Care Home: The Lodge Nursing Home

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What the care home does well The Lodge is a very pleasant home, which is welcoming and cosy. The homely environment is well maintained with a high standard care being delivered. Staffing levels were appropriate for the client group and there was evidence that the staff were appropriately trained. Family involvement remains high importance to the manager and homes philosophy as does client centred care. What has improved since the last inspection? The commission made no requirements or recommendations at the last visit. The management have continued to work well with relatives and the community nurse specialists. CARE HOMES FOR OLDER PEOPLE The Lodge Nursing Home 106 Cannock Road Burntwood Walsall West Midlands WS7 0BG Lead Inspector Joanna Wooller Key Unannounced 18th April 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Lodge Nursing Home DS0000022347.V362098.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. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge Nursing Home Address 106 Cannock Road Burntwood Walsall West Midlands WS7 0BG 01543 686188 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) Grangemoor Care Homes Karen Morris Care Home 14 Category(ies) of Dementia (14), Dementia - over 65 years of age registration, with number (14), Mental disorder, excluding learning of places disability or dementia (14), Mental Disorder, excluding learning disability or dementia - over 65 years of age (14) The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. DE Dementia minimum age over 60 years MD Mental disorder, excluding learning disability or dementia minimum age 60 years. 22nd December 2006 Date of last inspection Brief Description of the Service: The Lodge Care Home is a small “homely run” nursing home that admits residents with enduring mental health needs, who enjoy high standards of care and individual nursing care 24 hours a day. There are two lounge areas and a separate dining room along with 14 single bedrooms which all have a hand basin. Hairdressing services are available. There is a passenger lift to both floors. The current company Grangemoor Care Homes has run the home since 1993 and it is set in a semi rural location near to Burntwood village, close to the shops and amenities. There are car parking facilities and a pleasant rear garden, which is enclosed and has been carefully designed. The home is very accessible for visitors. The Lodge Nursing Home DS0000022347.V362098.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 that the people who use this service experience Excellent quality outcomes. The link inspector carried out this unannounced key inspection. The deputy care manager was present throughout and assisted the inspection process. The methodologies used to examine the quality of care and the general service delivery, involved a sample inspection of records and systems. A tour of the premises was also undertaken, to ensure that the environment was conducive in meeting the needs of the service users. The inspection included informal interviews with service users, relatives and staff members to establish their views and opinions, with regards to the services provided at the home. One service user accompanied the inspector throughout the time at the home; she spoke freely about events at the home and what it is like to live there. Several of the residents were very confused and they could not contribute to the inspection process. There was an open and positive dialogue with the deputy care manager and the overall impression was of a warm welcoming environment, complemented with high standards of care and satisfaction. The commission had taken factual information from the Annual Quality Assurance Assessment, which was completed by the homes care manager, and this has been incorporated into parts of the report. Records relating to the inspection process were again readily available and seen to be of good professional standard. Five Commission For Social Care Inspection ‘Have your Say’ feedback surveys were returned. Two from service users, two from health professionals and one from a relative. Comments included: “My Father is a resident and we are more than satisfied with the care he receives” “The service always treats Mum with the utmost care. They ensure she is always clean and tidy. They often put her nail varnish on. If there are any concerns about her health they ring the doctor immediately. We are lucky to have Mum in such a caring place.” The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 6 Visiting relatives commented… ‘The Lodge is an excellent nursing home. I am at the home most days helping with my wife’s care. The staff always make time to speak to me when I visit they all do a wonderful job.’ ‘Generally I am happy with the home, its not easy caring for such people with mental health problems, I think the staff are caring’. ‘The staff are very caring and friendly. I think they work really hard and know the individuals very well.’ Bed fee per week at present is £551 The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. What the service does well: What has improved since the last inspection? What they could do better: The commission made no requirements at this visit. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Lodge Nursing Home DS0000022347.V362098.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 The Lodge Nursing Home DS0000022347.V362098.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): Standard 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective service users and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract provided which clearly tells them about the service they will receive at The Lodge. Prospective relatives and service users are always invited to visit the home prior to admission. EVIDENCE: There is evidence that the home give an informed choice to the prospective relatives. On the day of the visit a family visited the home and they were given all the relevant information to make an informed choice. A current Statement of Purpose is available in the home along with a service user guide. The The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 10 manager or her deputy to ensure that their needs can be met by the home assesses each individual service user. They also assess that the individual will integrate well with the other service users. Each service user has a contract of care. Care planning is individually handwritten specifically to document the service users needs and this is reviewed regularly to assess their needs and identify if their requirements change. The staff makes themselves available on a one-to-one basis to give time to relatives and explain the service users guide and Statement of Purpose at a pace to suit the individual. Reviews are held approximately six weeks after the initial admission to confirm the suitability of the placement including the service users decision to stay. The Lodge Nursing Home DS0000022347.V362098.