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Care Home: Worsley Lodge

  • 119 Worsley Road Worsley M28 2WG
  • Tel: 01617940706
  • Fax: 01617947715

Worsley Lodge is a care home that provides personal care and accommodation for up to 48 older people. The Registered Provider is Southern Cross Care homes Limited. A driveway leads from the main road to a car park and the main entrance to the home. The home is a two storey, detached; purpose built property set in its own grounds. All of the bedrooms are single. Thirty-three of the rooms have an en suite facility; sixteen rooms have a shower en-suite and seventeen rooms have a toilet en suite. Assisted bathing facilities are available on both floors. There are lounges on both floors. Adaptations and aids are provided, including a passenger lift and hoists. The current weekly fees range from £317.00 to £475.00 dependent on the package of care required. Additional charges are made for hairdressing and other personal requirements. More information is available from the home and a statement of purpose and brochure are made available pre admission.Worsley LodgeDS0000006733.V378356.R01.S.docVersion 5.2

  • Latitude: 53.501998901367
    Longitude: -2.3689999580383
  • Manager: Manager post vacant
  • Price p/w: £396
  • UK
  • Total Capacity: 48
  • Type: Care home only
  • Provider: Southern Cross Care Homes No 2 Limited
  • Ownership: Private
  • Care Home ID: 18380
Residents Needs:
Old age, not falling within any other category

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 Worsley Lodge.

Key inspection report CARE HOMES FOR OLDER PEOPLE Worsley Lodge 119 Worsley Road Worsley M28 2WG Lead Inspector Elizabeth Holt Key Unannounced Inspection 10th November 2009 09:30 DS0000006733.V378356.R01.S.do c Version 5.3 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. Worsley Lodge DS0000006733.V378356.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 Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Worsley Lodge Address 119 Worsley Road Worsley M28 2WG 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) 0161 794 0706 0161 794 7715 worsleylodge@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Ltd Mrs Jacqueline Hodgson Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Worsley Lodge DS0000006733.V378356.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 The maximum number of service users who can be accommodated is: 48 10th November 2008 Date of last inspection Brief Description of the Service: Worsley Lodge is a care home that provides personal care and accommodation for up to 48 older people. The Registered Provider is Southern Cross Care homes Limited. A driveway leads from the main road to a car park and the main entrance to the home. The home is a two storey, detached; purpose built property set in its own grounds. All of the bedrooms are single. Thirty-three of the rooms have an en suite facility; sixteen rooms have a shower en-suite and seventeen rooms have a toilet en suite. Assisted bathing facilities are available on both floors. There are lounges on both floors. Adaptations and aids are provided, including a passenger lift and hoists. The current weekly fees range from £317.00 to £475.00 dependent on the package of care required. Additional charges are made for hairdressing and other personal requirements. More information is available from the home and a statement of purpose and brochure are made available pre admission. Worsley Lodge DS0000006733.V378356.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 2 star. This means the people who use this service experience good quality outcomes. This key inspection took place on Tuesday 10th November 2009. The manager of the home was not told beforehand of this inspection, which included a visit. An improvement plan, completed by the manager and Operations Director, was submitted to the Commission on 6th January 2009. This described the action being taken to make improvements and address the requirements made following the inspection in November 2008. A random inspection was carried out on the 19th May 2009 to follow up on requirements made at the last key inspection of 10th November 2008. We made recommendations following this visit but were satisfied that the staff at the home had met the requirements that had been made in November. All key National Minimum Standards for Older People were assessed at the site visit and information was taken from various sources including observing the staff, talking with people who live at the home, the staff team and the manager. A sample of people’s care files were looked at as part of the inspection and other documentation. A tour of some areas of the building including resident’s bedrooms also took place. The manager filled in an Annual Quality Assurance Assessment (AQAA) form before this inspection. The AQAA tells us what they thought they did well, how they have improved and what they could do better. Ten service user surveys and seven staff surveys were returned to us before this visit. We considered the responses and other information gathered during the visit and have referred to this in the report. Since the last key inspection there have been further changes to the management arrangements for the home, the home have a new manager who has been in post since March 2009. She has submitted her application and is now registered with the Commission. The concerns/allegations investigated under Salford Council’s adult safeguarding procedures have progressed and have been concluded. The owners were required to carry out their own internal disciplinary proceedings for a number of staff members which they have since advised us have been completed. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.2 Page 6 What the service does well: The pre admission assessments are well completed and the information was used to develop the person’s care plan. The environment both internally and externally makes a pleasant, comfortable environment for people to live in. People spoken to liked their bedrooms and comments in the surveys and observations made showed the home was kept clean. The home continues to have flexible visiting arrangements and encourages people to have regular contact with their families and friends. The staff were warm and welcoming with the people who live at the home and relatives. One relative said how,“ Warm, friendly and attentive” the staff are. The mealtimes were flexible and the food was enjoyed by the residents. Proper employment checks are carried out before new staff start work in the care home. This means that the home is sure the staff they employed are suitable to work with older people. Systems are in place to support people living at the home or relatives to raise any concerns and a visitor to the home