Eagle Lodge Care Home Service 488/1 Ferry Road Edinburgh EH5 2DL Telephone: 0131 551 1611 Type of inspection: Unannounced Inspection completed on: 19 July 2017 Service provided by: Salvation Army Service provider number: SP2004005634 Care service number: CS2003010900
About the service Eagle Lodge is a care home for older people located in north Edinburgh providing residential care for up to 35 older people. Public transport and shops are nearby in the local area. The home is set in grounds with its own parking. There is a small enclosed courtyard garden area for the use of the residents. The service is provided by The Salvation Army ("the provider"). There are 33 single bedrooms with en-suite toilet and wash hand basin facilities and two self-contained onebedroom flats. The home has three floors and a lift. The main lounge and the dining room are on the ground floor, where most people like to gather to socialise and take part in activities. There is an activities room and a hairdressing room and separate kitchen, laundry and staff facilities. Additional lounges and small kitchens are located on the second and third floor. The aims of the service are: 'To provide high quality residential care for older people from diverse cultures for whom independent living in their own home is no longer a possibility'. There were 34 residents at the time of the inspection. What people told us During the inspection we met the majority of the residents and spoke with 11 individually. We observed lunch time in the main dining room and activities in the lounge. We observed people getting around the home, setting off on an outing and receiving visitors. Residents told us they were happy with the staff supporting them and that they had confidence in the way the home was run. They confirmed they could make decisions about their care, that they were helped to maintain important relationships and that their visitors were welcomed. Comments included: - "We're well taken care of". - "I think I'm well looked after. I like to be in my own room, but there's always someone popping in". - "We are well looked after, staff are doing a good job". - "Staff are alright, I get on alright with them. I miss the domestic who is on holiday. The home is quite well run but my room isn't big enough for a wheelchair. I've been promised a room that will be altered. The food is not to my taste, I'm fed up with curries". - "It was my choice to come to live here. I am settling in". Three residents commented on the meals, requesting plain, Scottish food and fresh vegetables. Some residents were less able to tell us what they thought about the service or the care they received. We spent time observing how staff supported and interacted with these residents and how they spent their time. We noted that they were familiar with the home's routines and staff. We saw that residents responded positively to support from staff and enjoyed individual attention. We also saw how residents looked out for one another. page 2 of 10
We saw that the home was open, welcoming and friendly. Families were encouraged to make themselves at home and to join in with whatever was going on. Quiet spaces were also available. There was a relatives' noticeboard with current information. Relatives were encouraged to be part of the community and we saw that they were eager to participate or volunteer their time. We attended the home's Summer Fair and saw that it was a joint effort between staff and families. We spoke with nine family members, all of whom were very satisfied with the quality of the service. They liked the homely atmosphere and the provision of activities. Relatives said they found the home to be clean, comfortable and well run. They said they were happy to have chosen Eagle Lodge and felt that there was a partnership approach to looking after their family member. Comments included: - "Overall we're very pleased with Eagle Lodge and feel glad that mum is being well looked after by caring staff". - "Eagle Lodge was recommended and it has more than lived up to our expectations". - "Mum has thrived here". - "It's great, it suits my relative. We looked around at other care homes". - "Mum loves (the acting head of care)". - "The manager knows everyone and their story". - "The food can be calorific, but that's for a reason. The fresh sandwiches are lovely". - "It was the right choice to come here". - "I've been told we can book the small sitting room for a birthday gathering". - "The GP recommended Eagle Lodge". - "It would be good if they could have foot cycles for leg exercises. My mother used them when she went to a day centre". We spoke with two visiting professionals and contacted others for their feedback about the quality of the service. Comments included: - "The service definitely contributes to improved outcome for residents. This is evident in how they embraced the Care Inspectorate and Pharmaceutical Society guidance to administer medications from patient packs. Not only that, medications are now stored and in the main administered in individual rooms. This has allowed more privacy, less institutionalised and a safer environment where individuals are less likely to be disturbed thus reducing incidence of any errors. Also through regular audit, staff feedback and a clear disciplinary process the service have ensured that medicines are administered safely by staff and over the 2 years the service has been doing this there is a definite reduction in any administration errors and the standard of recording and medication management has improved to a very good standard. Thus residents and families can trust that staff administer medications safely. Furthermore the service has recently produced a clearer medication policy and guidance again to ensure more positive outcomes for residents. I find staff skilled and knowledgeable when it comes to medication. Having now empowered less senior staff to administer medications with appropriate training it has really increased their responsibility. Senior staff all take turns doing audits and indeed team leaders are rotating into the clinical lead role to widen their skill level. I have been impressed with the focus on medications and page 3 of 10
