Care Home: Walker Lodge Residential Home

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What the care home does well The service gives good support to enable individuals to identify and access health care and has good links with supporting health professionals, who give good health support to people who use the service. The service gives good support to enable individuals to maintain and develop personal and family relationships. The home and organisation has good systems to enable people who use the service to share their views and they continue to look at ways of involving people and improving individualised services. There is a complaints procedure and in addition the views of people who use the service are actively sought. People who use the service felt their views were listened to and acted upon. People who use the service said, and it was seen, that staff were kind, considerate and supportive. More than fifty percent of staff have undertaken National Vocational Training in Care at level Two or above and exceed the minimum standard, ensuring people who use the service receive care from a skilled and knowledgeable staff team. What has improved since the last inspection? Up to date information about the home is now available this will help reassure people who use the service and their relatives. The identification of individual mental health care needs and how these will be met are detailed within their care plan and this will help provide people with the help and support they may need. The review of the medication system and training ensures that people who use the service are protected. The manager and staff have addressed the poor practices that were undermining individuals dignity and now ensure that all people who use the service are supported to be clean, wear their own clothes and are well presented. The manager and staff have addressed the poor practices that were undermining individuals right to independence and choice. People who use the service have a more fulfilled lifestyle by an improvement in the social and leisure activities available to individuals. By improving and following menus and by giving people choice this has enabled people who use the service to have an improved and balanced diet. The completion of the complaints record has enabled management to review that people who use the service and their families are satisfied on how their complaints are managed. The improvements in the cleanliness, decor, furnishings and personalisation of bedrooms and taking into account the needs of people with dementias has enabled all people who use the service to have comfortable individuliased space. Improvements to the laundering of clothing has enhanced the dignity of people who use the service. Providing sufficient skilled staff gives improved support to people who use the service. Following staff recruitment procedures has ensured that people who use the service are better protected. The development of a staff training programme has ensured that all mandatory, NVQ, dementia and support training is completed and enable people who use the service to have their care provided by a more skilled staff team. Staff have undertaken fire drills and training and this will help keep people who use the service, staff and visitors safe. The provider has given good support to the new management arrangements and enabled them to complete all of the outstanding requirements and recommendations improving the care provided to the people who use the service. What the care home could do better: Improvements to the laundering of linen would enhance the comfort of people who use the service. The recording of actual fire drills would give a management overview and ensure that drills are undertaken and this will help keep people who use the service, staff and visitors safe. Key inspection report Care homes for older people Name: Address: Walker Lodge Residential Home Wharrier Street Walker Newcastle Upon Tyne Tyne & Wear NE6 3BR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Mary Blake     Date: 0 5 0 6 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 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. 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 Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Walker Lodge Residential Home Wharrier Street Walker Newcastle Upon Tyne Tyne & Wear NE6 3BR 01912243677 01912242657 walker.lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sylvia Helen Tidmas Type of registration: Number of places registered: care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: One named service user may be admitted in the category MD(E) The home may admit up to 15 people in the OP category and up to 48 people in the DE(E) category, subject to the maximum number of 48 places not being exceeded. Two service users in the OP category are under pensionable age. Date of last inspection Brief description of the care home Walker Lodge is situated in the centre of Walker with easy access to its services. The home is purpose built to provide care for older people and older people who may have dementia. 0 0 Over 65 36 12 Care Homes for Older People Page 4 of 26 Brief description of the care home The home is on two floors with passenger lift to all levels, there are a variety of aids to allow residents to move freely around the home. There is a car park at the front of the building and disabled access to the front door. The home does not provide nursing care. The other half of the building is used as a separate nursing home, Brampton Court. Both homes are run by Four Seasons, which is a private company. The home is located in Walker, close to shops, pubs, leisure centre, a post office, public park and other local amenities. There are good public transport networks in the area. The weekly fees are varied and avaiilable from the home. The statement of purpose, service user guide and last inspection report are available from the office. 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 that the people who use this service experience good quality outcomes. An unannounced visit was made on the 3rd June 2009 with a further announced visit on 5th June 2009. The manager was present throughout the inspection. Before the visit we looked at information we have received since the last inspection in June 2008, how the service dealt with any complaints and concerns, any changes to how the home is run, the providers view of how well they care for people, the views of people who use the service & their relatives, staff and other professionals, including surveys, the Annual Quality Assurance Assessment (AQAA), which is a self-assessment document, was sent to the home for their completion. Have your say questionnaires were sent out to people who have used or had interest in the home, three of which were returned to us. During the visits we talked with people who use the service, Care Homes for Older People Page 6 of 26 relatives, staff and the manager, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? Up to date information about the home is now available this will help reassure people who use the service and their relatives. The identification of individual mental health care needs and how these will be met are detailed within their care plan and this will help provide people with the help and support they may need. The review of the medication system and training ensures that people who use the service are