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Care Home: Trent Lodge

  • 6-8 Essex Road Enfield Middlesex EN2 6TZ
  • Tel: 02083672159
  • Fax: 02083645328

Trent Lodge is part of an organisation that has a number of homes. Trent Lodge is a care home registered for sixteen service users who are over the age of 65. The home is well established and is near the centre of Enfield Town. The home has twelve single rooms and two double rooms. None of the rooms have en suite facilities. The home has a stair lift. The home is situated near one of the entrances to Enfield Town Park. It is easily accessed by car and public transport and within walking distance of the town centre. The home benefits from a large garden at the rear of the house. The garden is well maintained and a pleasant place for service users to sit. The home provides care for service users of either sex who are older and in need of personal care only. The fees are between £450 and £550 a week. This report is available through the internet. Copies may also be obtained from the provider of this service.Trent LodgeDS0000010693.V377178.R01.S.docVersion 5.2

  • Latitude: 51.647998809814
    Longitude: -0.082999996840954
  • Manager: Mrs Janet Tracey
  • Price p/w: £500
  • UK
  • Total Capacity: 16
  • Type: Care home only
  • Provider: Mr Jashvant Babulal Kotecha
  • Ownership: Private
  • Care Home ID: 16989
Residents Needs:
Old age, not falling within any other category, Dementia

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Trent Lodge.

Key inspection report CARE HOMES FOR OLDER PEOPLE Trent Lodge 6-8 Essex Road Enfield Middlesex EN2 6TZ Lead Inspector Tony Brennan Key Unannounced Inspection 11th August 2009 11:00 DS0000010693.V377178.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trent Lodge Address 6-8 Essex Road Enfield Middlesex EN2 6TZ 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) 020 8367 2159 020 8364 5328 sirjit_trentlodge@tiscali.co.uk Dr Sirjit Singh Seyan Mr Jashvant Babulal Kotecha Mrs Janet Tracey Care Home 16 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (16) of places Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home only Code PC 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 Dementia – Code DE The maximum number of service users who can be accommodated is: 16 Date of last inspection 16th August 2007 Brief Description of the Service: Trent Lodge is part of an organisation that has a number of homes. Trent Lodge is a care home registered for sixteen service users who are over the age of 65. The home is well established and is near the centre of Enfield Town. The home has twelve single rooms and two double rooms. None of the rooms have en suite facilities. The home has a stair lift. The home is situated near one of the entrances to Enfield Town Park. It is easily accessed by car and public transport and within walking distance of the town centre. The home benefits from a large garden at the rear of the house. The garden is well maintained and a pleasant place for service users to sit. The home provides care for service users of either sex who are older and in need of personal care only. The fees are between £450 and £550 a week. This report is available through the internet. Copies may also be obtained from the provider of this service. Trent Lodge DS0000010693.V377178.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 two star – good service. This means the people who use this service experience good quality outcomes. This unannounced key inspection was undertaken as part of the annual inspection programme. We sought to confirm that the home continues to provide good outcomes for residents. Prior to the inspection the home had completed its Annual Quality Assurance Assessment. The Annual Quality Assurance Assessment provided us with information about the home and how it was seeking to provide the best outcomes for people. We also looked at any other information we had received about the home since the last inspection. This included any information regarding incidents that the home had told us about. The inspection took place over one day. We were assisted by Janet Tracey, the registered manager, with the inspection. Comment cards were received from residents. We spoke with three people who live at the home, two members of staff and three relatives. We observed care practice and interaction between staff and people living at the home. We toured the building and examined a number of records relating to the care, health and safety and management of the home. At the end of the inspection feedback was given to the registered manager, and areas for improvement were discussed. We would like to thank the staff that assisted us by answering questions about the running of the home. We would also like to thank the people who live at the home who discussed their views of the service they receive. What the service does well: We found that the needs of the residents case tracked were within a range of those specified in the statement of purpose. A resident told us, “I was given a booklet about Trent Lodge, and got to see the place. Its helped me to understand where I was going to live.” The home provides a statement of purpose that is specific to the home and the resident group that they care for. All the residents’ case tracked had both assessments from placing authorities, Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 6 and ones carried out by the home. These identified the individual’s needs for support and care. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for people. Care plans were based on initial assessments of the people case tracked. Residents spoken to told us that they felt they were well cared for. One resident said, “They are very helpful and know what I want.” The records of medicines received, administered and returned to the pharmacist were all complete. We were able to confirm that people were getting their medication as prescribed by their general practitioners. Medication records are fully completed, contain the required entries, and are signed by appropriate staff to ensure people’s safety. A resident said, “Food is very good.” Another resident commented about the choice of food offered and that staff, “do ask what you would like to eat.” People are offered a variety of meals that reflect their personal preferences and meet their dietary needs. Residents we spoke to confirmed that they knew how to make a complaint. A person told us, “I have not had to make a complaint about anything. I know I can talk to the manager about anything if there is a problem.” The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. Residents said they felt confident that any concerns they raised would be handled sensitively and appropriately. A person told us, “I feel safe here.” T People feel safe and well supported by the home, which has their protection and safety as a priority. We observed that staff were available to provide individual care for residents. A resident told us that, “Staff are helpful. I could not manage without them.” The staffing level is reviewed regularly to make sure there are sufficient staff to meet the needs of residents. Staff spoken to were able to explain how they supported people in a person centred way. A resident said, “Staff are doing a good job.” Staff are supported through training to meet the individual needs of people who live in the home. Staff training records showed that staff had done training in the essential areas, such as food hygiene, health and safety, administration of medication and infection control and first aid. Staff will also be doing further training on dementia and course on the Mental Capacity Act. We observed that staff demonstrated that they knew how to support and care for people. The home ensures that all staff receives relevant training that is focused on delivering improved outcomes for people. Both residents and relatives commented positively on the management and leadership of the registered manager. Staff spoke very highly of the registered manager. They said they felt well supported and received clear directions and Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 7 leadership. The registered manager has a clear understanding of how to deliver good outcomes for people living at the home. The home has a system for obtaining the views of the quality of the service it provides. The home makes sure that any areas for improvement are addressed. People’s views are sought and provide the bases for improving the quality of the service. The home has a consistent record of meeting the relevant health and safety requirements and closely monitors its own practice. Health and safety checks, procedures and training make sure that people living in the home are safe. What has improved since the last inspection? There were no areas for improvement identified at the last key inspection. Last year an Annual Service Review (ASR) of the service was completed. An ASR is a review of the service and how it is meeting the needs of people who use the service. We found that Trent Lodge has continued to provide good outcomes for people living at the home. The home has made sustained improvement in a number of areas to improve the outcomes for residents. We spoke with residents who told us that they are provided with regular activities. A resident said, “They arrange some entertainment regularly.” We observed that activities were taking place at various times throughout the day. The registered manager explained that the home plans to increase the range of activities provided for residents. The annual quality assurance assessment had highlighted that an activities organiser would be appointed to support residents so that they could have a wider range of activities. Residents are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. A relative said, “The attention residents receive from the staff is very good.” We could see from daily notes that residents had regular contact with relatives and friends. A relative commented on this, “They are always welcoming here.” Resident told us that they could see visitors in private if they wished. The home supports residents to maintain and develop their family and personal relationships. One of the bathrooms has been converted into a walk-in shower. The ground floor bath has been refurbished and a new accessible bath put in place. The Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 8 registered manager explained that this was done to respond to changing needs of residents. We saw that the walk-in shower and bath had the appropriate at adaptations for the needs of people whose mobility is restricted. Residents with whom we spoke felt that these were good additions to the homes facilities. New dinning room furniture has also been bought. Resident told us they like the new furniture and that it made meal more enjoyable. The home makes sure that the environment is developed to provide improved outcomes for residents. Since the last inspection new furniture, bed linen and curtains have been brought for residents bedrooms. A number of bedrooms have been redecorated. The registered manager explained there would be further work to improve the home’s environment for residents. Residents had a lockable space in their rooms to keep their personal and valuable items. Residents are encouraged and supported to personalise their bedrooms. 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 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. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 9 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 Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 13 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The statement of purpose provides people with a clear description of the service. People’s needs are assessed prior to admission to the home to make sure they receive the care and support they need. National Minimum Standard number six is not applicable to this service, as the home does not provide intermediate care. EVIDENCE: Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 11 We found that the needs of the residents case tracked were within a range of those specified in the statement of purpose. The statement of purpose identified the skills and staffing resources available to meet the needs of people. The statement of purpose was easy to understand and provided the necessary information about the home. A resident told us, “I was given a booklet about Trent Lodge, and got to see the place. Its helped me to understand where I was going to live.” All residents and relatives spoken to confirmed that they had been given sufficient information about the home so that they could decide if it was the right place for them to live. The home provides a statement of purpose that is specific to the home and the resident group that they care for. The statement of purpose confirmed that the cultural and