Care Home: West Lodge Care Home

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What the care home does well The service has a new and well designed building. The home is very well equipped with the latest designs in equipment and has almost all the aids and adaptations that it needs. The home provides a very good level of staffing to ensure service user needs are met. The staff are knowledgable about service users needs and treat them with respect. Service users have good access to local health services. Service users have a good social programme and are able to interact well with each other and with staff. The home provides apetising food and drinks are freely available. The home provides very good induction, training and support to staff. The home has safe and accessible garden areas. The home is well managed by an experienced team who put service users needs first. What has improved since the last inspection? The homes new extension has opened providing excellent accomodation and equipment. The home are introducing new care plans. What the care home could do better: Some of the information supplied by the home would benefit from being written in plain English. The home would benefit from having a loop indiction system to help hearing aid users. Key inspection report Care homes for older people Name: Address: West Lodge Care Home Peases West Billy Row Crook Durham DL15 9SY     The quality rating for this care home is:   three star excellent 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: Tom Moody     Date: 1 7 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 24 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 24 Information about the care home Name of care home: Address: West Lodge Care Home Peases West Billy Row Crook Durham DL15 9SY 01388763650 01388768368 enquiries@westlodgenursinghome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: West Lodge Care Homes Limited care home 90 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 90 The registered person may provide the following category of service only: Care Home with Nursing, Code N. To service users of the following gender: Either. Whose primary care needs of admission to the home are within the following categories: Old age, not falling within any other category, Code OP, maximum number of places 90 Physical Disability, Code PD, maximum number of places 90 Date of last inspection Brief description of the care home West Lodge care home is registered with the Care Quality Commission for 90 places providing nursing and residential care. The home is situated in a small residential thoroughfare within the County Durham village of Billy Row, approximately 1.5 miles north of Crook Town. The semi rural setting around the village green features the Post Office, general store, church and pub and is on a regular bus route to Crook, Bishop Auckland, Weardale, Darlington, Durham and Newcastle. Care Homes for Older People Page 4 of 24 Over 65 90 0 0 90 Brief description of the care home West Lodge was originally a large stone built country house and, although this part of the home remains registered, the service users are now housed in a new purpose built extension. This has been equipped and furnished to a very high standard. there is lift access to all floors. The home is surrounded by attractive well cared for gardens with seating and good access. There is ample parking space for visitors. There is a friendly and welcoming atmosphere and good links are well established with the local community in which the home enjoys a well-deserved reputation for providing good care. The current cost of living at the home ranges between £459.71 and £627.74 per week and does not include the cost of hairdressing and chiropody. Care Homes for Older People Page 5 of 24 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: three star excellent 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 three star. This means the people who use this service experience excellent quality outcomes. Before the visit we looked at information we have received since the last visit. How the service has dealt with any complaints since the last visit. Any changes to how the home is run The providers view of how well they care for people set down in their self assessment. An unannounced visit was made on 19 June 2009 During the visit we talked with people who use the service, relatives, staff, the manager &and visitors We looked at the residents meal and looked at how staff support the people who live here. We gathered information about the people who use the service and how well their needs are met We looked at other records which must Care Homes for Older People Page 6 of 24 be kept We checked that staff had the knowledge, skills and training to meet the needs of the people they care for We looked around the building to make sure it was clean, safe and comfortable We checked what improvements had been made since the last visit We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 of 24 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 9 of 24 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. The service users needs are accurately assessed and the home can meet those needs Service users have information they need to make choices and a service users guide is available containing all the necessary information. Service users can make a trial visit and are able to make an informed choice about coming into the home. Evidence: The homes statement of purpose and service users guide are well written, up to date and contain all the necessary information. The home also has a printed brochure but the style it is written in may not be understood by everyone and it is recommended that plain English should be used when this is revised. A comprehensive assessment of service users needs takes place before admission and is available in their care plans. This takes into account information provided by other professionals and the placing authority. The service users have contracts contained in the Residents