said he knew he could speak to the manager if he needed to. The manager knew the needs of the people well and was a positive influence in making changes at Worsley Lodge. What has improved since the last inspection? Since the last inspection the record keeping, particularly the risk assessments and care plans have been improved. These are being reviewed and monitored on an ongoing basis to make sure information is current and it updates staff of the level of support required by each person. There have been improvements to the care delivered to people and the attention to detail. The amount and variety of activities provided has improved and the activities organiser has plans to develop this further. Medicine management and the procedures in place were still being monitored. The atmosphere in the home is more positive and relaxed and the staff are motivated to provide a pleasant environment for the people who live at Worsley Lodge. There has been an improvement in the training and induction made available for the staff. There has been no use of agency staff in the last twelve months. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.2 Page 7 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. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People using the 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 are given information, and have their needs assessed before moving into Worsley Lodge, so they know that their needs can be met. EVIDENCE: A copy of the Statement of Purpose and a Service User Guide was on display in the reception area on the day of this visit. The manager stated that when a person is admitted to the home they are given a copy of these which outline the complaints procedure and information about the service provided. Nine of the ten people who returned surveys stated they “Don’t know” if they received enough information to help them decide if the home was the right place for them before they moved in. It should be noted that all surveys were completed by one of the care workers who supported people to fill in the forms. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 10 Since the last inspection there have been new admissions to the home and three care plans looked at included a detailed pre admission assessment of people’s needs. In the self assessment the manager wrote that the person is visited prior to admission and potential service users are given the opportunity to visit the home to have a meal and get a feel for the home. One relative spoken to confirmed they did visit and spent a good few hours at the home before they made the final decision to stay at Worsley Lodge. A recommendation made at a previous inspection was for the pre admission needs assessment to include the individual’s concerns and wishes about coming into a care home to ensure these identified needs can be met. From the sample looked at it was clear the assessment included people’s needs and wishes. Worsley Lodge does not provide intermediate care. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8, 9 and 10 People using the 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’s health and personal care needs were met in the way they liked by staff that respected their privacy and dignity. EVIDENCE: During this visit we looked at care plans for three people and where possible we spoke to the person to whom the care plan belonged to. These contained detailed assessments of the activities of daily living, risk assessments and daily record sheets. There was evidence of reviews of the plans of care, risk assessments and evaluations made of the problems identified. At the last key inspection a requirement was made for the care plans to be kept under review and to be changed as needed so any changes in a person’s care needs are met. From the sample looked at it was clear these had been reviewed and a number of these rewritten to show clearly the persons individual likes and dislikes. A discussion with the manager and two staff members confirmed that Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 12 a lot of work has gone in to developing a more person centred care plan and they had found this a good exercise to get to know each person well. There was evidence to show the health needs of the people living at the home are monitored, for example monthly weights and if there was a decrease what action was to be taken. For one person the care plan showed that they may react more positively to a male care worker and where possible there were recordings of how the staff had addressed this. Records of visits from health professionals and other services were recorded and showed the advice or change in treatment given. Care plans included a written record of reviews of the person’s care since they had moved in to Worsley Lodge. The manager stated that, “The person centred care plans provide good direction to staff and how service user needs can be met.” Examples were seen of how the assessment of the person’s likes and dislikes was made into a plan of how the staff should support the individual. Appropriate risk assessments were in place for each person. Samples of risk assessments were looked at and there was evidence these were being reviewed and monitored. In the AQAA the manager stated that, “Risks include risk of developing pressure sores, nutrition, moving and handling, continence, bed rails, falling and individual risk assessments.” A recommendation was made at the last inspection for the risk assessments, including moving and handling assessments to be updated when people’s needs have changed. It was clear from the sample looked at to showed these had been updated. One person’s assessment showed that an alarm pad had been put in place to alert the staff when they got out of bed and staff had talked through with this person how to use the call bell system when the need arose. Body mapping records were in place and one of the care plans looked at showed these had been updated to record bruising and any skin markings following their return from hospital. For three of the people looked at risk assessments for nutrition were seen. These included detailed care plans in relation to nutrition and there was evidence of regular evaluations of these in place. Improvements were seen in the care plans and risk assessments overall. The manager told us that one person was being supported by the District Nurses for monitoring their pressure areas and we saw that pressure relieving mattresses were in use for people identified as being at risk. Some improvements were seen in the detail written in daily statements recorded which showed what had happened to the person during the day. Staff were seen to encourage people to drink throughout the day although juice was not as readily available as seen on previous visits. One person said, “Oh I am always ready for another cup of tea but the girls do make me them when they can.” Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 13 Care plans included reports of reviews of people’s care needs that have been carried out with the person and their families either face to face or by telephone. People who expressed a view about their care were satisfied with the way their needs were met. One person’s relative said they were included in the plan of care and they found this useful to know how the staff were supporting and treating their relative. The commented, “The manager and in fact all the staff are very approachable and they communicate well with us.” In the surveys people stated that they always or usually received the care and support they needed. One person commented that, “The staff here are very kind and helpful.” Comments from the people living at the home and from observations made during the inspection showed they were treated with respect and dignity. Staff were heard talking to people in a respectful and pleasant manner. Where possible people were encouraged to carry out tasks to promote independence and staff were seen allowing people to mobilise whilst supporting others who needed this. A staff member was seen supporting a person who was tearful. They showed respect towards the person’s feelings and encouraged them to attend the hairdresser. At lunchtime this person said, “Oh I feel so much better for having my hair done, it makes me feel human.” Another person was seen to enjoy assisting the staff to set the tables at lunchtime, this person said, “I like to do some jobs it makes me feel good.” A sample of medication administration records was looked at together with the medicines held by the home for those people. Overall these were found to be satisfactory. Medicines were stored in a locked room and the medicines currently in use were neatly stored in locked cabinets. Residents were given their medicines as prescribed. Staff were not always sure of what the prescribed medicines were for and a recommendation was made for staff to be aware of what these were for to assist them in understanding the person’s needs more fully. We saw that the manager had made regular checks about how well staff were handling medicines. Errors in the record keeping were being picked up and staff were reminding each other if there were shortfalls in the records. A list of staff specimen signatures regarding medication administration was available. A sample of Controlled Drugs were looked at and found to be stored, recorded and administered appropriately. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 14 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 and 15 People using the 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 opportunities in place for people to engage in social activities and an improvement in the care plans means that people’s social, dietary, cultural and recreational needs are being met more fully. EVIDENCE: The manager said that information about people’s daily lives and social activities were gathered on admission. The care plans looked at included a photograph of the person and each person has a “Map of Life” which details where the person was born, school, employment, interests, marital status, children, grandchildren, pets, hobbies and holidays. Each person living at the home now had an individual log of activities to record activities they had joined in. We spoke to the care worker who has recently been appointed as the activities organiser who was keen and enthusiastic about her role and how she planned to develop this. A varied programme of activities was displayed in the entrance hallway which included baking, crafts, pampering, and entertainment. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 15 A small group of people were seen enjoying playing musical instruments and singing during this visit for a photograph from the local paper, this followed on from a new entertainment session which had started the previous day. One person said they had, “Enjoyed making some cards and had a lovely chat with the nice girl.” Another person said they had enjoyed watching a movie with some other people and they had recently enjoyed a Halloween party. The staff were seen spending time with people on a one to one basis and being kind and considerate. A staff member was seen listening and reassuring a person as they gently assisted them to have put their socks on and rest their legs on a stool. Since the last inspection improvements were made to the recording of information about people’s personal wishes, preferences, likes and dislikes. During the visit people told us they were able to receive visitors in the privacy of their bedroom if this was their choice. One relative spoken to said, “The staff are very helpful and kind, they always let me know what has been happening and I have no hesitation in recommending them here.” The home was supporting people to follow the religion of their choice, a local church visits the home to give people communion on a monthly basis. One person said, “I like to receive communion and have quiet time to think and say a prayer.” During this visit the meal was served in a timely manner from the hot trolley in the dining room. Some people chose to eat in the privacy of their bedroom and the staff respected these wishes. The tables were pleasantly laid with tablecloths, flowers and condiments. Choices were made available in line with the likes and dislikes of individuals. One person said, “Look I have a jacket potato and fish but it is my favourite.” The dining tables showed details of the day’s menu, which was displayed in a format that could be seen by the people living at the home, so that they know what the meal choices are for each day. The meals shown in the entrance hall did not reflect the meal of the day although the manager took steps to correct this information during the visit. People who expressed a view were positive about the meals provided and responses in the surveys were they usually or always liked the meals provided. Visitors said they were always made welcome at the home and this is positive as it encourages people to maintain their links with family and friends. