Inspection on 03/11/09 for Colin Gardens Lodge

This is the latest available inspection report for this service, carried out on 3rd November 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Similar services:

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Chatsworth Care - Tudor Lodge

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Colin Gardens Lodge 67 Colin Gardens London London NW9 6EP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Thomas McKervey     Date: 0 3 1 1 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 Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Colin Gardens Lodge 67 Colin Gardens London London NW9 6EP Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Martin Kriho Type of registration: Number of places registered: care home 3 Dana Care Ltd Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Whose primary care needs on admission are within the following categories: LD (Learning disability) PD (Physical disability) The maximum number of service users who can be accommodated is: Three The Registered Person may provide the following categories of service only: Care Home only-Code PC To service users of the following gender: Either Date of last inspection Brief description of the care home Colin Garden Lodge was an existing registered care home, but was newly registered in June 2009, under the proprietorship of Dana Care Ltd. The home continues to be managed by the same registered person. The home is a terraced house located in a quiet residential street in Colindale. The Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 3 3 3 3 Brief description of the care home house consists of three bedrooms, one on the ground floor and two on the first floor. There is a small room on the first floor for staff, which is used as an office and sleep-in room. The ground floor has a toilet, lounge and fitted kitchen. There is a secluded enclosed garden at the rear of the property. The home provides care and support for up to three people, male and female, who have a learning disability. The registered owner also has another small care home in a neighbouring borough, which provides a similar service. The Service User Guide states that the aim of the home is to provide a comprehensive service where the needs of service users will be recognised through proper assessments and care plans. Inspection reports produced by the Care Quality Commission, (CQC) are available upon request from the registered manager/provider. Following Inspecting for better lives the provider must make information available about the service, including inspection reports, to service users and other stakeholders. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was completed in four and a half hours. The inspection was carried out as part of the Commissions inspection programme and to check compliance with the key standards. At the time of the inspection, the home was fully occupied and there were no vacancies. When we arrived at the home, the registered manager was absent, but we were assisted by a member of staff who cooperated fully with the inspecton. The manager arrived towards the conclusion of the inspection and also offered us every assistance. The inspection involved sampling care plans and records and visiting all areas of the home. We observed how the manager, staff and the resident who was present, interacted with each other. Before the inspection, the manager sent us the homes AQAA, (Annual Quality Assurance Audit). This document is a self assessment of how the home meets the National Minimum Standards. Against each standard, the home is asked to provide Care Homes for Adults (18-65 years) Page 6 of 26 evidence about what the home does well, what they could do better, how they have improved in the last 12 months and what their plans are for improvement. The AQAA also provided numerical information about the service. Reference is made to this document in relevant sections of the report. Care Homes for Adults (18-65 years) Page 7 of 26 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 Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. People who may use this service can be confident that their needs will be thoroughly assessed before being admitted to the home and they will be provided with good information about their rights. Evidence: No new people have been admitted to the home since the last inspection and the home is fully occupied by three residents, one male and two females. The records showed that they had been assessed by the Community Learning Disability Team or the Primary Health Care Trust when they were referred to the home. The manager had also carried out his own assessment to ensure that the home was appropriate for their needs. The assessment includes life histories and the individuals likes and dislikes, which are written in the first person. Two people were at their day centre or college, but one resident was present during the inspection. They said they enjoyed living at Colin Garden Lodge and liked their room. All the residents are fully mobile and the property provides a homely environment. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Each person who lives in the home has a Service User Guide, which is written in pictorial format. One resident had signed this document. There is a clause in the Service User Guide about what is covered by the fees and states that the residents contribute the mobility component from their disability living allowance towards the homes transport costs. This is a minibus that is used to take the residents to various day centres, colleges or on other outings and may also pay for taxis if necessary. In the AQAA, the manager states; Every Service user is given a Service User Guide, comprehensive care Plan, risk assessment, behaviour management guidelines and Health Action Plan. Several visits and an orientation programme are planned in accordance to the individuals need including overnight stay prior moving in and visits to many of the local facilities. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 resident can be confident of having a care plan that focuses on their strengths and is written in a style that they can understand. These plans are kept under review to take account of any changes in the persons needs. The residents are involved in the day to day running of the home and are supported to make their own decisions and choices. Evidence: All three care plans were examined. They were written in plain language and were pictorial in format. The care plans contained full assessments of the persons needs; for example, health, social, religious and cultural issues were identified. Each person has a pen portrait, providing examples of their likes and dislikes, such as; I am a happy person but I like to be kept busy and stimulated by being involved in what is going on in the home. The plans were typed and there were handwritten comments by staff to show they were regularly reviewed to assess any changes. Detailed risk assessments that covered activities in the home and the community were also documented. There were Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: clear guidelines for staff about how to support residents activities that may compromise their safety, for example; Remind her to keep a short distance away when cooking. The manager states in the AQAA; Every service user has a care plan, risk assessment, health action plan, behaviour management guideline (if needed) which clearly identifies needs and choices of every individual. It also guides the staff to identify the level and area of support and guides them to promote individuals independence. The manager informed us that a particularly vulnerable resident was assessed under the Mental Capacity Act, relulting in Deprivation of Liberty safeguards being put in place to protect them. We were informed however, that it has not been necessary to impose any restrictions at the present time. We recommend that copies of relevant documents are kept in the residents file in the home. Regular meetings are held between the residents and staff, the minutes of which showed that residents are supported to make decisions and offer suggestions about day to day activities in the home. A resident told the inspector that they decided what time to go to bed and described the type of food they chose to eat. This person offered us tea during the inspection on their own initiative, without any prompting by staff. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 people who live in this home have a lifestyle that enables them to be part of the local community and promotes their independence. The residents are supported to maintain links with their families and they are able to exercise choice about their food and the range of activities available to them. Evidence: We noted that each person has a weekly activity programme, a copy of which was kept in their bedrooms. At the time of the inspection, one resident had just returned from an outing with a member of staff. We were informed that this persons placement in a day center had been withdrawn because of challenging behaviour. However, they have now been referred to a more appropriate day care centre. The other residents were at their day centre/college. One person also attends pottery classes. We observed a resident helping staff to put away the weekly shopping. The home has a minibus, and all the residents have freedom passes, which are used to go on outings. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: The residents are supported by staff to clean their rooms and do their laundry. These tasks are recorded in each persons daily diary. Considerable effort has been made in the past by staff to support residents holidays abroad. Currently, it is planned for one of the residents to go to Tunisia. Two residents have regular contact with their relatives. One person often goes home at weekends and one person has occasional visits from their family who live abroad. Visits to the home by relatives and friends were recorded in the visitors book. Copies of the menus were available in the kitchen. There was a good variety of meals some of which were prepared from Halal meat in accordance with residents culture and religion. The meals actually taken are recorded in daily diaries. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are supported in a sensitive manner that respects their privacy and dignity. The residents have full access to healthcare services and medication is administered safely and is regularly reviewed to safeguard their wellbeing. Evidence: Guidance about how to support residents regarding their personal hygiene is documented in the care plans. The resident who was present during the inspection appeared clean and well dressed. All the residents were reported as being in good health. The resident we spoke to said that the staff treated them well and we observed that the staff were respectful in how they spoke to the resident. Each resident has a Heath Action Plan in pictorial format to help the residents to understand them. They provide the persons medical history and information about allergies and any immunisations. All appointments with health professionals such as, the G.P and members of the Community Learning Disability Team were clearly recorded. We saw records of CPA meetings with the psychiatrist at which medication was reviewed and altered if necessary. The residents had also been seen by dentists, opticians and chiropodists, Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: and a behavioural psychologist had provided advice about managing a resident who has challenging behaviour. There were records showing that people are weighed monthly. None of the residents are able to self-medicate. There was evidence in the case files that medication was reviewed regularly by the consultant. The manager states in the AQAA; We have probably prevented a mental health break down of a resident, by monitoring and quick referral to seek help and advice from mental health team in Barnet with whom we have very good and close relationship. We also sought support from the Psychiatrist and Medical Appliances Department of Barnet General Hospital. Any accidents are recorded on special forms, along with details of any actions taken. The forms are filed in the individuals case records. None of the residents are able to self-medicate. There was evidence in the case files that medication was reviewed regularly by the consultant. Medication in the home is dispensed in blister packs and PRN medication is in labelled containers, both of which were stored securely in locked cupboards. The signatures of staff who had been trained and authorised to administer medication were in the medication folder and the records of administration had no gaps and were up to date. The manager stated that the home has a book for recording unused medication, but at the time of this inspection, it was with the pharmacy. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home can be confident that any concerns are listened to and acted upon and they are protected from abuse through staffs training and awareness of abuse issues. Evidence: The home has a written complaints procedure, and following a recommendation at the last inspection, the complaints procedure is in pictorial format so that residents can more easily understand the process. We looked at the complaints log which showed that none had been received in the past year. The home made a safeguarding referral to Barnet Social Services in the past year, which lead to a strategy meeting being held. The outcome of the meeting was that the incident had been managed properly by the manager and appropriate further safeguards were implemented to protect residents. Staff records showed that they had undertaken adult protection training, and the member of staff we spoke to, demonstrated a good awareness about whistle blowing and how to report suspected abuse. The manager states in the AQAA; All our service users are encouraged and have plenty of opportunities to speak out or talk about their concerns and worries in private. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, 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. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate 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 home that is comfortable and clean, but is in need of refurbishment to improve their enviornment. They are able to have their own possessions around them, which contributes to them seeing the home as their own. Evidence: The home is very comfortable and inviting. The communal lounge is well furnished with comfortable leather seating, and there is a large television. There are three bedrooms and a room that is used as a staff sleep in, and office. There is a kitchen/diner, which also contains domestic style laundry equipment. The home has one toilet on the ground floor, and a bathroom & toilet situated on the first floor. The garden had appropriate furniture and the garden gate was secured with a padlock. We saw evidence of personal items in residents bedrooms, including family photographs etc. The resident who was present during the inspection said they were happy with their room. There was no shower curtain or screen in the bathroom, which we have made a requirement about. We also noted several other maintenance and repair issues; for example, the kitchen worktop cover was damaged and needs to be replaced; the cover for the gas boiler was loose, and the wallpaper in a residents bedroom was torn. The manager assured us that the home was about to be refurbished and these issues are included in the operational plan and in the AQAA; There are plans to improve and Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: redecorate the home. At the time of the inspection the home was clean and tidy and there were no offensive odours. Care Homes for Adults (18-65 years) Page 20 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Residents can be confident that their needs are being met by staff who are well trained and competent to support them. The homes recruitment procedures are thorough, which safeguards residents best interests. Evidence: The satff rota showed that there are two staff on duty during the daytime, and a member of staff sleeps in at night. Three new staff had been recruited since the last inspection and we looked at their records. We found that application forms had been completed, interviews held and checks made with the CRB. References were also obtained before staff started working in the home. We saw evidence that new staff had undergone an induction and they had either completed, or were enrolled on, mandatory health and safety training courses. Other courses attended included POVA, medication and the use of rectal Diazepam. The AQAA states; All the staff have completed NVQ Qualification or are in a process to do so. All staff undertook a common induction programme and have a job description. The home operates an Equal Opportunity Policy. We saw records of some staff supervisions, but these were not being done regularly. Therefore, we have required that formal supervisions take place at least six times a year. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. Residents can be confident that the registered manager has the skills and experience to run the home efficiently. There is a good standard of record keeping and appropriate procedures are in place to safeguard residents health and safety. Evidence: The manager has been in post for several years and was able to demonstrate a thorough knowledge of the residents and their needs. He has City & Guilds management qualifications at National Vocational Qualification level 4. During the inspection, there was a relaxed atmosphere in the home and we observed a good relationship between the manager, residents and staff. The staff who we spoke to, said the manager was always available for support and gave clear leadership about the standards expected. The standard of record keeping was good. Residents and staffs files and other important documents were well structured and easy to follow. We were informed that the Responsible Individual carries out monthly visits to the home to monitor the service. However, the reports of these visits were not available in the home. Therefore, we have made a requirement for these reports to be available Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: for inspection on the premises. The manager told us that a survey of the residents and stakeholders views about the service had recently been carried out, but he had not yet had all the responses. We saw records of regular meetings between residents and staff, demonstrating that they are involved in the day to day running of the home. Health and safety certificates pertaining to the homes installations were up to date and temperatures of the fridge and freezers, were monitored. A fire risk assessment of the property is in place and there were records of fire alarm tests and drills which were carried out regularly. No hazards were identified during the inspection, and staff had been trained in health and safety and first aid. The homes registration certificate and a current certificate of insurance were on display in the home. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 36 18 All staff must receive at least six formal supervisions a year. To monitor staff performance and afford staff a regular opportunity to discuss their work. 30/11/2009 2 39 26 Reports of the monthly visits 30/11/2009 on behalf of the provider must be available for inspection in the home. To provide evidence about the quality of the service provided in the home. 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 6 We recommend that copies of relevant Deprivation of Liberty safeguards documents are kept in the residents file in the home. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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