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): Standards 7 to 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users health, personal and social care needs are individually hand written in a plan of care. Service users medication is administered following the homes policy and procedure. EVIDENCE: Service users care needs are met by involving multi-disciplinary agencies on a regular basis. Involvement with the GP’s and Practice Nurses is ongoing and ensures that the needs are identified appropriately. Each service user has an individual plan of care, which identifies their needs in respect of health and welfare. Care records were current, reflected the service users condition and were exceptionally well personalised. The individual plans of care were comprehensive and informative, outlining for care staff the procedures and observations they were to undertake for each person in their care. There was evidence that the care plans were reviewed monthly or more frequently if The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 12 required. All required information concerning personal, social and health care needs were in place and adequately and appropriately documented. Service users are assisted to access other health care facilities such as chiropody, hospital appointments, dentist and opticians. Risk assessments are in place with appropriate tools such as falls, continence, urinary and bowel screening. Medication administration follows the homes current policy and procedures and this is presently being reviewed for a more suitable system to meet the homes and service users needs. No issues were raised with regard to medication. One relative commented, “They look after my Mother very well, always clean and tidy. Have time to chat and give her a little one-to-one. Also very prompt if she is in need of medical assistance.” The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12 to 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users lifestyles do match their expectations and that of their families. Service users are able to exercise choice within the home and they receive a balanced diet, which includes individual preferences. EVIDENCE: Many of the service users are now elderly and this has reduced the amount of activities that were available, however care staff initiates a daily activities programme suitable to their needs and abilities. It was evident that the service users were able to freely move around the home and go about their daily routines. Service users were observed in the lounges and the dining room. The care plans contained relevant information about preferred rising and retiring times and activities. Several service users joined the inspection whilst in the office and contributed to the inspection evidence gathering. One gentleman service user read the paper in the office and talked about what he did when he was young. It was obvious that he was in comfortable surroundings and that he was used to doing this. He was relaxed and content. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 14 The staff are currently introducing a ‘Collage of Life’ for each service user which is being developed by asking families for photographs and memorabilia of family life which will hopefully provoke happy memories for the service user and involves the individuals family and friends. One service user told us that “They enjoyed the music nights and especially the karaoke and dancing.” Freeview TV has been recently purchased and they service users enjoy the football and boxing events. Parties are arranged for birthdays with a buffet tea and entertainment. The homes philosophy is to involve family and friends as part of the care need. The husband of one service user confirmed he was able to visit in the lounge areas or privacy of his wife bedroom but he also enjoyed chatting to other service users and they were familiar with doing this also. Advocacy services are accessed as and when required and social workers were involved with regard to reviews and placements. The four weekly menus were evidenced and available for service users and their relatives to see. Individual food preferences were documented in care records and the cook was aware of these. The menus provided a varied and nutritious diet with alternative food choices available. The cook has recently completed her NVQ2 course in catering and has since introduced homemade soups and cakes. One relative spoke highly of the quality, quantity and varied menus and food provision another relative was unsure of the alternative choice on the menu – but this was explained to them during the visit. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users and relatives are confident that their complaints or concerns will be listened to, service users rights are ensured and they are protected from abuse. EVIDENCE: The home demonstrates a comprehensive complaints procedure that was displayed in the main hallway and is readily accessible to service users and visitors. The CSCI had again received no formal complaints about the home in the last twelve months. The manager was proud that no formal complaints have been received at the home. The deputy manager informed us that comments concerning smaller details or minor concerns were dealt with appropriately as they were raised. A relative confirmed that if he had concerns he would feel confident raising these with the manager or any of the staff, as they were all friendly and approachable. The AQAA tells us that the manager sees the relatives on a regular basis and the deputy manager and relatives confirmed this. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 16 Service users reviews are carried out at least 12monthly with social services, which is an opportunity to discuss care issues. All staff is POVA first checked and are Criminal Record Bureau screened before commencing employment and work in accordance with Staffordshire Vulnerable Adults Protection Policy. The staff is knowledgeable about whistleblowing and vulnerable adults and updates of this information occur on a regular basis. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 17 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): Standards 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The cosy layout of the home enables service users to live in a safe, well-maintained and comfortable environment, which encourages their individual independence. EVIDENCE: The home continues to be decorated in a domestic manner and was clean, comfortable and homely. There was sufficient evidence that the service users lived in a safe, wellmaintained environment. There were sufficient bathing and toilet facilities provided to meet the needs of service users. The home was fitted with aids to assist the service users daily living and to maximise their individual independence. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 18 Bedrooms were personalised and reflected the individual preferences and life styles. There were no malodours evident and the environment was bright and airy. One service user showed us around the home and was keen to show me her bedroom. It was very personalised and full of cuddly animals, which she had named. New bed linen and towels have been purchased within the last 6 months and furniture is replaced as required. A recommendation was made to replace the remaining dining room furniture. A new garden has been laid out in a secure area with raised planters for service users to assist with gardening and benches to sit out in good weather. The garden provides a calm settling area for some service users. Service users were discussing what they wanted to plant out in the summer. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 19 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): Standards 27 to 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users needs are met by the numbers of staff and skill mix ensuring that the service users are in safe hands at all times. The staff is trained to do their jobs and service users are protected and supported by the homes recruitment policy and procedures. EVIDENCE: On the day of the inspection there were 14 service users in the home and the staffing was considered appropriate numbers and needs of the present service users. The duty rotas were checked and projected good staffing levels and skill mix. There is a qualified member of staff on duty 24hours a day and on the early and late shift there are two care staff. At night there is one care staff with the nurse. Also in the home are a cook and 1 kitchen assistant, 2 domestics and 1 handyman. The domestic staff and kitchen staff are in the home 7 days a week. The owners and the manager together complete the homes administration work for the home. The deputy manager confirmed that all statutory training was up to date and this was evidenced . The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 20 The following training had taken place in the last 12 months: • • • • • • • Fire Safety and drills Moving and Handling Food Handling Protection of Vulnerable Adults Infection Control Health and Safety Dementia care NVQ in care (levels 2 & 3) are ongoing in the home, including kitchen and domestic staff. Two personnel files were inspected and found to be complete and as required. Robust recruitment practices included two written references, a POVA 1st check and CRB clearance. There was evidence to confirm that regular meetings with the staff took place. Staff received annual appraisal, and regular informal supervision, however the minimum standards ask that this be documented in a formal manner at least 6 times a year. A recommendation was made to ensure this happens. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 21 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): Standards 31,33,35,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is managed by a person able to demonstrate strong leadership skills and openness. The home is run in the best interest of the service users and the health, safety and welfare of service users and staff is promoted and protected. EVIDENCE: There is good accountability and leadership in the home. The registered manager has been in post for many years with sound experience of care of the older person with mental health problems. She operates a best practice service, which she develops regularly. She has achieved her Managers Award. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 22 The quality assurance system in place is audited and addressed as necessary. She ensures that staff are aware of the needs of the service users and the Department of Health dignity in Care Agenda has been embraced in the home as this underpins all aspects of the homes administration and care provisions. The home continues to be run in the best interest of the service users, safeguarded by the homes policies and procedures. There was a caring atmosphere in the home generated by the care staff on duty, relatives feedback confirmed that staff were approachable and friendly, and very caring to their loved ones. Regular auditing of accidents to identify trends or risk areas is carried out to insure service users safety at all times. Health and safety aspects checked included: • • • • • • • Fire extinguishers Hoist check Sling checked Passenger lift serviced Bath hoist checks Gas service Fire Alarm test Clinical waste from the home is disposed of in line with infection control guidelines. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 23 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 4 X X X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 3 X 4 The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? 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. 1 2 Refer to Standard OP36 OP19 Good Practice Recommendations The many supervision sessions carried out in the home are to be formalised and documented at least 6 times a year. The remaining dining room furniture requires replacement as identified on the visit. The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 The Lodge Nursing Home DS0000022347.V362098.R01.S.doc Version 5.2 Page 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. 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