Guide. This is well Care Homes for Older People Page 10 of 24 Evidence: written, contains all the necessary information and it is easy to understand. The manager confirmed that trial visits can take place and relatives said they had been able to visit he home as part of the process of choosing a placement. Care Homes for Older People Page 11 of 24 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. Each person has a detailed plan, which explains how their care they will be given and peoples health care needs are met. The homes policies and procedures for dealing with medication protect service users. Service users feel that they are treated with respect by the staff Evidence: The service providers self-assessment says that they have a new care planning and records system which is based on research and best practice. There is a named nurse responsible for the overall care and care planning for each individual resident, ensuring accountability for care. There is a good assessment of service users physical, mental, spiritual and social needs in their care plans. The care plans are rather elaborate and perhaps overcomplicated but they are recently introduced and staff are adapting them as circumstances dictate. The plans contain information from care specialists from many different disciplines. Service users and their relatives are able to help with this and care plans have examples of information from both. Care plan indicate service users have access to health services such as hospital specialists, doctors, dentists and other practitioners. They also contains good risk assessments, Care Homes for Older People Page 12 of 24 Evidence: nutritional assessment, weights and other necessary information. End of life preferences were also recorded. It was noted during the site visit that some staff were coming in on their days off to work on the new care plans and assist with the change over process. Staff who were spoken to know about the service users history and condition and they confirmed they had had training and induction.This was also evident from looking at their care practice and their interactions with service users. service users and relatives were also comlimentary about their knowledge and skills. One visitor spoke of staff encouraging their relative to eat, pointing out that they had come in with a feeding tube and they now ate and enjoyed food. The home has good arrangements for giving and recording medicines. The home has well equipped clinical areas providing safe storage and a drug fridge is available in these rooms. Residents are asked whether they wish to manage their own medicines, subject to a full risk assessment. Service users were well dressed in appropriate clothing and looked well groomed. Staff spoke respectfully to service users and knocked before entering their rooms. all of the care practice seen on the day enhanced the dignity of service users. Care Homes for Older People Page 13 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes provision matches service users recreational, social and cultural needs, and helps them maintain contact with the surrounding community. They are able to exercise choice and control over most aspects of their lives and they enjoy nutritious and appetizing food. Evidence: The service providers self-assessment says that, they have changed the menus and the main cooked meal of the day from lunchtime to the evening with the exceptions of Friday when most residents opt for fish and chips at lunchtime, and Sunday when a traditional roast lunch is provided. These changes were based on residents preferences. On the day of the site visit service users enjoyed a traditional meal of fish and chips. Service users said they enjoyed their meals. One said, I am well fed, I enjoy it very much. Another said that he food was, Champion. Service users were supported by staff when they needed help to eat. Menus showed at least to choices of cooked meals were available and kitchen staff confirmed alternatives are available if residents want other options. The kitchen is very well equipped and it is stocked with a variety of foodstuff including Care Homes for Older People Page 14 of 24 Evidence: small tins and containers. This would allow staff to provide smaller amounts if an individual asks for alternatives. Visitors were coming and going throughout the time of the site visit. Service users were able to move around the home and make use of a variety of communal areas or go to their own rooms. Service users were taking part in small scale activities. Some were reading papers in a quiet lounge area. The home also has a dedicated hairdressing salon. Bedrooms are pleasantly decorated and contain personal items and photographs that are treasured by service users. One service user said, My room is nice, it could not be better. Care Homes for Older People Page 15 of 24 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. The service users and relatives know how to raise issues and they are confident staff and managers will act on their concerns. Training and procedures ensure service users are protected and that their rights are upheld Evidence: The service providers self-assessment says that, all concerns and complaints are responded to positively, with rapid action and responses. There is a complaint record but there are few recorded complaint. It also says staff have a very high level of training and awareness on safeguarding adults issues, including direct training by the local safeguarding team. training records confirm this. Staff who spoke to the inspector had a good awareness of adult protection issues. Training records indicated training in this area took place. Relatives and service users said they would be happy to approach the manager or staff if they had any concerns. Recruitment records indicate all pre employment checks are carried out including Criminal Records Bureau, POVA list and previous employers references. Care Homes for Older People Page 16 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and