protected. The manager and staff have addressed the poor practices that were undermining individuals dignity and now ensure that all people who use the service are supported to be clean, wear their own clothes and are well presented. The manager and staff have addressed the poor practices that were undermining individuals right to independence and choice. People who use the service have a more fulfilled lifestyle by an improvement in the social and leisure activities available to individuals. By improving and following menus and by giving people choice this has enabled people who use the service to have an improved and balanced diet. The completion of the complaints record has enabled management to review that people who use the service and their families are satisfied on how their complaints are Care Homes for Older People Page 8 of 26 managed. The improvements in the cleanliness, decor, furnishings and personalisation of bedrooms and taking into account the needs of people with dementias has enabled all people who use the service to have comfortable individuliased space. Improvements to the laundering of clothing has enhanced the dignity of people who use the service. Providing sufficient skilled staff gives improved support to people who use the service. Following staff recruitment procedures has ensured that people who use the service are better protected. The development of a staff training programme has ensured that all mandatory, NVQ, dementia and support training is completed and enable people who use the service to have their care provided by a more skilled staff team. Staff have undertaken fire drills and training and this will help keep people who use the service, staff and visitors safe. The provider has given good support to the new management arrangements and enabled them to complete all of the outstanding requirements and recommendations improving the care provided to the people who use the service. 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. 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. Admissions to the home are appropriately managed and people who use the service know how their needs will be met. Evidence: Pre-admission assessments are undertaken and reflect the needs of the people who use the service. Care plans had good information to ensure that the home can meet the needs of the prospective service user. The manager is involved in the decisions and in the majority of instances visits the people herself prior to their admission. The service is efficient in obtaining a summary of any assessment undertaken through care management and working closely with the care management team. The assessment focuses on achieving positive outcomes for people and ensuring that the facilities, staffing and specialist service provided by the home meet the diverse needs of individuals. People who use the service and their relatives spoke of visiting the home prior to admission and that this was useful to reduce anxiety and make the settling in process easier. Care Homes for Older People Page 11 of 26 Evidence: The people who use the service also have a care management assessment, which is provided to the home on admission. An individual care plan is produced from these documents. 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. People receive care and support that is well planned and takes into account their diverse needs whilst promoting their privacy and dignity and medication systems are safe. Evidence: All people who use the service have a care plan which includes an assessment of their needs and a plan of how these should be met. Four Seasons documentation includes risk assessments for prevention of falls, moving and assisting as well as assessment tools for clinical areas such as continence promotion. These had been completed to a good standard, which reflected the health needs of the people who use the service. The care plans were up to date and contained the information to assist the staff to care for the people who use the service. The manager had ensured that all recorded information is reviewed and summarised on a monthly basis. Care Homes for Older People Page 13 of 26 Evidence: The people who use the service receive personal support the way they prefer and their physical and emotional health needs are met. Staff were confident when giving care and are supported by effective training in areas such as moving and handling and dementia care. The individual health needs of people who use the service are identified and people are supported to access community health services such as doctor, district nurse, dentist, and optician. The ordering, administration and disposal of medication was satisfactory. Staff receive training from the community pharmacist and the manager undertakes her own assessment and review. Case tracking of two service users medication was satisfactory. People who use the service feel their privacy and dignity is respected and that they are listened to and what they say is acted upon. Staff receive training that helps them to make sure that everyone is treated with respect, and as an individual. Staff help people make their own decisions and provided information and assistance when it is needed. Staff were friendly toward the people who use the service and were attempting to engage them in conversation. They have a good knowledge of the needs of the people living in the home and the senior staff are giving good direction and leadership to help them in the day-to-day delivery of care. 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. Daily life and experience of activities meets peoples expectations of the service. People are supported to live full and active lives, and keep links with family and the local community. Evidence: People who use the service were generally happy and enjoyed being able to move freely around the home. Relatives and people who use the service felt that there was a developing social activities programme both within and outside of the home and this was thoroughly enjoyed by all. Each individual has a pen picture which outlines their interests and activities they have taken part in on a daily basis. Individuals have the choice to follow their spiritual beliefs and attend church services if they wish. The home has sought the views of the people who use the service by questionnaires, meetings, individual social assessment and family reviews. The daily activities that had been provided were varied and thoroughly enjoyed. The social activities coordinator helps develop and support the social interests of people who use the service. A programme of activities was available and being referred to by people who use the service. People are encouraged to go to places in the local area and families are encouraged and supported to take them out and about. The local Care Homes for Older People Page 15 of 26 Evidence: community participates in home events, which people said they really enjoyed. People who use the service take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. They said they are able to make choices about how they spend their day. The individuals bedrooms were personalised and the decor and furnishing had improved. People who use the service have visitors at any time and are able to use their own rooms, the small lounges or the larger, busier lounges to receive them. Staff assist and encourage people who use the service to maintain family links and previous friendships, respecting the individuals wishes. Staff seek permission prior to entering individual rooms and were communicating well with people. People who use the service were observed to move freely around their part of the home. The meals served were good and people said they enjoyed the food, which was well cooked. Staff support was on hand. The tables were nicely set and lunch was seen as social occasion. Hot and cold drinks were readily available. The chef is part of the staff team and made themselves available to people who use the service for comments and requests. People who use the service were positive about the choice and range of food available. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns have access to an effective complaints procedure and have their safety and rights protected. Evidence: The home ensures that people who use the service and their relatives are aware of the complaints policy by making it available in a variety of places. Complaints are managed satisfactorily and the necessary action taken and recorded. The complaints procedure is displayed in the home and available to individuals and their families. The complaints record was examined and was satisfactory. People who use the service and their relatives spoken to know how and who to complain to and were confident that their concerns would be dealt with commenting, they help with any problems the manager and staff listen to your queries and try to sort things out. Staff have undertaken training on the Protection of Vulnerable Adults and there is further training planned. Staff were aware of the whistle blowing policy and felt able to raise concerns if necessary. The manager was aware of the need to protect all people who use the service. 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 facilities are designed to meet the needs of people who use the service, it is homely and is well decorated and maintained. Evidence: Walker Lodge was purpose built as a care home to provide personal care and accommodation for older people. It is comfortable and attractively furnished. Bedrooms are well presented and reflect their individual styles and tastes. Throughout the building there was evidence of improvement. There had been extensive redecoration, refurbishment and replacement of carpets in corridors, communal areas and individual bedrooms. New furniture had been purchased for lounges, dining rooms and bedrooms and this improved the appearance and comfort of the home. Bathrooms had been redecorated and fitted with specialist equipment improving the bathing experience. The garden has been developed and has more seats and is being used more by people who use the service. The home was well maintained. New flat screen televisions and audio equipment further enhanced peoples lives. New bedding and towels had been purchased but whilst individual clothes were better repaired and laundered the bedding remains poorly ironed and detracted from the standards within the home. The laundry had been updated with more staff and new equipment to assist with ironing but does not seem to have improved the care of the bed linen. The home was very clean with no offensive odours. The requirements relating to the environment had been met. Care Homes for Older People Page 18 of 26 Evidence: Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are adequate numbers of appropriately skilled and experienced staff to care for the people who use the service and the recruitment processes in place protects people who use the service. Evidence: Staffing rotas showed that there are now enough staff on duty to meet the necessary staffing levels. The home operates with one senior and two carers on each floor. There is additional and good ancillary staff support. People who use the service and their relatives were positive about the staff support and attitude. People who use the service commented, lovely very kind the staff have time for you. Relatives commented, helpful keep you informed. Recruitment procedures within the home are safe. Records confirm that appropriate checks are carried out for all staff. The home has an induction programme and the manager is currently developing the Care Homes for Older People Page 20 of 26 Evidence: training programme for all staff working in the home. Staff spoke knowledgeably about the individual needs of people who use the service. Staff had undertaken refreshers in mandatory training. Staff said that they are undertaking or had completed National Vocational Qualification in Care level 2 (NVQ) or over, with over 50 staff having or undertaking NVQ 2 or above. Specialised training in dementia care and mental capacity awareness is being undertaken. Regular staff meetings are held for management, carers (day and night) and ancillary staff and these were documented. Policies and procedures are available. Staff supervisions and annual appraisals are being undertaken. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is consistent and effective and offers leadership to the staff this improves the life of the people living in the home and protects them from harm. Evidence: The manager of the home has satisfactorily completed her registration as a manager and is only responsible for Walker Lodge. The manager has introduced systems to enable people who use the service, relatives and staff to voice their views and has an open door policy. Family and resident meetings have been held. Questionnaires were sent out and any comments/suggestions acted upon Regular meetings had been held for people who use the service, relatives and staff to discuss and review practices and the running of the home. The people who use the service and staff made positive comments about the manager Care Homes for Older People Page 22 of 26 Evidence: and staff team, they gave examples of improved practices and of the staff team taking time to listen and respond to any concerns they may have. The providers quality assurance and audit systems are comprehensive covering areas such as medication, home manager audit, catering. Monthly provider visits are undertaken with good written reports. The provider has prepared an improvement plan following the last inspection and had worked through this to meet all of the outstanding requirements and recommendations. The manager has an open and inclusive style that was commented upon by people who use the service, relatives and staff. She undertakes daily walkabout to talk to people who use the service, staff and visitors and has an open door policy. Accident and risks assessment are appropriately documented with preventions put in place. Staff supervision and staff appraisals are being undertaken. Records, policies and procedures were established, clear, concise and appropriately recorded and stored. Fire and other system testing had been undertaken at the recommended timescales, staff confirmed they had undertaken fire drills but this was not clearly recorded. Systems were established for maintenance to be undertaken when necessary. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 16 The provider must ensure that all linen is suitably laundered To improve appearance and comfort of bed linen for service users 22/07/2009 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 38 To keep an individual record of all fire drills undertaken. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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