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 16 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 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home encouraged and supported people to raise their concerns or complaints and had the policies, procedures and systems in place to protect people from abuse. EVIDENCE: The complaints procedure was available and a copy was displayed in the reception area of the home. There has been three complaints made either directly to the home or to the Commission since the last inspection in November 2008. Two were in relation to staffing issues and the other in relation to the meals provided. These concerns have been appropriately investigated and the concerns have been addressed by the service. The concerns/allegations being investigated under Salford Council’s adult safeguarding procedures have now been concluded. We were told that areas identified for the management to address had been addressed including internal disciplinary action for staff members as necessary. Two staff members spoken to were aware of the procedures to follow in the event of an allegation of abuse. The home has a copy of the guidance from Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 17 the local council. Nineteen staff had attended Protection of Vulnerable Adults (POVA) training since the last inspection. From the ten residents surveys returned before this visit, the majority of surveys showed they were aware of how to make a complaint and one person added they knew whom they would speak to if they had any concerns. In response to the question, “Is there someone you can speak to if you are not happy.” All residents/relatives responded “always”. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 18 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): People using the 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 residents live in a safe, well-maintained home that was clean and comfortable. EVIDENCE: A partial tour of the home showed that the bedrooms of people living at the home and the downstairs lounge and dining room were homely and pleasantly decorated. The first floor lounge and dining areas looked homely and these rooms were not currently in use. Bedrooms were personalised with photographs and ornaments. Some people showed us their bedrooms which were personalised with items of their own furniture and photographs, homely, clean and pleasant. The corridors included pictures and newspaper headlines to encourage people to use their memory and one person was seen to chat and tell a staff member Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 19 a story as they walked along the corridor to the bathroom. Resident’s bedroom doors are painted different colours to help them be orientated within the home. The environment overall was clean, homely and reasonably well maintained. The carpet on the ground floor was looking worn and a number of bedroom doors had paint damage from the wheelchairs, the manager stated that both these were due to be addressed. The home employed domestic and laundry staff and these were observed to be busy throughout the home. A variety of equipment was available in the home to ensure the physical care needs of the residents could be met. All staff had received training in infection control practices since May 2009. Of the ten residents/relatives who returned comment cards the responses were positive about the cleanliness of the home. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 20 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 and 30 People using the 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 number, deployment and training of staff appeared sufficient to meet the needs of people accommodated. Procedures for staff recruitment were in place to protect people at the home. EVIDENCE: The staff on duty on the morning of this visit was the manager and two care workers for the seventeen people accommodated .The manager was “hands on” until the senior care worker was due in at lunchtime. The staff team were supported by laundry, kitchen and domestic staff. An administrator is usually on duty however they were not in on the day of this visit. Although we consider people’s needs were met, there were periods when the lounge area was unattended due to the demands on the manager and staff on this particular morning. One person’s relative was looking for a staff member to support their relative because they were trying to leave the premises and their relative was demanding “another smoke.” Another person fell to the floor during the late morning and the activities organiser had to press the emergency call bell to alert the care staff. There were lengthy periods of time where people spent time dozing in their chairs. During the lunch time meal one person needed some encouragement to eat their lunch and the staff were busy supporting other people and giving out meals to those who chose not to eat in Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 21 the dining room. Some people were asking for another drink and although the staff were able to provide this eventually, the people had to wait to fit in with the staff. The demands on the staff present were high, relatives were present for a review of a person’s care, nurses came to administer flu vaccinations, the hairdresser was present in the home. It was of some concern the vaccinations were given in the day area and with no respect for a person’s wish for privacy. The manager agreed that even though these had been previously arranged, there was “insufficient time to take people to their rooms for them to receive the vaccinations in the privacy of their bedrooms.” This was confirmed by the staff on duty. Discussion with the manager, the staff team and from observations made during the visit identified that people’s care needs were being met. The manager added that she did have the option to bring in an extra person if she had considered it necessary. People were seen to be appropriately dressed and one person said, “I do choose what I want to wear with the help of these girls.” In order to be confident the number of staff on duty are sufficient staff to meet the needs of the people living at the home, the manager should monitor the rota in relation to the skill mix, the needs of the people accommodated and the activities of the day. People living at the home spoke favourably about the staff team and said they were kind and helpful. Staff were heard chatting pleasantly to people living at the home and they were seen to be kind and supportive. There was evidence that there had been no use of agency staff by the home since the last inspection. This had been an issue creating a lack of continuity of staff. A look at a sample of duty rotas for recent weeks showed that no shifts were covered by agency staff. One of the staff that worked at the home said, “I think we generally work well as a team and they thought the atmosphere was good for the residents.” As part of the visit we looked at the procedure in place for the recruitment of staff. We looked at the staff records to check that people are supported and protected by the home’s recruitment policy and practices and that staff are trained and competent to carry out their job. Four staff files were looked at which