Care Home: Stockton Lodge Care Home

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What the care home does well Stockton Lodge provides a good standard of care for the people who live in the home. The home is decorated to a good standard and is well maintained .People spoken with were complimentary about the level of care received. Comments included, `Provides a safe and pleasant place to reside. Every need is catered for and staff are friendly and very polite`. `Stockton Lodge has always shown care, consideration and genuine concern for my relative`. `I am certainly happy with the care and help my relative receives from a truly dedicated staff`. `I and other members of my family feel sure that our relative is receiving excellent care and attention to physical, mental and social needs. `Staff are very friendly and quite caring, they look after me well`. `The staff here have been a tower of strength to me and have supported me through a very difficult time`. People were in the main satisfied with the level of activities and all said that the food was good. What has improved since the last inspection? The last inspection report contained three requirements and four recommendations. Although there was evidence to confirm that the complaints procedure had been discussed, some people still indicated that they did not know how to make a complaint. A new shower chair has been purchased to replace the one which could not be used as it had rubber bungs missing. Staffing levels are kept under constant review to make sure that they are in sufficient numbers to meet the changing dependency needs of all of the people who live in the home. Most of the people spoken with felt that there is normally sufficient staff on duty. The manager confirmed that there is always sufficient and appropriate protective clothing available for staff to use. This is to reduce the risk of cross infection. Staff now receive fire training at appropriate intervals. A new manager has been appointed since the last inspection. Therefore the previous requirement and recommendation about the mangement arrangements are no longer applicable. What the care home could do better: Handwritten entries and changes to MAR charts should be accurately recorded and detailed.This makes sure that the correct information is recorded so a person receives their medication as prescribed. Medication must be given as prescribed and a record must be made at the time that it is given. Applications of creams should also be recorded. This will make sure that people receive their medications correctly and the treatment of their medical condition is not affected. It was noted on the day of inspection that the menu on display did not correspond withwhat was being served. Where it is necessary to change the menu, written details of this should be available. The manager should confirm at meetings that all of the people who live in the home know the process to follow should they wish to make a complaint. The manager must apply to the CQC to be the Registered Manager of Stockton Lodge. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Stockton Lodge Care Home Harrowgate Lane Stockton-on-Tees TS19 8HD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Susan Lowther     Date: 2 6 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Stockton Lodge Care Home Harrowgate Lane Stockton-on-Tees TS19 8HD 01642617335 01642617323 stocktonlodge@highfield-care.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross Home Properties Limited care home 48 Number of places (if applicable): Under 65 Over 65 48 0 old age, not falling within any other category physical disability Additional conditions: 0 48 The maximum number of service users who can be accommodated is: 48 The registered person may provide the following category of service only: Care with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 48 Physical disability - Code PD, maximum number of places: 48 Date of last inspection Brief description of the care home Stockton Lodge Nursing Home is a purpose built facility providing personal and nursing care to 48 older people. The home is owned as part of the Southern Cross group. Stockton Lodge is a single storey facility with 4 lounges, a dining room and appropriate toilet and bathing facilities. 46 bedrooms are single all with en-suite facilities comprising of a WC and hand basin. There is one double bedroom which is also ensuite. Externally there is a pleasant courtyard where service users and their families can sit and enjoy the wide range of plants and flowers. Care Homes for Older People Page 4 of 26 Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection of this home took place on the 26th May 2009. Records were examined and a tour of the building took place. Time was spent talking to staff, the people who live in the home and their relatives. A pharmacy inspector also visited and inspected Standard 9, which is about medications. The manager supplied some written information to the CSCI before the inspection. The inspection focused on key standard outcomes for people who live in the home and Care Homes for Older People Page 6 of 26 to check whether requirements from the previous report had been met. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The fees charged at the time of this inspection were between 382 pounds and 537 pounds and 70 pence weekly. This does not include the cost of hairdressing, chiropody, newspapers and personal toiletries. What the care home does well: What has improved since the last inspection? What they could do better: Handwritten entries and changes to MAR charts should be accurately recorded and detailed.This makes sure that the correct information is recorded so a person receives their medication as prescribed. Medication must be given as prescribed and a record must be made at the time that it is given. Applications of creams should also be recorded. This will make sure that people receive their medications correctly and the treatment of their medical condition is not affected. It was noted on the day of inspection that the menu on display did not correspond with Care Homes for Older People Page 8 of 26 what was being served. Where it is necessary to change the menu, written details of this should be available. The manager should confirm at meetings that all of the people who live in the home know the process to follow should they wish to make a complaint. The manager must apply to the CQC to be the Registered Manager of Stockton Lodge. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient information is available for people to decide whether they would like to live in the home. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. Evidence: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is usually the manager. This is to make sure that the home can meet the care needs of the people who go to live there. The manager said that she is currently developing the assessments further. This is to include more information about preferences with regard to how individual people wish to be cared for at night. All of the people who responded to the survey said that they had received enough information about the home before they went to live there. People spoken with during Care Homes for Older People Page 11 of 26 Evidence: the inspection confirmed that they had been invited to look around the home prior to going to live in the home and had been provided with a Service User Guide. The home does not admit people for intermediate care therefore assessment of standard 6 is not required. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good systems are in place to ensure that health care needs of the people who live in the home are met. Evidence: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Three were examined during the inspection. These were comprehensive and contained individual plans of care. This is to make sure that staff meet all of the needs of the people who live in the home. People spoken to during the inspection and those who returned surveys confirmed that that they are happy with the care received and the level of information given. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Care Homes for Older People Page 13 of 26 Evidence: A pharmacy inspector carried out the medication assessment during the course of this inspection. Her comments are included as follows. Examination of the medication administration records (MAR) charts and medicine storage and handling procedures indicate that medicines are given safely and correctly Medication administration was for the nursing and residential unit was observed to be in accordance with recommended guidance. There is a good, detailed policy in the home covering all aspects of medicine management. This means staff have access to up to date information on legal requirement and guidance. A record of medication received into the home was kept and a stock destruction record book was in use. Copies of prescriptions were kept. The cupboard used to store controlled drugs appears to meet regulations. Records were kept in a bound book and they were neat. All stock balanced. There was a well organised medicine room and trolley with a good record of fridge and room temperatures. The record of staff authorised to administer medicines is up to date. This makes it possible to identify who might be involved if a problem or error was to occur. The home had a good record of when required medication and instruction for use in the MAR chart folder. Photocopies of the anticoagulant record page was kept alongside the MAR chart for people taking warfarin. The MAR charts contained clear records of medicines received and given. There were very few gaps and most medicines audited on the day balanced with the stock available in the home. Further improvements could be made with the administration records for creams, and handwritten entries to the MAR chart were sometimes difficult to read. People spoken to said that staff always treat them with dignity and respect. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The activities are varied and provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and people are given a choice. Evidence: Most of the people said that activities are suitable. The activities organiser spends time with people on an individual basis to find out what activities they would like to do. One to one activities take place during the morning and group activities in the afternoon. Regular activities include card and board games, bingo, and arts and crafts. Outside entertainers visit on a regular basis and a church service is held once per month. People are also taken out. Relatives said that they could visit at any time and that they are always made welcome. People said that they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a shower or bath. Care Homes for Older People Page 15 of 26 Evidence: The lunch looked nice. Staff who were helping people were doing this in a discreet and dignified manner. Evidence was seen in care plans to confirm that nutritional needs are assessed and other professionals consulted if required. However on the day of the inspection the menu displayed did not correspond with what was being served. Where it is necessary to change the menu, details of this should be available. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the Service Users Guide. There have been nine complaints recorded since the last inspection. Evidence was seen within the home to confirm that the appropriate authorities had been consulted and that the complaints had been dealt with appropriately. Some of the people who returned surveys indicated that they did not know how to make a complaint. It was a recommendation in the last report that the procedure be discussed at meetings to make sure people know the process to follow. This was discussed with the new manager during the inspection and she agreed to put this in place. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. Care Homes for Older People Page 17 of 26 Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. Evidence: During a tour of the building the inspector saw that many of the rooms are decorated to the persons own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. A good standard of decor and furniture is provided throughout the home. There was a range of equipment seen around the home to support people with bathing and mobility. The last inspection report contained a recommendation about one shower chair which did not have appropriate rubber bungs fitted. The manager confirmed that a new chair has been purchased. The inspector found the building to be clean, tidy and free from offensive odours. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. Most of the people spoken with confirmed that there are sufficient staff available and that they respond quickly. One person did feel that they sometimes have to wait longer that they would have wished. The manager said that she keeps staffing levels under constant review as recommended in the last report. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with most of the staff having an NVQ at level 2 or above. Recent training has taken place in fire safety, adult protection and health and safety. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Care Homes for Older People Page 20 of 26 Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: Since the last inspection a new manager has been appointed. She has previously been the registered manager of another care home and was considered to have the appropriate skills, experience and qualifications. She must now apply to the CQC to be the registered manager of Stockton Lodge. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to her if they had any concerns. Staff also confirmed this to be the case. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. Staff confirmed that supervision takes place on a Care Homes for Older People Page 22 of 26 Evidence: regular basis and that they are well supported. Regular meetings are held and there are a number of systems in place to consult with people living at the home. Relatives and the people who live in the home can approach the staff at any time. The manager carries out regular audits covering all environmental and care aspects which may result in improvements being made. An operations manager also visits on a monthly basis to undertake a audit. During this visit the findings of the audits by the manager are considered. Personal finances are kept in the home for people who request this. Signatures are obtained and receipts are kept to ensure peoples financial interests are safeguarded. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 31 9 The manager must apply to be registered with the CQC. To comply with the regulations. 30/10/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 Handwritten entries and changes to MAR charts should be accurately recorded and detailed.This makes sure that the correct information is recorded so a person receives their medication as prescribed Medication must be given as prescribed and a record must be made at the time that it is given. Applications of creams should also be recorded. This will make sure that people receive their medications correctly and the treatment of their medical condition is not affected. Where it is necessary to change the menu, written details of this should be available. The manager should confirm at meetings that all of the people who live in the home know the process to follow should they wish to make a complaint. 2 9 3 4 15 16 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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