religious needs of residents would be respected. Records showed that people were supported by the home to maintain contact with their church or other community groups. The annual quality assurance assessment identified that peoples cultural and religious needs would be identified in initial assessment and their care plans. We spoke with the registered manager who told us that cultural and religious needs would be addressed and identified through initial assessments and care planning. Residents have varying degrees of disability. The environment has been adapted so that it is accessible. For example, since the last key inspection a walk-in shower and bath has been provided for residents. We observed that people were able to move about the home safely. The homes environment is adapted to meet peoples diverse needs. A person who lives at the home said, “The home is nice.” The annual quality assurance assessment stated that there were comprehensive pre admission assessments in place. All the residents’ case tracked had both assessments from placing authorities, and ones carried out by the home. These identified the individual’s needs for support and care. All the residents spoken to confirmed that they received the care and support they needed. A relative observed that, “Staff are magnificent. They are really concerned about the residents.” As part of the assessment process information on the needs of residents had been obtained from health professionals. This had been used to inform the home’s own assessment. The annual quality assurance assessment highlighted that the home only admit people when they know that they can meet their needs. We found that the initial assessment information had been used to identify and plan how the needs of residents would be met. Needs were clearly stated so that staff know how to help each resident. Admissions are not made to the home until a full needs assessment has been undertaken to ensure the best outcomes for people. The annual quality assurance assessment stated, “We involved relatives, perspective residents and relevant professionals in the assessment process.” Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 12 Initial assessments recorded the involvement of people and their representatives in identified areas where they needed support. Both relatives and residents told us that they had been actively involved in the initial assessment process. We found that initial assessments reflected the individual’s preferences and how they wish their needs to be met. Detailed initial assessments are carried out with the involvement of residents and their representatives to make sure their needs are identified. Care staff spoken to was able to explain the individual needs and preferences of the four people case tracked. Training records showed that staff had all the necessary training to meet the needs of residents. We observed the interaction between staff and residents. We found this supported their continued well being. Admissions to the home only take place when staff have the necessary skills to meet the assessed needs of perspective residents. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s personal, social and medical care needs are fully planned for. People who use the service are fully protected by safe procedures for handling medication. Peoples right to privacy is supported. EVIDENCE: The annual quality assurance assessment highlighted that comprehensive care plans covering all the needs of residents were in place. We found that Care plans were based on initial assessments of the people case tracked. Residents spoken to told us that they felt they were well cared for. One resident said, “They are very helpful and know what I want.” There were Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 14 clearly defined actions highlighted in the care plans to meet the needs of people. The registered manager explained that she was in the process of reviewing all the care plans. This would be part of introducing a new way of recording the needs of residents. The annual quality assurance assessment stated that care plans were prepared with involvement of residents, their families and professionals. We found that people’s choices and preferences are recorded in their care plans. Residents changing capacity to make decisions were reflected in their care plans. The care plans for the people case tracked were found to reflect their choices and preferences. Residents spoken to said that they had been asked about how they wish to be supported by staff. A relative that staff “Very understanding.” Staff were observed to interact respectfully and sensitively with residents. They said that staff respected their privacy and treated them with respect. Residents we spoke to told us that they felt staff understood their needs. We saw examples where staff members did relate well with residents, for examples speaking to people in a way that was appropriate given their age. We observed that residents were well-dressed. Care plans were personalised, and referred to the cultural needs of people. This included whether or not they wish to take part in religious services. People are involved in the planning of their care that affects their lifestyle and quality of life. Registered manager explained that as part of providing more personalised and Person centred care they are developing life histories with residents. The registered manager showed us an example of one of these life histories. It was comprehensive and covered all aspects of the person’s life and interests. Although the life histories will be developed with all residents they will be of particular benefit from residents who have dementia. Care will be focused on the individual needs of residents and related to their interests and preferences. Detailed nutritional, tissue viability, falls and manual handling assessments are in place. People were being weighed regularly and action taken if their weight changed. The people case tracked all had nutritional assessments. The care plan provided clear guidance on how the resident wished to be supported. We observed how this resident was helped to eat and drink. The guidance in the care plan was being followed. The member of staff supported the resident to eat at their own pace. Each care plan includes a manual handling risk assessment. Equipment had been provided to assist people to mobilise safely and independently. The member of staff did this in a way that maintained the resident’s safety. Management of risk ensures that safety issues are addressed whilst at the same time improving the quality of life for residents. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 15 Diary notes showed that appropriate medical attention and advice is sought. All surveys from residents confirmed that they had access to the medical support they needed. Diary notes also confirmed that the people case tracked had access to their General Practitioner when necessary. Where the General Practitioner had recommended specific medical interventions these were followed up. People’s health is promoted to ensure their continued well being. The records of medicines received, administered and returned to the pharmacist were all complete. We were able to confirm that people were getting their medication as prescribed by their general practitioners. We found where the General Practitioner had made changes to peoples medication this was signed to confirm the change had been made. We found that the medication for each of the people case tracked was accurately recorded. The people we case tracked had their consent to staff administering their medication recorded in their care plans. No residents currently self-medicating. There is a policy in place to make sure that if a resident chose to add minister their own medication they could be supported to do this safely stop Medication records are fully completed, contain the required entries, and are signed by appropriate staff to ensure people’s safety. Medicines were stored safely. All medicines are stored at the appropriate temperature. Separate records were maintained for controlled drugs. The management team monitor staff to make sure that the correct procedures are followed when administering medication. Regular management checks are carried out to make sure that medication is administered safely to people. Training has been provided on the safe administration of medicines. Training records confirmed that this training had taken place. The registered manager explained that further medication training had been planned. This will make sure that staff are updated on a safe handling of medication. We were able to observe staff administering medication, and confirmed that this was done safely. Staff understands how to administer medication safely to residents. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living at the home are provided with varied activities to meet their needs. People living at the home are supported to maintain contact with relatives and other representatives of their choice. The menu offers a balanced diet to people living at the home. EVIDENCE: We spoke with residents who told us that they are provided with regular activities. A resident said, “They arrange some entertainment regularly.” We observed that activities were taking place at various times throughout the day. We saw that people were enjoying reading newspapers, talking with staff and listening to music. We observed that there were photos of recent crafts and other activities that residents had participated in at the home. There was a Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 17 record of activities that have been taking place at the home. This showed that residents were offered a range of activities. The registered manager explained that the home plans to increase the range of activities provided for residents. The annual quality assurance assessment had highlighted that an activities organiser would be appointed to support residents so that they could have a wider range of activities. Discussions with a registered manager highlighted that the home had already begun to do some reminiscence work with residents who had dementia. Both discussions with a registered manager and the annual quality assurance assessment showed that the home was seeking to increase the range of activities provided for those residents who have dementia. This will provide residents with dementia with a greater variety of things to do that are focused on their individual needs. Residents spoken to told us that these activities are provided regularly. Peoples’ interests were recorded as part of their care plans. We found that the residents who we case tracked had their emotional and personal interests recorded in the very person centred way. A relative told us that she had seen activities taking place. Diary notes showed that people had regular contacts with family, friends and the wider community. Residents are involved in meaningful daytime activities of their own choice and according to their individual interests and capabilities. We observed that staff spend time talking with people who live at the home and listening to what they had to say. Staff spoken to understood the importance of one-to-one contact for people. A relative said, “The attention residents receive from the staff is very good.” We could see from daily notes that residents had regular contact with relatives and friends. A relative commented on this, “They are always welcoming here.” Resident told us that they could see visitors in private if they wished. The home supports residents to maintain and develop their family and personal relationships. The menu showed that options are offered at each meal. The registered manager explained that she will be reviewing the menu to make sure that the meals provided meet the needs and preferences of residents. This will support more individualise meal plans for residents. We spoke with people who were generally pleased with the quality of the food provided. A resident said, “Food is very good.” Another resident commented about the choice of food offered and that staff, “do ask what you would like to eat.” People are offered a variety of meals that reflect their personal preferences and meet their dietary needs. Meals were balanced and nutritious. People’s dietary needs are recorded as part of their care plans (for example if they were diabetic or needed a puree meal). We observed that meals were well presented in a warm and friendly way. We saw that people were supported to eat. We observed that this was done at the pace of the people being assisted. People are able to enjoy the food they prefer and like. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 18 Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are confident that their complaints will be listened to, taken seriously and acted upon. The home’s procedures protect people from abuse. EVIDENCE: The annual quality assurance assessment confirmed that a clearly defined complaints policy with agreed timescales for managing complaints was in place for people to use. We found that the detailed policy was in place. Residents told us they had received a copy of the complaints policy. No complaints had been referred by the Commission to the home since the last key inspection. A complaints book is available to record all concerns, allegations and complaints. We found that the complaints book recorded the actions that had been taken to address issues. There had been one complaint since the last key inspection. The complaints record showed actions taken to resolve complaints. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 20 We found that there were a number of compliments from relatives about the care residents were receiving. Residents we spoke to confirmed that they knew how to make a complaint. A person told us, “I have not had to make a complaint about anything. I know I can talk to the manager about anything if there is a problem.” The home has an open culture that allows people to express their views, and concerns in a safe and understanding environment. There were policies on handling abuse and protection. Residents said they felt confident that any concerns they raised would be handled sensitively and appropriately. A person told us, “I feel safe here.” There had been no adult protection issue since the last key inspection. We found that training records confined that staff had received training on adult protection. Staff spoken to could recognise the signs of potential abuse, and explained how they would respond to it. A relative said, “The staff attitude towards the residents is good.” People feel safe and well supported by the home, which has their protection and safety as a priority. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People live in a home that provides a safe and homely environment. The home is clean and hygienic. EVIDENCE: We walked round the home and found that it was accessible for people. We observed that people were able to access all areas in the home safely. The home has the necessary adaptations to support people to move around safely. Bathrooms and toilets were fitted with appropriate as the adaptations to meet the needs of residents. These are accessible to people who have mobility difficulties. We saw that since the last inspection that a ramp has been put in Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 22 place so that residents can access the garden. We saw that the home was appropriately decorated and furnished. Records showed that these had been maintained. There is a dining and sitting area for the use of people. The home’s environment is appropriate to the specific needs of residents and promotes their independence. The annual quality assurance assessment and discussions with the registered manager highlighted that a number of improvements had been made to the homes environment. One of the bathrooms has been converted into a walk-in shower. The ground floor bath has been refurbished and a new accessible bath put in place. The registered manager explained that this was done to respond to changing needs of residents. We saw that the walk-in shower and bath had the appropriate at adaptations for the needs of people whose mobility is restricted. Residents with whom we spoke felt that these were good additions to the homes facilities. New dinning room furniture has also been bought. Resident told us they like the new furniture and that it made meal more enjoyable. The home makes sure that the environment is developed to provide improved outcomes for residents. We saw that bedrooms were personalised with items of furniture and pictures belonging to people. One person said, “My bedroom is very nice.” Another resident told us that; “I’ve got my own furniture in my bedroom.” The registered manager explained that she encourages and supports residents to personalise the bedrooms. Since the last inspection new furniture, bed linen and curtains have been brought for residents bedrooms. A number of bedrooms have been redecorated. The registered manager explained there would be further work to improve the home’s environment for residents. Residents had a lockable space in their rooms to keep their personal and valuable items. Residents are encouraged and supported to personalise their bedrooms. We saw that the home was clean. A relative confirmed that, “The home is clean.” We found that a range of appropriate measures is in place to prevent cross infection. The home has detailed policies on the prevention of cross infection. Staff have received training on infection control measures. Staff spoken to understood how to work to minimise the possibility of cross infection. Staff confirmed that they had access to disposable gloves and aprons. Liquid soap and paper towels were available throughout the home. The experts by experience noted “I found the rooms were clean and smelling of freshness.” Effective infection control measures are in place to make sure that residents are safe. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Sufficient staff are always available to meet the needs of people who live at the home. Staff have all the skills to meet the assessed needs of people who live at the home. People who live at the home are protected by the home’s recruitment practices. EVIDENCE: Residents said that there were always enough staff available to meet their needs. The rota showed that a consistent staffing level was being maintained in the home. We observed that staff were available to provide individual care for residents. A resident told us that, “Staff are helpful. I could not manage without them.” Staff said that the current staffing level allowed them to meet the needs of residents. The registered manager explained that she will be carrying out a review of the staffing level due to the increasing needs of residents. This will Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 24 allow her to determine whether any changes to the staffing level need to be made to meet the needs of residents. The staffing level is reviewed regularly to make sure there are sufficient staff to meet the needs of residents. The annual quality assurance assessment highlighted that staff had been on a range of courses. Residents spoken to felt that staff had the necessary skills to meet their needs. A resident said, “Staff knows do look