showed completed application forms, written references and proof that POVA first and Criminal Records disclosures had been carried out. The staff-training matrix showed there was an ongoing programme of staff training. Recent training for some staff had included infection control, bed rail safety, moving and handling, fire safety and food hygiene. Each staff member had an individual training record and the training matrix showed any gaps. A recommendation made at the last inspection for a training Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 22 plan to be put in place so that any gaps seen in the training can be identified and a plan put in place to address the shortfalls had been addressed. Staff records showed that regular supervision and appraisal of staff’s performance was being monitored. In response to the question, “Do you feel you have enough support, experience and knowledge to meet the different needs of people who live at the home?” Five staff who filled out surveys said, “Always” and two said, “Usually.” One person added, since the new manager has been here there has been more training provided. A staff member spoken to said she had a three day induction, where she felt she gained a lot of knowledge to help her to get started. She went on to say that she has felt “Well supported by caring staff.” Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 23 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 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place to monitor care practices, medication and record keeping to safeguard the interests and well being of the people living at the home. EVIDENCE: Management arrangements for the home had changed since the last inspection in November 2008. The new manager had been in post for eight months at the time of this visit. As part of the request to have the restriction on admissions to the home lifted we requested that an application for the Care Quality Commission to register the manager be commenced. This was addressed and her application was processed. The service is benefiting from a period of Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 24 management stability for the service to respond fully to the needs of the people living at the home. The manager stated she “was enjoying her role in developing the service and making this a good home for the people who live here.” A discussion was held with the Operations manager who said she visits the home regularly and audits the service on a monthly basis and is there to support the manager. One of the care workers said, “Jackie is what this home needed, she is great because she knows what is happening with staff and residents.” Conversations with the manager during the day showed she had addressed areas for development, for example care planning and documentation, training and activities and improvements were seen to make the service better for the people living at Worsley Lodge. Staff were seen to be kind and supportive to the people living at the home and were chatty and relaxed in their approach. Records of accidents and incidents occurring in the home were being made in an appropriate log book. At the last inspection a discussion was held about the time delay when these records were looked at by a senior staff member. From the sample looked at during this visit the manager had reviewed these in a timely way and there was a record of appropriate courses of action to be taken following a review of the accident/incident for the person involved. For one person, new wedges had been purchased as a preventative measure following a re assessment of risk after a fall from their bed. Staff said the manager was supportive, approachable and that she spent time working alongside the care staff in the home. The manager said she liked working with the staff as it gave her an opportunity to monitor the care practices and staff supervisions. Minutes were available of staff meetings, and relatives meetings had recently started. Equipment in the home is checked and maintained by professionals e.g. hoist, gas, electric and fire extinguishers. Records were maintained of professional visits and service reports were available which detailed the ongoing maintenance in the home and this included fire safety records. A quality assurance questionnaire had been sent out since the last inspection in July 2009 to find out the views of people living at the home, professionals and visitors. A copy of the results was held on file, which the manager said were generally positive. Visitors spoken to said they would not hesitate to raise any concerns with the manager. In addition to the formal quality assurance programmes the views of the people living at the home are gained during the service provider’s Regulation 26 visits. Copies of these monthly visits continue to be forwarded to us at present. The manager said she has an open door policy and encourages people to raise concerns or discuss any issues about the service being provided. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 25 Procedures for the management of peoples’ monies were computerised. Money is not held on site but evidence of receipts for purchases made on a person’s behalf were seen. The sample looked at was found to be satisfactory which ensured that peoples’ financial interests were protected. For two people a concern was raised in relation to the large amount of money held that could be in an interest bearing account for the individual. The manager stated she would look into this. One staff member wrote in the survey, “In the last 7-8 months this home has been transformed, this is down to the staff and in particular the manager. She is really bright and bubbly and is always encouraging us to think of new ideas to help give our residents a better quality of life, because she cares about older people. Residents are well cared for and always put first.” Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 26 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 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 Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP27 Good Practice Recommendations In order to be confident the number of staff on duty are sufficient staff to meet the needs of the people living at the home, the manager should monitor the rota in relation to the skill mix, the needs of the people accommodated and the activities of the day. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 28 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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). 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. Worsley Lodge DS0000006733.V378356.R01.S.doc Version 5.3 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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