Care Home: Teesdale Lodge Nursing Home

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What the care home does well A good standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. Comments received were very positive about the care. People living at the home were comfortable and well cared for and all of them said that the food was good. The environment was nicely decorated and well maintained. Staff were motivated and enthusiastic about their work. One member of staff said, `Almost everyone who works here has the same goal which is to ensure the safety and care of all residents and cooperate fully with other members of staff`. Another said, `We provide a comfortable, clean and safe environment for our residents. Carers work extremely hard to the benefit of the residents`. One health care professional who returned a survey felt that the home is particuarly good at communication at all levels. Between staff and healthcare professionals, staff and residents, staff and visitors and between staff themselves. Another comment on the survey about what the service does well was `Caring for individual residents with compassion and allowing them privacy and dignity`. What has improved since the last inspection? The staff now consult with people about activities, entertainment and outings. Most of the people said they are now suitable. A new activities co ordinator is to commence working at the home in the near future. Over 50% of care staff are now trained to NVQ Level 2 or above in Care. This meets the National Minimum Standards. What the care home could do better: Care plans must have the actual date of evaluation identified. This is to demonstrate that they have been updated immediately where a need has changed. The tool used to identify the risk of someone developing a pressure sore has changed recently. In one of the records seen both tools were referred to. This could lead to confusion for staff. Reference should only be made to the actual tool used. Where medication is handwritten on the Medication Administration Record, these must be signed by two members of staff to confirm accuracy. The manager and administrator carry out a regular audit with regard to personal finances. However it is recommended that a second audit is carried out by another person who is not dealing with the money on a regular basis. This is to make sure that people are safeguarded. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Teesdale Lodge Nursing Home Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS     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: 0 5 0 2 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: Teesdale Lodge Nursing Home Radcliffe Crescent Thornaby Stockton-on-Tees TS17 6BS 01642-612821 01642612436 teesdalelodge@ukonline.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cleveden Care Limited Name of registered manager (if applicable) Susan Wyer Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Five named individuals who are under the age category are allowed to reside in the home. The home are able to admit a maximum number of 10 service users with a physical disability aged 50 and above. Date of last inspection Brief description of the care home Teesdale Lodge is registered to provide personal and nursing care to forty-four residents aged sixty-five and above. The home has a variation to registration that allows them to admit a maximum number of ten residents aged fifty and above within the forty-four registered beds. Teesdale Lodge is a single storey, purpose built facility providing accommodation to residents in the form of forty-four single bedrooms. All bedrooms have ensuite facilities, which comprise of a toilet and hand washbasin, all bedrooms meet the Care Homes for Older People Page 4 of 26 care home 44 Over 65 44 0 Brief description of the care home required amount of space. The home provides three lounge areas and a separate dining room. Each bedroom has television and telephone points, however pay phone access is available. The home is set in accessible grounds and provides car-parking facilities for visitors to the home. 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 5th February 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. The manager supplied some written information to the CSCI before the inspection. The inspection focussed on key standard outcomes for people who live in the home and to check whether requirements from the previous report had been met. Care Homes for Older People Page 6 of 26 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 was 420 pounds per week plus the free nursing component. This does not include the cost of chiropody, hairdressing and personal toiletries. What the care home does well: What has improved since the last inspection? 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 4. Care Homes for Older People Page 8 of 26 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. Assessment procedures are in place to ensure that the home can meet the needs of the people who 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 family of one person who had recently gone to live in the home confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. The five people who returned surveys all indicated that they had received sufficient information. One said, My family chose this home. They were given all the information needed from Matron before deciding to choose this home. Care Homes for Older People Page 11 of 26 Evidence: 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. Peoples health care needs are well managed by the home. Systems to administer medication are safe and people living at the home say that they are treated well and that the standard of care is good. 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. Four were examined during the inspection. These contained individual plans of care which included quite a lot of detail. However although care plans were evaluated monthly some did not have the actual date of evaluation identified. Therefore it was difficult to assess whether care plans were updated immediately where a need had changed. In addition the tool used for assessing the risk of someone developing a pressure sore has changed recently. In one of the records seen both tools were referred to. This could lead to confusion for staff. People spoken to during the inspection said that they are happy with the care received Care Homes for Older People Page 13 of 26 Evidence: and the level of information given. One person said, The staff here are lovely and try to do everything I ask. Four of the people who returned surveys indicated that they always get the care and support they need. One health care professional who returned a survey said, The nursing staff provide an excellent service for the individuals in their care. I have observed this in all areas including medical, nursing and social care. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Medication is administered by appropriately trained staff. The home has a comprehensive medication policy. Accurate records of all medicines received, administered and those leaving the home are maintained. However where medication is handwritten on the Medication Administration Record, these are must be signed by two members of staff to confirm accuracy. 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 most of the people who live in the home. Family and friends can visit 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 and that they have improved recently. The last inspection report recommended that they be developed further. The manager said activities organiser was due to commence soon. Staff said that they spend time with people on an individual basis to find out what activities they would like to do. Regular activities include arts and crafts, bingo, dominoes and card games. Outside entertainers visit on a regular basis and a church service is held once per month. People are also taken out. Recent excursions have include visits to shops, museums and pubs. 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. One person said, The meals are good and you get a choice. Another said, The food is good, you get too much sometimes. 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 two complaints recorded since the last inspection. These were investigated by the home. Staff spoken to confirmed that they now know how to assist people to complain if they are unhappy. All of the people who returned surveys and those spoken with on the inspection confirmed that they know how to make a complaint. 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 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 high 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 inspector found the building to be clean, tidy and free from offensive odours. Care Homes for Older People Page 18 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. The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the people who currently live in the home. Training is provided for all staff. 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. People said that staff were usually around and answered the call bells quickly. One person said, The staff come quickly when I need them. 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.Over 50 now have an NVQ at level 2 or above. This was highlighted in the last inspection report. Recent training has taken place in fire, moving and handling, first aid, food hygiene, infection control and dementia awareness. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments included There is always plenty of training going on and you can ask for additional Care Homes for Older People Page 19 of 26 Evidence: training if you want to. Another said, I have regular supervision with the manager and can discuss my training needs or any other concerns in private. Care Homes for Older People Page 20 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. The manager provides clear leadership, support and guidance to those living and working at the home. Evidence: The manager is a qualified nurse. Since the last inspection she has completed an appropriate management course, which was a requirement in the last report. There was an open and friendly culture between the management team and staff working at the home. One member of staff said, The manager is very approachable and will bend over backwards for staff, the people who live in the home and visitors. 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. Regular meetings are held and there are a number of systems in place to consult with Care Homes for Older People Page 21 of 26 Evidence: people living at the home. Relatives and the people who live in the home can approach the staff at any time. The area manager completes a regulation 26 visit monthly. This is an audit which covers all aspects of the environment and the care delivered. The manager said that during this audit staff, the people who live in the home and visitors are consulted about their views. Any suggestions made are considered and improvements made where possible. 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 and administrator carry out a regular audit with regard to personal finances. However it is recommended that a second audit is carried out by another person who is not dealing with the money on a regular basis. This is to make sure that people are safeguarded. 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 regular basis and that they are well supported. 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 22 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 23 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 7 15 Care plans must have the actual date of evaluation identified. This is to demonstrate that they have been updated immediately where a need had changed. Where medication is handwritten on the Medication Administration Record, these must be signed by two members of staff This is to ensure accuracy and keep people safe. 30/04/2009 2 9 13 30/04/2009 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 7 The tool used to identify the risk of someone developing a pressure sore has changed recently. In one of the records seen both tools were referred to. This could lead to confusion for staff. Reference should only be made to the Page 24 of 26 Care Homes for Older People actual tool used. 2 35 The manager and administrator carry out a regular audit with regard to personal finances. However it is recommended that a second audit is carried out by another person who is not dealing with the money on a regular basis. This is to make sure people are safeguarded. 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. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Older People Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!