Care Home: South Africa Lodge Nursing Home

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What the care home does well When asked this question the following comments were made: "South Africa Lodge provides a pleasant, relaxed and safe environment for service users and gives excellent support for service users, relatives as well as staff""The nursing care and management of South Africa Lodge is of the highest standard" "The care is not merely kind, frankly the word is loving" "The home is clean, the food is good and it is a nice environment to work in The equipment is well maintained. Training is regular in all areas" These comments were representative of peoples` views in general. South Africa Lodge has a track record of providing good quality care and continues to do so. Record keeping is detailed and accurate and this helps to ensure that staff provide the right amount of support and care to individual service users. Routines and activities reflect service users wishes and interests and ensure that people can continue to make choices in their lives. There is a good atmosphere in the home and staff have a friendly and respectful relationship with service users. The home is well managed and the manager is supported by a knowledgeable and committed staff team. A particular strength of the home is the high level of quality assurance that is undertaken. This means that staff are continuously reviewing and evaluating the practices and policies that inform the care that is given and it helps to ensure that people`s different and changing needs and wishes are at the heart of the service. What has improved since the last inspection? Care plans have been further developed and are now more personalised. Plans also include a detailed consideration of the persons` mental capacity. This helps to ensure that people make as many decisions and choices for as long as possible. The service has liaised with a dietician to look into the nutritional status of service users. Air conditioning has been installed in clinic rooms to regulate the temperature where medicines are stored. The garden has been redeveloped and more sensory equipment has been purchased. The nurse call system has been replaced with a pager system to reduce noise levels. Staff have undertaken further training for example; nurses have completed syringe driver training and Liverpool pathway training and all care staff have undertaken training in infection control. What the care home could do better: The annual quality assurance assessment lists the service`s plans for improvement over the next twelve months. This includes more staff to be given training in The Mental Capacity Act, to compile nutritional values of sample meals and for dementia training to include ancilliary staff. The service meets all National Minimum Standards that have been assessed and no requirements or recommendations have been made as a result of this inspection. CARE HOMES FOR OLDER PEOPLE South Africa Lodge Nursing Home Stakes Hill Road Waterlooville Hampshire PO7 7LA Lead Inspector Kathryn Kirk Unannounced Inspection 12th March 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 South Africa Lodge Nursing Home DS0000011473.V361179.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. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service South Africa Lodge Nursing Home Address Stakes Hill Road Waterlooville Hampshire PO7 7LA 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) (023) 92 255556 South Africa Lodge Ltd Mrs Maria Stavert Care Home 55 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (55), Learning disability (10), Mental disorder, of places excluding learning disability or dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (55) South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No service users under the age of 50 will be admitted. No more than twelve (12) service users may be accommodated between the age of 50 years and 65 years. 2nd August 2006 Date of last inspection Brief Description of the Service: This service is a nursing home for older people and for those with mental health difficulties. There are 55 individual rooms 54 of which are en suite. The service is offered on two floors that are divided into group living facilities. The home is within large grounds and service users have access to a garden, which is landscaped to meet resident’s needs. Fees at the home range from £850 - £1600 per week and service users are responsible for paying for their own toiletries, hairdressing, chiropody and items of a personal or luxury nature. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. Evidence for this key unannounced inspection was gathered from the following sources: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Seven surveys returned to us by the relatives of people using the service and three from staff members. The previous key inspection which took place in August 2006 and a thematic inspection which took place in October 2007. A thematic inspection is a short, focused inspection that looks in detail at a specific theme. This inspection looked at the quality of care people with dementia experience when living in care homes, focussing on ‘dignity’ as an important part of people’s quality of life. A visit to the home on 12 March 2008, which lasted for 6 hours. The needs of the majority of service users are such that they were unable to contribute verbally to the inspection process. Time was therefore spent in their company and by observing interactions between them and staff in the commmunal areas. One service user gave their views about the service as did seven staff and four visitors. All communal areas and some bedrooms were seen. Time was spent with the manager and some administrative records were viewed. What the service does well: When asked this question the following comments were made: “South Africa Lodge provides a pleasant, relaxed and safe environment for service users and