comfortable environment with good access to all areas. The home is extremely well equipped in almost every respect, and well furnished. It is spacious, clean and meets or exceeds most of the service users needs Evidence: The new development of this home has been built and equipped to an excellent standard. All residents have an electric profiling bed with a minimum standard of a medium risk pressure reducing mattress (high risk if the assessment demonstrates the need), ensuring maximum comfort and facilitating the delivery of care. All bedrooms have well designed en suite facilities, with a wet room WC and shower, and they exceed the National Minimum Standards (NMS) for space. Bedrooms and communal areas have well designed ceiling-track hoists fitted that are capable of reaching all areas of these rooms. Bathrooms are equally spacious and fitted with good quality equipment. There is an assisted bath with light sensitive controls so that it can be used by people with impaired grip or co-ordination problems. Corridors and lounges are also spacious and exceed the NMS requirements for size. All areas of the home are well decorated and have good quality furnishings and fittings. The home is well ventilated and warm. There was no excessive noise and the Care Homes for Older People Page 17 of 24 Evidence: atmosphere was calm. Almost all rooms have pleasant and extensive views of the surrounding area or the gardens. The garden area is well maintained with paved areas that permit easy access for all. The home has an extremely well equipped kitchen. The home also has a well equipped laundry with a chute system to avoid bringing laundry through corridors. The home is very clean and well maintained. there are no unpleasant smells anywhere in the home. It has a piped vacuum system that avoids noise or disturbance when the cleaners are at work. The home would benefit from having a loop induction system for hearing aid users. Care Homes for Older People Page 18 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing of the home meets service users needs. They are supported in a safe manner, by staff who are properly recruited, and have the appropriate training. Evidence: The duty rota was seen at the time of the site visit and this shows a very good level of staffing. Service users needs were met, call buzzers were answered within a reasonable time and care was given in an unhurried manner. Service users and relatives commented on how good the staff were. one service user said, If they treat you half as well as they have treated me you will be all right. Another said, they are all good, they are marvellous staff. One relative said, All of the staff are good, but some are exceptional. Training records show that staff receive mandatory training, and further development, to meet service users care needs. 96 of staff have NVQ level 2 or above. Records also show staff receive an induction and discussions with staff confirmed this. One said, I had a good induction. There is a dedicted computer facility in a training room to assist staff with research, training and personal development. Staff records also indicate all pre employment checks are carried out including Criminal Records Bureau, Protection Of Vulnerable Adults list and previous employer references. Records also show that staff are interviewed and they receive terms and conditions. Care Homes for Older People Page 19 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced person who has service user,s interests at heart. The home is run in the best interests of service users. They are kept safe and their welfare and rights are protected by good record keeping and the promotion of good practice Evidence: The service providers self assessment says that they have a strong management team led by the Registered Manager and Clinical Care Manager, fully supported by the Directors. This was evident during the site visit. The home has been extensively changed to provide a first class facility and little expense has been spared to achieve this. This demonstrates that the ethic of the management team of this home is to put the needs of the service user first. One relative commented on this saying, I give this home 15 out of 10. The manager and owner of the home say that they have an open door policy. This is helped by the siting of the managers office, and reception on the ground floor. The nurses and carers stations on each floor also help make staff and managers available. Care Homes for Older People Page 20 of 24 Evidence: There are staff meetings including Registered Nurse meetings. The homes self assessment says that safety is a high priority at the home, and they adhere to safe working practices. During the site visit there was evidence that safe practices are adopted and the homes equipment supports this. Staff morale is very high. One staff member said, It is nice to come to work and know your going to get along with everyone. The home has achieved and maintains the Investors in People standard award. All clients monetary transactions are recorded as per company policy. Running balances are kept and receipts retained. Records reconciled regularly. It would be useful if it was made clear which clients retained responsibility for their own expenditure. Staff supervision takes place, records are available and staff confirm that this happens. Care Homes for Older People Page 21 of 24 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 22 of 24 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 1 19 35 When revising the homes brochure plain English should be used to make it more accessible to prospective users. The home would benefit from having a lop induction system for hearing aid users. It would be useful to record which service users are responsible for their own finances and expenditure because records may have to be kept differently for this group. Care Homes for Older People Page 23 of 24 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. 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