home’s procedure and residents have stated that their views are listened to and acted on. Residents are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All staff have attended Adult Protection Training, a copy of the West Sussex Safeguarding Adults procedures is available in the office. Mrs McCarron has attended the WSCC Safeguarding Adults roadshow that was held to promote the new Safeguarding Adults policy. Many of the residents vote by post in elections. There have been no complaints made about the home to the CSCI and the complaint book in the home had no complaints recorded since the last inspection. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. Residents live in a comfortable, homely, clean and comfortable environment and there are sufficient facilities and equipment to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 17 The location and layout of the home is suitable for its stated purpose. It is well maintained both externally and internally and meets service users needs in a comfortable and homely way. The Inspector toured the premises and found the service user’s rooms to be fresh and clean, beds had been made and washbasins and toilets were clean and fresh. Residents rooms are personalised by the addition of small items of furniture pictures ornaments and photographs. The communal accommodation consisting of two lounges a dining room and a conservatory is homely, comfortable and well decorated. The front garden is tidy, attractive with garden furniture for residents to sit out. The building complies with the requirements of the local Fire Service and The Environmental Health Department and maintenance records were available for examination. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. There are sufficient staff employed to ensure that resident’s needs are met. The home has a sound recruitment policy and all checks are made for permanent staff. Staff training is provided and staff are competent to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels are appropriate to meet the needs of the residents. One resident said “the staff always come promptly when you call. They always have time for a chat.” Care staff were noted to be supported by an appropriate number of ancillary staff including cleaners and chefs. All staff employed at the home have undergone Criminal Records Bureau (CRB) and all the other required recruitment checks to ensure safety for the residents, copies of these were available for inspection. Staff training had been undertaken in all areas and the evidence showed that all staff are offered training relevant to their work. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent. The way the home is run is beneficial to the resident’s needs. The home is managed by a well-qualified, caring and competent manager. Resident’s financial interests are safeguarded and the health and safety of residents are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 20 Mrs McCarron the Provider/Manager is a first level nurse and an experienced manager. Both staff and residents commented on the support they receive from her. Staff confirmed that there were clear lines of accountability within the home. On the day of the inspection the Inspector noted there to be an open and friendly atmosphere within the home.. Since the last inspection a quality assurance and monitoring system have been put into place to enable the home to gain feedback on the services they provide. Policies and procedures are clear and available in the office for staff. The Inspector confirmed that Insurance cover is available in the home. Service users are encouraged to manage their own affairs with the help of relatives or advocates if necessary. Secure facilities are available and the financial records and petty cash accounts were examined and discussed, the inspector concluded that the process is robust. Since the last inspection staff are being appropriately supervised, this was confirmed by staff. The home also has an annual appraisal system in place for staff. Service users rights and best interests are safeguarded by the home’s record keeping. Staff training records were examined and it was found that staff have received training in appropriate health and safety procedures. Since the last visits the providers have ensured that windows only open to provide adequate ventilation whilst still protecting the safety of residents. Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 21 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Saxby Lodge DS0000014703.V363064.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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