gives excellent support for service users, relatives as well as staff” South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 6 “The nursing care and management of South Africa Lodge is of the highest standard” “The care is not merely kind, frankly the word is loving” “The home is clean, the food is good and it is a nice environment to work in The equipment is well maintained. Training is regular in all areas” These comments were representative of peoples’ views in general. South Africa Lodge has a track record of providing good quality care and continues to do so. Record keeping is detailed and accurate and this helps to ensure that staff provide the right amount of support and care to individual service users. Routines and activities reflect service users wishes and interests and ensure that people can continue to make choices in their lives. There is a good atmosphere in the home and staff have a friendly and respectful relationship with service users. The home is well managed and the manager is supported by a knowledgeable and committed staff team. A particular strength of the home is the high level of quality assurance that is undertaken. This means that staff are continuously reviewing and evaluating the practices and policies that inform the care that is given and it helps to ensure that people’s different and changing needs and wishes are at the heart of the service. What has improved since the last inspection? Care plans have been further developed and are now more personalised. Plans also include a detailed consideration of the persons’ mental capacity. This helps to ensure that people make as many decisions and choices for as long as possible. The service has liaised with a dietician to look into the nutritional status of service users. Air conditioning has been installed in clinic rooms to regulate the temperature where medicines are stored. The garden has been redeveloped and more sensory equipment has been purchased. The nurse call system has been replaced with a pager system to reduce noise levels. Staff have undertaken further training for example; nurses have completed syringe driver training and Liverpool pathway training and all care staff have undertaken training in infection control. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 7 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. South Africa Lodge Nursing Home DS0000011473.V361179.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 South Africa Lodge Nursing Home DS0000011473.V361179.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): 3 Quality in this outcome area is good. Admissions are not made to the home until a full assessment of the needs of the person has been completed. This helps to ensure that the service can provide the appropriate level of care and support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The quality in this area was judged to be good at the last key inspection. The annual quality assurance assessment says that all service users, prior to admission to the home, have a full needs assessment carried out by qualified staff. From the initial assessment a comprehensive care plan is developed. When available, copies of assessments which have been carried out through other care management arrangements are obtained. In addition care plan information may be sourced from other professional bodies i.e. speech therapy or dieticians. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 10 An initial temporary care plan is also used prior to placement and upon return from hospital to ensure continuity of care when there has been a sudden change in needs. The files of two service users who had been admitted since the last inspection were viewed during the visit. Both contained detailed information, which had been obtained before they moved to South Africa Lodge. This covered all aspects of their care, medical and social needs. One person who had been admitted through care management arrangements also had an assessment on file that had been made by a health care professional before they had moved in. The information provided in the AQAA was therefore found to be accurate. Seven relatives who completed surveys on behalf of service users were asked “Did you receive enough information about this home before you moved in so you could decide if it was the right place for you”. All said “yes”. Comments included: “ I was taken round” “I saw the set up and received full handouts” “was given enough information and had a talk with the matron on all aspects of the home” Intermediate care is not provided. South Africa Lodge Nursing Home DS0000011473.V361179.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 Care plans are clear, accurate and person centred. This helps staff to respond effectively to each individuals need. Service users rights to privacy and dignity are always observed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The quality in this area was found to be good at the last key inspection in August 2006. A requirement was made however at that time that care plans must be amended to provide clear information to staff so that they have all the information they need to give the right support for service users. The report from the thematic inspection of October 2007 also commented that care plans were very general, pre typed and offered no personalisation. Evidence found on this occasion shows that there have been a number of improvements made to the care planning processes. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 12 The AQAA states that “All patients have a care plan which is person centred generated from the needs assessment. Care plans are reviewed monthly by a key nurse to the service user. Where patients have the proven mental capacity to contribute towards the care plan they are encouraged to do so Family are invited annually to contribute to the formal process of care planning and in the interim as and when required” Care plans seen on the day of the visit reflected what had been said in the AQAA. Plans were clear, up to date and had been signed by the service user to indicate their agreement where this was possible. Information about service users needs and wishes were included with picture prompts and focussed on strengths and decisions the person concerned was able to make, for example it was identified that one person likes to choose and buy their own clothes. Staff surveyed were asked “are you given up to date information about the needs of people you support or care for” All replied “always” and this was endorsed by staff spoken with during the visit. Relatives surveyed and spoken with were all positive about the service and mainly described the care provided as “excellent” One visitor said that their relative had improved since coming to South Africa Lodge –they could eat by themselves and their mobility had increased. They attributed these improvements to staff giving him time and stimulation. Records show that there are a number of assessment tools which are used by the home to monitor peoples’ health and wellbeing. These include Waterlow Score, Bartel, JADS screening tool for falls Nutritional Screening, pain assessment, and Moving and Handling assessments. These are reviewed every month. Records also contained clear information about peoples’ medical conditions, for example there was information available about schizophrenia and guidance for staff on how to respond appropriately to a service users anxieties. Records showed that appointments are kept to see specialist health care professionals for example, opticians and dentists. Staff said that a GP visits routinely twice a week and a psychiatrist also visits every week. The manager said that since the last inspection the service has developed a pressure sores policy and procedure and has increased its provision of tissue viability equipment e.g. seat cushions, and air boots. There are procedures in place for the safe management of medicines. The manager said that no current service users have mental capacity to administer their own medication although a policy is in place if this is required. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 13 Records of medications checked were properly completed and senior staff confirmed that they are audited by senior nurse to ensure accuracy. The AQAA lists areas of improvement over the last twelve months regarding improvement in medication systems. These include that medication has been reviewed to see how easy people find it to swallow tablets; some has changed to liquid as a result. Also air conditioning has been installed in clinic rooms to achieve appropriate room temperatures for storage of medications. Records seen and observations made during the visit substantiated this. The annual quality assurance assessment states that: Each person has their own bedroom and toilet facilities (apart from one room) Shifts are staffed to ensure that a balance of male and female carers are on duty to meet preferences when delivering personal care. Staff ensure that personal care is delivered in private and at a time and place that is agreeable to person receiving care. Staff are trained to ensure that they have skills and knowledge to address the privacy and dignity of service users Service users are addressed by their preferred names. During the thematic inspection the following was noted “The inspector observed good examples where staff upheld people’s individuality and supported their uniqueness. The staff were observed to interact with the residents with no one being left for long periods. Support was given after asking the individual if they wanted it. People were heard to be addressed by the name they wished that was recorded on their care plans.” This was still observed to be the case during the most recent visit to the service. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 14 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 excellent Great attention is paid to ensure that service users are given as much choice as possible in their daily lives and that the social activities provided match their interests. Visitors are made very welcome. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous key inspection commended the range of activities provided by the service. The home continues to employ an activity co coordinator during the week, who plans and implements a number of individual and group activities throughout the home. She spoke very enthusiastically about her role and was observed leading a music session in which staff, service users and visitors were all encouraged to participate. Other activities include arts and crafts, baking, gardening, bowls, skittles, music and movement, board games, discussions, quizzes, reminiscence, bingo and a PAT dog. One visitor said that there were ““very good informative newsletters and details of events that are due to take place.” The manager said that Church of England services are held monthly and communion for Roman Catholics is held weekly. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 15 People’s birthdays are celebrated. On the day of the visit staff had decorated a service users room and had provided flowers to mark his wedding anniversary. Staff had also prepared a special meal, which he and his wife enjoyed in private. Sensory resources are available for people with cognitive impairment. There are also a number of opportunities to stimulate people through reminiscence, for example a seaside area has been developed in the garden. The manager said that visitors are encouraged to visit any time. There are no restrictions in place although visitors are encouraged to leave by 22:00. Visitors spoken with all felt that they were made very welcome – one representative comment was “I always get a smile and am asked how I am when I come in” There are leaflets available in the foyer about advocacy services and giving advice about