after me.” Training records showed that staff had been on a range of courses relating to the needs of people who live at the home. There were training certificates available to confirm this. We observed that staff understood how to respond and communicate with residents. Staff spoken to were able to explain how they supported people in a person centred way. A resident said, “Staff are doing a good job.” Staff are supported through training to meet the individual needs of people who live in the home. The registered manager was able to show 50 of staff have achieved the National Vocational Qualification in care. The registered manager explained that a number of staff are also either working towards or have completed their national vocational qualification in care at level 3. Training records we examined confirmed this. A relative observed that, “Staff pays attention to the needs of residents.” Staff training records showed that staff had done training in the essential areas, such as food hygiene, health and safety, administration of medication and infection control and first aid. Staff will also be doing further training on dementia and course on the Mental Capacity Act. We observed that staff demonstrated that they knew how to support and care for people. The home ensures that all staff receives relevant training that is focused on delivering improved outcomes for people. We looked at two staff files. These contained all the necessary documentation to ensure that these members of staff were safe to work with people who live at the home. Their employment record had been checked. Two references and a POVA first/CRB check had been obtained prior to them starting work at the home. This showed that the home followed a clear recruitment procedure that ensures the safety of people. The staff group reflect the cultural backgrounds of people living at the home. People living in the home said they felt that staff could be trusted. Robust recruitment procedures are followed to ensure the safety and well being of people. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 25 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Appropriate management structures are in place to ensure that people receive the care they need. People who live at the home are consulted about the quality of the service, and encouraged to make suggestions for improvement. People who live at the home have their financial interests protected by the home’s procedures. People who live at the home and staff are protected by the home’s health and safety procedures. EVIDENCE: Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 26 Both residents and relatives commented positively on the management and leadership of the registered manager. The registered manager has extensive experience of managing a service for older people. The registered manager has maintained and updated her skills regularly. She has a clear understanding of the key principles and focus of the service to make sure that people receive the care they need. She has also provided training on a range of areas to staff. We observed that the registered manager spent time talking to people who live at the home. The registered manager has a clear understanding of how to deliver good outcomes for residents. Staff spoke very highly of the registered manager. They said they felt well supported and received clear directions and leadership. A member of staff said, “The manager is very professional. She is always available.” The registered manager and staff work to make sure that the home is running in the best interests of residents. We observe this throughout the inspection. Relatives and other professionals provided positive feedback about how the home was managed to makes sure that the needs of residents are met. The home has a system for obtaining the views of the quality of the service it provides. The home makes sure that any areas for improvement are addressed. A survey of the views of people who live at the home, relatives and professionals had recently been carried out. The findings of this survey had been action to improve the home. Staff meetings take place to make sure that staff are aware of how they should support and care for people. People’s views are sought and provide the bases for improving the quality of the service. The home does not hold money for residents. The home invoices their families or the relevant social service department for any expenditure made on their behalf. A system is in place to ensure receipts are obtained for any expenditure. No resident currently manage their own finances. There is a system in place should a resident wish to manage their own finances. People who use the service can have confidence in the home’s procedures for handling their money safely. The home has a consistent record of meeting the relevant health and safety requirements and closely monitors its own practice. Fire drills were taking place and the fire alarm was tested regularly. We found that the fire risk assessment includes an assessment of all the potential fire risks in the home. We questioned staff on the fire safety procedures and found that they understood fire safety issues. All health and safety policies were available. Certificates for gas, legionella and electrical testing were in date. COSHH guidance was in place and chemicals were stored safely. We discussed health and safety issues with staff and they demonstrated their understanding. The home has an effective system for monitoring accidents to ensure the safety of people who live and work at the home. The temperatures of the fridges and Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 27 freezers were recorded and within safe limits. Health and safety checks, procedures and training make sure that people living in the home are safe. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 28 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 29 No 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. Refer to Standard Good Practice Recommendations Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 30 Care Quality Commission Care Quality Commission London Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.london@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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Trent Lodge DS0000010693.V377178.R01.S.doc Version 5.2 Page 31 - 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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