Inspection on 18/11/08 for Dalkeith Lodge

This is the latest available inspection report for this service, carried out on 18th November 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Dalkeith Lodge 22/12/06

Dalkeith Lodge 03/03/06

Dalkeith Lodge 18/01/05

Dalkeith Lodge 18/05/04

Dalkeith Lodge 21/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2009.

CARE HOME ADULTS 18-65 Dalkeith Lodge 41 Mickleburgh Hill Herne Bay Kent CT6 6DT Lead Inspector Wendy Gabriel Unannounced Inspection 18th November 2008 10:00 Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dalkeith Lodge Address 41 Mickleburgh Hill Herne Bay Kent CT6 6DT 01227 362820 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) sheorattan@aol.com Mrs Baswantee Sheo-Rattan Mrs Baswantee Sheo-Rattan Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One Service User whose date of birth is 14/09/1933. Date of last inspection 27th November 2007 Brief Description of the Service: Dalkeith Lodge (the Service) is registered to provide accommodation and personal care for eight adults who have a learning disability. The accommodation is arranged on two floors. When full, there is provision for two of the bedrooms to be shared by two service users each. All of the remaining bedrooms are for single occupancy. The property is detached and located in a residential street and is within normal walking distance of Herne Bay town centre. There is some private offroad car parking and further parking is available in the surrounding roads. There is an attractive garden to the rear of the property. People who are interested in finding out about the Service, can read the Service Users’ Guide and the Statement of Purpose. These are available from the registered provider. Between them, they give a lot of information about the facilities and services that are provided in the Service. For up to date information about the range of fees, please contact the registered provider. Dalkeith Lodge DS0000023389.V373242.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. The inspection was a Key unannounced and this means that we did not give any warning to the home prior to our visit. The home was fully staffed at the time and there was one service user at home during the day. Other people were out at different clubs or groups. The registered provider has met the requirements made at the previous inspection. The registered provider and one member of staff were on duty at the time. Members of staff changed shift around midday. We were introduced to both staff and spoke to one member of staff as well as the registered provider. The one person in the home was introduced and communicated her contentment with her activities that day. Another person arrived home as we were leaving. The registered provider has plans for a conservatory leading from the dining room and for it to be built before Christmas. The conservatory will free different areas in the home to make a dedicated office space downstairs in addition to the current office. Further plans include decorating and recarpeting various parts of the home. The medication administration is sound but the storage is not altogether secure. The registered provider said she would seek suitable and dedicated storage that will be moved into a new office space when available. What the service does well: The home has improved staff training since the previous inspection and this is ongoing. The plans for a new conservatory are well under way and will improve communal space for people who live in the home as well as provide some dedicated office space for staff. The registered provider was able to demonstrate a clear understanding about the National Minimum Standards. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are arrangements to ensure that people who might want to move in will have their needs assessed and their wishes acknowledged. EVIDENCE: The home has not had any new admissions for some time. The provider said that assessments would take place by consulting the prospective service user and family or representative and using the information from the placing authority and other health care professionals. The home maintains a service user guide and a statement of purpose to help people make an informed decision about choosing a place to live. The service user guide has informal comments from some of the people already living in the home about their life in the home. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Peoples individual plans reflect their needs. People are enabled to make choices and their individual risk assessments promote an independent life style. EVIDENCE: Each person living in the home has an individual support plan that details the assistance they may need. The plans carry a good level of health care information about peoples needs including details of health care professionals input with each individual. The provider has obtained a format for providing person centred plans in the near future. The plans are one of the means for people living in the home to agree and be informed about care they are to receive. They are important documents. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 10 The provider has already started some person centred work in the service users guide with brief information written by people about their lives in the home. This is good practice as it means people using the service have a say in how their home is run. Risk assessments were seen and these are not overly intrusive in peoples lives but help them lead as normal a life as possible. People are encouraged to make decisions about their every day lives. This is done through 1-1 sessions with staff or during group meetings. One person who was staying at home that day said that she wanted to spend her time that way and that the staff were with her. This persons outlook was happy and relaxed. Some comments regularly recorded in service users meetings were of some people saying they liked sharing their bedrooms. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are enabled to take part in a range of social and vocational activities. They are encouraged to keep in touch with their families. The menu is varied and can cater for dietary needs and choices. EVIDENCE: Most people attend one or more community opportunities in the area. Care has been taken to ensure that the clubs or groups are suitable for the range of needs and abilities for each person. Some people are able to travel independently. Families are welcomed and encouraged to visit the home. The provider considers this an important part of the way of life in the home because where there is special communication needs it helps support community contacts. The home has a policy that encourages visitors at reasonable times and has parameters of expected behaviour from any visitor. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 12 The home has a varied menu and this is prepared with active consultation from people living there. This is documented regularly in residents meetings. The menu had a good variety of home cooked food and one person said she liked her dinners. Dietary needs and preferences can be catered for as needed. The kitchen was well ordered. The dining room is light and airy but is currently in need of some redecoration and is cluttered with filing cabinets. However, the provider has plans for a conservatory to be built before Christmas and this will provide more communal space and a dedicated office area for staff where the filing cabinets can be stored. The provider also has plans for the dining room to be redecorated next year. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive physical and emotional support that suits their preferences and needs. Medication administration is suitable and will be improved by better storage facilities. EVIDENCE: Medication is stored in filing cabinets that although locked are not the most secure means of storage. The provider agreed to source a suitable storage system in line with the Royal Pharmaceutical Society of Great Britain. Medication administration is sound and procedures are in place for medication administration to be undertaken by staff. Only staff who have received training in management of medication are able to administer medication. The home has good written records of the involvement of health care professionals with individuals. Health care is responded to as it is identified and records indicate that staff report matters in a timely manner. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 14 One person was seen being supported by staff regarding a health issue and was enabled to express her own choices about the matter. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective system for dealing with complaints and the well being of people who use the service is safeguarded. EVIDENCE: No formal complaints about the service have been received about the service since the previous inspection. The provider and a member of staff were able to discuss clearly complaints and adult protection issues and the importance of acting in a quick and responsive manner should a concern be received. There is a complaints procedure in place and this explains how people can raise a concern about the service. Staff spend 1-1 time with people as well to ensure people can feel comfortable talking about any concerns they may have. Residents meetings are held regularly and these are documented. Records indicate that people are free to express their choices and decisions about their life in the home. A procedure is in place for staff to guide them about what is good practice and how to safeguard peoples well-being. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a well-maintained and comfortable environment. The home is clean and hygienic. EVIDENCE: The home was clean and comfortable and the provider pointed out several areas where redecoration is planned in the coming year. Since the previous inspection the home has completely overhauled the upstairs bathroom. This is now a clean, modern and pleasant room. There are advanced plans for a conservatory to be built on to the back of the house. The provider hopes that this will be completed by Christmas. As previously stated, the conservatory will provide an office area for staff in addition to the main office upstairs. It will also be an area for the filing cabinets to be kept that are cluttering the otherwise airy and spacious dining room. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 17 The lounge is also to be redecorated and this will brighten up that environment. One person spent the day in the lounge and indicated that she liked it there and was happy listening to music and talking to the staff who spent much of the time with her in that room. The laundry area off the kitchen was clean and tidy. The kitchen was clean and well ordered and has been found satisfactory by the department of environmental health. Although there was anecdotal evidence of people being aware of hot radiators the registered provider agreed to provide suitable risk assessments and systems for ensuring the radiators are not a hazard to people. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are trained and people benefit from the homes recruitment procedures. EVIDENCE: The provider said she is currently advertising and interviewing for two staff posts. The rota was seen to been fully covered. A staff file was seen and this included evidence of CRB checks, references and application details. Staff receive induction through learning direct which is accredited by TOPPS. Supervision is undertaken. Two staff were introduced during the course of the day and one member of staff spoke at some length to us. The member of staff confirmed on-going training and an awareness of the complaints procedure and what constitutes abuse and how to properly respond. Training includes mandatory training as well as service specific courses such as epilepsy, challenging behaviour and the Mental Capacity Act. Training is Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 19 recommended for Deprivation of Liberty legislation, effective from April 2009. The provider said that in addition staff were registered nurses, although did not practice nursing in the home as it is not registered for this. There was friendly communication noted between the staff and the person staying at home that day. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a well run home. Peoples know their views are encouraged and listed to. Various measures are ion place to safeguard peoples’ health and safety. EVIDENCE: The provider is qualified to run the home and has many years experience working with people with a learning difficulty. The provider has progressed with the quality assurance system since the last inspection. Questionnaires are sent out and examples of those seen included positive remarks about the care the people living in the home get. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 21 There was evidence that the provider has been trying to organise an informal families and representatives meeting to discuss how the home could improve the service they offer. The provider ensures that staff handovers and daily reporting is undertaken and evidence was seen of completed daily reports as well as reviews in care plans. The requirement made at the last inspection for the electrical testing to be brought up to date has been met. The fire record book has been maintained. Peoples individual finances are accurately maintained and include recording and receipts being kept. A sample checked was accurate and corresponded with records held. People are encouraged to attend regular meetings. These are recorded and records seen evidence people being encouraged to state every day preferences including meals and activities. There was also evidence in some of the meetings that people have stated they enjoy sharing their rooms. One to one meetings with staff can be undertaken if the individual would prefer to communicate this way. Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Dalkeith Lodge DS0000023389.V373242.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? 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 YA24 Good Practice Recommendations Employ suitable systems and risk assessments for the radiators. 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