getting it right by the different team leaders. The manager, clinical leads and team leaders as well as the company's overall clinical lead are all a pleasure to work with, very responsive to feedback, proactive also in asking for feedback and often consult myself and the pharmacy for advice. Well done Eagle Lodge. Definitely a home that takes the importance of administering medication very seriously". - "The Caring for Smiles programme is working well within Eagle Lodge and a number of staff have started the SCQF accredited training programme. Staff have engaged well. They provide good care, there's a good leadership team who are willing to listen". - "It is friendlier than other homes I got to. It is like a community or a village. I go out feeling better than when I came in". - "The staff in Eagle Lodge are always looking out for the interests of their residents, and where this can improved. They have contacted our services to help/support them in doing this (reducing stress/distress). There is positive communication with senior staff at Eagle Lodge, and good links with the Residential review team. In my view this seems to work very well. In general staff at Eagle Lodge strive to support their clients in their current setting (rather than trying to move them on). They demonstrate a reasonable knowledge and skills which they apply to their client group where they can - e.g. they will try different approaches/ways of doing things if the resident is becoming distressed or resistive. Staff will listen to advice (from our service) and carry out any instructions/gather information where asked. Managers/senior staff are always available and responsive when asked for". - "The home's previous practice closed and we took it on to see if we could help. The manager and team leaders are really great, they are quick to respond to calls and have taken on new forms that we've introduced. They are keen to get good working relationships and to have a more regular visit, so it's really positive. The care appears good, the home is warm and welcoming. The only thing is that the team would benefit from more training and confidence in end of life care. They took on board feedback about this. We'll work together on anticipatory care planning". - "Our District Nursing team generally visit Eagle Lodge twice a week for planned visits, then visit when called by the staff or the GP. The staff are helpful, skilled and knowledgeable. If one member of staff is not as familiar with an issue, they consult another member of staff so we are fully informed. The managers and team leaders are available to assist with any concerns or questions, and respond promptly as necessary. The service provided at Eagle Lodge definitely has improved the outcomes for the service users. We have noticed that there are fewer calls to the District Nursing Service over the year that we have been visiting and the residents are treated with respect in a friendly manner. When we have patients who are needing palliative care, the staff are very supportive to the patients and their families. We have not had any adult protection concerns in the year that our District Nursing team have been caring for the residents". - "Every visit to Eagle Lodge Care Home is a friendly one. Staff are always helpful and accommodating. If we have any requests or questions the manager/staff are always on hand to help out with no fuss. This comes across as a very professional establishment". - "I have found that Eagle Lodge is very proactive with regard to the management and prevention of falls. The manager takes positive steps to support staff with increasing their skill and knowledge in this area. Staff are always very helpful. The team leads have a very good understanding of the needs of the residents and they readily embrace advice and suggestions made by myself". page 4 of 10
Self assessment We did not ask services to submit a self-assessment for this inspection year. Instead, we are asking services about their improvement or development plan. We looked at the self assessment the service submitted in 2016. We found this to be a fair self-evaluation and awarded the same grades as those suggested by the service for the themes we looked at during this inspection. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good not assessed not assessed 5 - Very Good What the service does well People received very good care in a comfortable, welcoming and safe environment. Residents were respected and listened to. Most enjoyed the community feel of the home, choosing to spend time together and joining in with activities. Residents' personal plans were well maintained and guided staff on how each individual should be supported with their health and care needs. Potential risks were clearly identified and monitored. Regular care reviews took place to ensure that residents' care plans were up to date and everyone was being consulted. Families confirmed that the manager and staff knew their relative very well. They said they had been asked to help record their relative's life story. We saw examples that contained stories and photographs and provided staff with a good sense of key events in a person's life and what was important to each person in