Care Home: Stokeleigh Lodge

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What the care home does well We spoke with a number of individuals living in the home and they told us that staff were all "very good" "friendly". One individual told us that staff "think about you as individuals, consider your needs" and how they were able to make choices about their daily lives "beauty of the place we have choice". We found that individuals felt staff treated them with respect and those we spoke with all said that they never felt staff spoke them in a way which was patronising or belittling. We asked about the activities in the home and individuals told us "we are never bored" "always enough to do". It was evident that the home provides a warm and homely environment which is welcoming to relatives and other visitors. This was confirmed by a relative we spoke with who told us "can`t fault the home, very family friendly" "never been unhappy about anything". The manager since her appointment has started to review documentation such as care plans and introduced a new format this is providing a greater degree of detail and information about health and social care needs of individuals. We discussed with the manager the need to introduce risk and nutritional assessments. Communication has improved through the introduction of a communication book and this is an area the manager is continuing to look at for improvement. What the care home could do better: We have identified a number of areas which need to be improved so that individuals are fully protected and staff behave in a manner which is not seen or is abusive. We have made a requirement about staff receiving updated training around Safeguarding and Abuse in that this will raise the awareness of staff. We are also requesting the manager look at the performance of the member of staff who has been named in the recent allegation and actions should be taken under the homes disciplinary procedure. With regard to communication we believe the improvements made by the manager will improve this area of practice however we have requested the home review the management, roles and responsibilities of individuals in the home. This would we believe lead to clarification of duties and responsibilities and improve staff communication. With regard to medication arrangements in the home we have made a requirement that there must be clear protocols and procedures around the administering of medication. Further that staff must receive updated training to improve knowledge and confidence in this area of their work. We note that some of these areas are being addressed by the home. To further improve communication and clarification we have made a requirement that the manager reviews policies and procedures so that staff are fully informed particularly Safeguarding, Drinking Alcohol on Duty, and Whistle Blowing. With reference to the staff member who had not at time of our visit had returned CRB there must be robust arrangements so that individuals are not employed in the home without the required induction and training and importantly have the communication skills required when working with older people. Any employment of such individuals must be supernumerary to roted care staff and not be providing personal care unless supervised. Random inspection report Care homes for older people Name: Address: Stokeleigh Lodge Stokeleigh Lodge 3 Downs Park West Westbury Park Bristol BS6 7QQ two star good service 10/11/2008 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: John Clarke Date: 0 4 0 3 2 0 1 0 Information about the care home Name of care home: Address: Stokeleigh Lodge Stokeleigh Lodge 3 Downs Park West Westbury Park Bristol BS6 7QQ 01179624065 01179624065 dawnsherwood22@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lyn R Farrall-Miles Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 17 Number of places (if applicable): Under 65 Over 65 17 old age, not falling within any other category Conditions of registration: 0 May accommodate 17 persons aged 65 years and over requiring personal care Date of last inspection Brief description of the care home Stokeleigh Lodge is a large semi detached house which has been extended and adapted over the years to provide accommodation for older people. The home can be found in Bristol close to Durdham Downs which has extensive facilities to offer. There are a number of bedrooms each vary in size; some bedrooms have en-suite toilet facilities. All the rooms are accessible via a stair lift. The main objective of the home is to have strong commitment and dedication towards Care Homes for Older People Page 2 of 10 1 0 1 1 2 0 0 8 Brief description of the care home residents in all aspects of their well-being and to make changes according to feedback from residents. The staff team provide care on a 24 hour basis which includes 1 wakein and 1 sleep in member of staff. The home can be found to have access to Cribbs Causeway, Clifton, Westbury and its surrounding neighbourhood such as Henleaze and Redland for example. A small community exist in the area of Westbuy which consists of church groups, local shops and supermarkets, Bristol Zoo can also be found close by. The fees charged are based on individual assessments of £375.00-£535.00 per week. Items not covered by the fees are: chiropody, hairdressing, daily newspapers and the dental hygenist. Care Homes for Older People Page 3 of 10 What we found: This visit was undertaken as a result of anonymous Safeguarding concerns which had been received. They related to a specific individual who is now deceased and staff practice around the administering of medication. There was an allegation about the behaviour of a staff member which if substantiated would be seen as abusive. A further concern was the employment of a staff member for whom a Criminal Record Bureau had not been received and their suitability to work in the home. Finally a concern expressed to us was the practice of staff around drinking on duty. With regard to the medication and instructions being given we found that whilst these had been given staff were still unclear about the level of medication to be given. In part this was because they did not feel confident about the administering of medication. Further that when they sought advice they again were not confident it was correct. However records showed that medication had been given which was appropriate to that individual and as prescribed. We were unable to substantiate whether an incident had occurred which amounted to abuse though we understood from speaking with staff that they were concerned about what had happened. We also established through talking with a number of staff that they were unhappy about the approach of a member of staff. This approach led to low morale and we believe impacted on the quality of care provided in the home from what are a committed staff group. From examining records we found that there was little available to evidence discussion with senior staff around instructions relating to the care individuals needed to meet their identified needs. Records generally were not adequate in providing details of care provided. However there have been changes related to communication and written records following the recruitment of a new manager. We looked at staffing records particularly relating to the training of staff. We found that whilst staff had received training about Safeguarding this was some time ago. In talking with staff about their understanding of what amounted to abuse there was varying levels of understanding and knowledge. Again staff had received medication training but for some this was up to 4 years ago. We asked staff what their understanding was about the homes policy about drinking whilst on duty other then one staff member individuals were very clear that it was not accepted behaviour. It is also noted that there has been an occasion when a staff member was sent home because of being intoxicated and was subsequently dismissed. The owner and manager of the home co-operated fully with information and discussion about the allegations made to us. They confirmed a staff member was employed without a CRB and that this member of staff was also working on shifts where there was only one other care worker on duty. This we believe was not acceptable and placed pressure on the sole care worker and placed the individual in position where they were liable to be unsupervised to a safe extent and provide and respond to requests for assistance with personal care. During our visit we were informed that further allegations relating a staff members behaviour had been made. Following discussion with the owner and with their agreement the manager is currently investigating these allegation under Safeguarding procedures and the local authority Safeguarding team has been informed. We advised the manager about Safeguarding procedures and policies it is our understanding that currently there is no policy in the home regarding responding to Safeguarding concerns. Staff were also unclear or fully aware of the home having a Whistle Blowing policy. Care Homes for Older People Page 4 of 10 What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 5 of 10 Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 9 13 The registered person shall 28/05/2010 make arrangements for the recording, handling, safekeeping, safe administering of medicines in the home. This refers to having clear instructions and protocols around the administering of medication and staff receiving training so that are competent and confident to perform this task namely management or administering of medication. 2 30 13 The manager shall make 28/05/2010 arrangements, by training staff to prevent service users being harmed or suffering abuse or place at risk of harm or abuse. The relates to the need to improve the awareness and knowledge of all staff about Safeguarding and protecting individuals from abuse. 3 32 12 The registered provider and 28/05/2010 Page 8 of 10 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 manager shall in relation to the conduct of the care home encourage and assist staff to maintain good personal and professional relationships with service users. This relates to having in place robust procedures to manage staff performance and address poor or concerning performance and maintain record and evidence of actions taken. 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 2 32 32 To review management arrangements, roles and responsibilities of staff in the home. To review policies and procedure specifically Safeguarding, Whistle Blowing, Drink On Duty and ensuring staff are made aware of these procedures and expectations with regard to professional practice. Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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