making decisions. Rooms seen were furnished and decorated with service users possessions Choice was integral to care plans seen. The manager said that people are able to access all communal areas of the home and all areas of the garden, which is safely enclosed. Service users are provided with a key to their rooms unless an assessment suggests that they are not able to make use of this. Relatives commented “Most decisions are made for “x” but are done in such a way that she will be told what is intended and confirmed with her “My sister has no restrictions.and is given an escort if she wants to go out” “Despite the fact that the loved one is in care, I feel in charge whilst I am there and can meet her wishes” A varied monthly menu is available, providing people with a choice of meal. The menu is colourfully presented and displayed in each area of the home. The Menu also reinforces the day month and season. Each area of the home has its own kitchenette to ensure that refreshments can be made easily. The manager said that mealtimes are given high priority to ensure that they are calm unhurried and social. (This was observed to be the case during the visit). It was also observed that there were sufficient staff on duty to provide people with the support that they needed at mealtimes. Pureed meals are the same as those on the menu and are presented in compartmental dishes. The compartmental dishes are a recent improvement made following advice from a dietician. The service conducts regular surveys regarding food provided and ten surveys were seen. Relatives had completed these in November 2007 and the results were positive. People were asked what were the most popular and South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 16 least popular menus were and were also asked for any suggestions on ways to improve meals or mealtimes. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 17 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 There is an effective complaints procedure in place and staff understand how to protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This area was judged to be good at the previous key inspection. There is information about how to make a complaint in the service users guide and the procedure is also on display in the foyer. Surveys showed that people know how to make a complaint and are confident that any concern would be listened to and acted upon. Comments made included “All the staff from the matron to the carers are constantly available to discuss any problem … Any discussion is always welcome” “There is an excellent line of communication and as most residents are unable to speak easily the relatives are always advised and encouraged to ask about any concerns we may have about anything.” Records of complaints seen showed that they had been responded to quickly and effectively, following the procedure. Policies and procedures are in place to ensure that service users are protected from abuse. These include a whistle South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 18 blowing policy that advises staff on how to report concerns. The manager said that adult protection is covered as part of staff induction training and staff confirmed this. Records show that training in protection is ongoing, and staff are given training in how to manage challenging behaviour as well as in adult protection. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 19 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 excellent The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable, well maintained and reflects the individuality of the people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The quality in this area was judged to be good at the last key inspection Relatives surveyed rated the overall environment and atmosphere of the home as excellent. Staff and visitors spoken with on the day of the visit echoed this view. One relative said, “The home is similar to hotel accommodation, clean well decorated with good furniture. The manager said that South Africa lodge employs a full time maintenance person and there is a programme for routine maintenance and renewal of the home. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 20 Since the last inspection the call system has been upgraded to a pager system to reduce noise levels. This has been done in response to comments made in the homes quality assurance processes. Records seen showed that the service had a food hygiene inspection in February 2007 and a fire service inspection in December 2007.The manager confirmed that any recommendations made had been followed. Everybody asked said that the home was kept clean and tidy and free from odour. Some comments were made as follows: “The cleaners are very good” “ Carpet cleaning is a ritual and it clearly works well” “Excellent standards of cleanliness whatever time of day I visit” Records show that all staff have undergone infection control training in accordance with new NHS Infection Control guidelines.2007. There are sluicing facilities in the home, although the manager said that these are not often used as service users are encouraged and supported by staff to use the toilet facilities for as long as possible. . The laundry was seen to be suitable for purpose and domestic staff spoken with were enthusiastic about their jobs and were clearly motivated to provide a very good service. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 21 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 The home has mix of staff that has a range of skills and there are sufficient numbers of staff on duty to meet the needs of service users. The homes recruitment policy and practice supports and protects service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Quality in this area was judged to be good at the last key inspection. The annual quality assurance assessment says the following about the staff complement “The staff rota reflects that the staffing numbers are maintained through the year and the home never operates with shortfalls in nursing care catering laundry cleaning or maintenance Staff are always willing to cover shifts when required. In the event of unforeseen circumstances the home works closely with 2 nursing agencies who provide staff who are familiar with the home and service users to provide continuity of care” All staff spoken with during the visit said that there were enough staff on duty at all times to support service users properly. One staff member described South Africa Lodge as ”a joy to work in” and said that they had plenty of time South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 22 to talk and interact with service users. Other staff said, “There is plentiful staffing to provide person centred care” “I couldn’t work with a better team of people” Visitors surveyed said that staff were helpful and described them as “brilliant” and “wonderful” 35 staff surveyed as part of the homes own quality assurance processes mainly described their knowledge and understanding of their role as “excellent”, with a few describing it as “good”. Staff spoken with and those surveyed, confirmed that they have a job description and a specification, which clearly defines their role and responsibilities. Staff that completed the CSCI survey all confirmed that recruitment checks such as CRB and references were made before they started work Two records of recent employees were checked during the visit, these included two satisfactory written references and completed CRB checks. One recently employed member of staff said that they had had a thorough induction training programme and that they had shadowed experienced staff for the first two weeks. The manager said that all new staff complete induction workbooks. One of these was seen and it included training in understanding principles of care, protection, safety at work and communication. Staff surveyed felt that they were provided with enough training to fulfil their role. Comments included: “Training sessions and study days are always available to staff to assist with carrying out their duties” “We are given formal and informal training and a continuous update so as to be able to meet a high standard of care” Training records were seen and included moving and handling and fire safety, some staff had also completed food hygiene, first aid at work, dementia care, adult protection, challenging behaviour and in the use of syringe drivers. The manager said that the home has developed links with a local college to provide in house National Vocational Qualification (NVQ) training. Currently 32 staff have obtained an NVQ level 2 or above in care and 5 staff are currently undertaking this award. In addition the home employs 11 nurses who have an RGN or RMN qualification. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 23 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 home is very well managed in the best interest of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Quality in this area was good at the last inspection. The Registered manager is an experienced dual registered nurse RGN/RNM and holds the Registered Managers award. She has also considerable teaching experience and qualifications in health and social care. All staff spoken with felt that the manager was very good. One person said for example “she has the service users best interests at heart” another said ““she is very supportive in all aspects.” and another commented ““the manager South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 24 makes sure that she keeps clear and understandable policies and procedures for all the staff to read” The home has a quality assurance system which ensures that all aspects of the homes management is systematically reviewed Records seen confirmed that relatives are surveyed twice a year. Newsletters provide staff, service users and relatives with updates about the home. The annual quality assurance assessment was completed in an informative and accurate way and demonstrated clearly where the service hopes to develop. The provider visits unannounced once a month to talk with service users and staff and to inspect the premises and records. This visit was taking place on the day of the visit by CSCI. In 2006, the home achieved the Investors in People Award. The service acts as appointee for two people. Both have their own bank accounts and individual records of financial transactions are kept. One was seen and was accurate. The manager said that these records are checked every two months. The annual quality assurance assessment shows that policies and procedures relating to health and safety matters are in place and have been reviewed and updated in November 2007. These include; fire safety, first aid, hygiene and food safety, health and safety and control of substances hazardous to health (COSHH). Records also show that gas appliances, fire detection and fighting equipment, lifts and hoists and emergency call equipment have all been serviced or tested since September 2007. The manager said that the handyman is now able to test portable electrical equipment and has recently done so. Records showed that accident reports were completed where necessary. South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 25 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 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 4 X 4 X 3 X X 3 South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 26 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 South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 27 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. Extracts may not be used or reproduced without the express permission of CSCI South Africa Lodge Nursing Home DS0000011473.V361179.R01.S.doc Version 5.2 Page 28 - 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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