their care. The activities programme was varied, meaningful and inclusive. There were group and one to one activities. During the inspection there was a barge trip, a summer fair and an outing to Leith woollen mill in addition to inhouse activities. People described warm working relationships between staff and residents and a relaxed atmosphere. This was consistent with what we saw during the inspection. Care was rights based, person centred and compassionate, in keeping with the new Health and Social Care Standards, available at: http://www.gov.scot/resource/0052/ 00520693.pdf. The home was calm and well run. Senior staff had very good oversight of residents' needs. The manager was visible and actively involved in day-to-day life in the home, demonstrating the quality of practice expected from each team member. There was continuity of care delivered by a team of well motivated staff who knew the residents and their relatives very well. Dependency assessments were up to date and linked to staffing levels. The service was working to deliver staffing above that set out in the home's staffing schedule, in order to enhance the care provided. In addition, the activities coordinator hours had been increased. Staff were well supported. The home's qualification audit for June 2017 showed that 81% of care staff held SVQ level 2 (above the national average for care homes for older people) and that all care staff had registered (or were in the process of) with the SSSC. They had very good opportunities to develop their skills. For example, page 5 of 10
team leaders were making use of the leadership resources available from the Scottish Social Services Council. There were plans to roll out the Supporting Excellence dementia training resources. There was sound knowledge of adult protection matters (safeguarding). Supplementary adult protection training had been arranged with the City of Edinburgh Council. The staff team worked very well together and with external professionals and agencies, to the benefit of clients. The area manager (Scotland and the north of England) was Edinburgh based and visited frequently, guiding and monitoring the service. The service had a robust range of quality assurance systems to monitor all aspects of the service, ensuring residents and staff were protected. The staff enjoyed their work and were well motivated. There was a high level of enthusiasm for developments and new ideas. Managers were working hard to deliver continuous planned improvements and routinely involved residents, relatives and staff in determining the areas to prioritise. Progress with improvements was shared with residents and families. Improvements to the environment included: the refurbishment of bedrooms and en-suite facilities; better lighting and signage, in keeping with good practice for people with dementia; an improved entrance area and further developments to the enclosed garden. The service was working hard to strengthen medication administration and recording systems. Supplementary training was to be added to reduce errors, including in-depth training and support for staff. The service had linked with a new GP practice and residents were having their medication regularly reviewed. The service had acted on the suggestions made at the last inspection. There was an open and receptive approach to inspection. What the service could do better We made a number of suggestions for further improvement, including: - Exploring activities which may be of specific interest to male residents, - Considering how to meet the new Health and Social Care standard: I can participate in menu planning, - Requesting copies of legal powers such as Power of Attorney as advised by the Mental Welfare Commission for Scotland. This ensures that the staff team know who the attorneys are and what is included in the powers, - Ensuring we are notified of all incidents of actual or potential harm to residents, in particular, medication errors. Requirements Number of requirements: 0 Recommendations Number of recommendations: 0 page 6 of 10
Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. Inspection and grading history Date Type Gradings 27 Jul 2016 Unannounced Care and support 5 - Very good Management and leadership 14 Jul 2015 Unannounced Care and support Management and leadership 18 Aug 2014 Unannounced Care and support Management and leadership 6 Mar 2014 Unannounced Care and support Management and leadership 5 Sep 2013 Unannounced Care and support Management and leadership 12 Feb 2013 Unannounced Care and support Not assessed Management and leadership 27 Jun 2012 Unannounced Care and support page 7 of 10
Date Type Gradings Management and leadership 2 - Weak 1 Feb 2012 Unannounced Care and support Management and leadership 17 Nov 2011 Unannounced Care and support 1 - Unsatisfactory 1 - Unsatisfactory 2 - Weak Management and leadership 1 - Unsatisfactory 9 Sep 2011 Unannounced Care and support 1 - Unsatisfactory 1 - Unsatisfactory 2 - Weak Management and leadership 1 - Unsatisfactory 20 Jun 2011 Unannounced Care and support 2 - Weak 1 - Unsatisfactory 2 - Weak Management and leadership 1 - Unsatisfactory 8 Nov 2010 Unannounced Care and support 2 - Weak 1 - Unsatisfactory Not assessed Management and leadership 1 - Unsatisfactory 8 Jul 2010 Announced Care and support Not assessed Management and leadership 4 Mar 2010 Unannounced Care and support Management and leadership 21 May 2009 Announced Care and support page 8 of 10
Date Type Gradings Management and leadership 10 Feb 2009 Unannounced Care and support Management and leadership 10 Oct 2008 Announced Care and support Management and leadership page 9 of 10
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 10 of 10