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Inspection on 21/05/10 for Denmark Lodge

Also see our care home review for Denmark Lodge for more information

This is the latest available inspection report for this service, carried out on 21st May 2010.

CQC found this care home to be providing an Adequate 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

This inspection took place in May 2010 and involved a visit to the home by one inspector on 13th May. The registered manager was present throughout. She had completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing information about the service and plans for further improvement. It also provided numerical information about the service (DataSet). We had received surveys from three staff and one person living in the home. This random inspection focused on the requirements issued at the last inspection, case tracking two people living in the home including their medication records,examining recruitment and selection documents for one new member of staff and notification and accident records. We were also shown around the communal areas of the home and looked at one person`s room with their permission. We also checked to see whether the home had complied with requirements issued at the last inspection. There had been no new admissions to the service so we looked at records for two people currently living in the home and sampled the care plans for one person who was in hospital and due to move into nursing care. Each person had a current care plan which was person centred and indicated how they would like to be supported with their personal and health care needs. They had an assessment of their physical, emotional, social and intellectual needs in place from which care plans and risk assessments had been developed. People had signed their plans and one person said they had a key worker. Care plans clearly identified where other documents or systems were in place relating to them including risk assessments, staff support or training and policies and procedures. Each document had an evaluation sheet in place which key workers were completing monthly. Some of these evaluations were comprehensive but most indicated that there had been no change. Annual reviews were taking place and where needed people were having access to Community Psychiatric Nurses and a Care Programme Approach review. Where any restrictions were in place such as the use of lap belts this was recorded in care plans and risk assessments with the rationale for their use noted. Records for the person in hospital had been kept up to date whilst they were living at the home and indicated that there would be a review upon their return. The registered manager said that theyhad been assessed as needing nursing care and she had been involved in supporting them to find suitable alternative accommodation. It was evident from records on their file that as their needs had changed the home had endeavored to provide access to the appropriate health care professionals and make the necessary adaptations to the home to enable them to remain there for as long as possible. Letters of thanks were examined from relatives and health care professionals. Records were being kept of health care appointments indicating people had regular access to a range of health care professionals. Outcomes of appointments were recorded. Systems for the administration of medication were found to be satisfactory. Staff had received training in the safe administration of medication and medication audits were in place. A monitored dosage system was in place and medication administration records were being correctly completed. Evidence was in place confirming that the General Practitioner had given permission that homely remedies could be used. The home does not have any controlled drugs. The home was pleasantly decorated and in good condition at the time of our visit. Communal areas had been redecorated and new fixtures and fittings had enhanced the general decor of the home since our last visit. The first floor bathroom had been refurbished complying with a requirement issued at the last inspection. The garden provides accessible areas for people and has a patio with tables and chairs. People were being supported to grow plants and vegetables. One new member of staff had been appointed since the last inspection. Their file confirmed that they had completed an application form and that any gaps in employment history had been queried and evidence was recorded by the registered manager to provide a full employment history. A checklist was used by the home to indicate when records were requested and when they were returned. Two references had been provided prior to employment and an additional reference had been sought from a previous social care employer to verify why they left their employment. Proof of identity had been obtained including a photograph and evidence that the birth certificate had been seen. The Criminal Records Bureau (CRB) check was examined. This was kept on the staff file. This is contrary to guidance under the Data Protection Act. The person had been appointed before the CRB check was returned. There was evidence that an ISA (Independent Safeguarding Authority) adult first check had been completed prior to employment. We discussed with the registered manager the restrictions put in place on staff until the CRB check was returned. These were in line with our guidance. A risk assessment had not been completed, although the registered manager said she would normally have produced one. Training records confirmed that staff had completed an induction programme and had access to mandatory training. Staff confirmed that the training programme was good and a survey indicated, "we have plenty of training opportunities." Copies of training certificates were on file including training completed during the person`s previous employment. Staff confirmed that staffing levels were being maintained enabling people to access a range of activities. The home had continued to develop their quality assurance process including obtaining feedback in April this year from people living in the home, their relatives, friends and health care professionals. Staff had also been involved in this process. A quality assurance review had been produced from these surveys in April 2010 and the registered manager confirmed she was in the process of identifying concerns and addressing these in an improvement/action plan.We examined accident and incident records and found there had been 3 accidents over the last 12 months. These were not reportable under Regulation 37. The home had notified us about concerns about the health and wellbeing of one of the people living in the home and had kept us up to date with their progress.

What the care home could do better:

Evaluation sheets could provide more detail about progress made or changes to need. When staff are employed before their CRB check is returned and after all other information has been obtained, then a risk assessment should be put in place to describe what duties they can and cannot do and how they are to be supervised. CRB checks should be kept securely and separately from other staff records.

Random inspection report Care homes for adults (18-65 years) Name: Address: Denmark Lodge 38 Denmark Road Gloucester GL1 3JQ one star adequate service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lynne Bennett Date: 2 1 0 5 2 0 1 0 Information about the care home Name of care home: Address: Denmark Lodge 38 Denmark Road Gloucester GL1 3JQ 01452311102 Telephone number: Fax number: Email address: Provider web address: dalewcathcare@msn.com www.carehomes.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Dale Williams Type of registration: Number of places registered: Conditions of registration: Category(ies) : Cathedral Care (Gloucestershire) Limited care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 7 The maximum number of service users who can be accommodated is 7 The registered person may provide the following category of service only: Care home only - code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (code LD) Date of last inspection Brief description of the care home Denmark Lodge is a detached Victorian house, which has been modernised for its current purpose and is adjacent to a sister care home called Denmark House. Bedrooms have en suite facilities and there is a kitchen, dining room and spacious lounge. Outside, there is a large level garden. Both care homes provide care for people with a learning disability and there is access between the properties via patios at the side of the buildings. The home is situated in a residential area and close to all the Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home amenities of Kingsholm in Gloucester. The home has the use of both a car and a people carrier. The weekly base fees charged by the home are 817 pounds per week. An additional charge of 10 pounds is payable towards the cost of the homes transport. Copies of the homes Statement of Purpose and Service User Guide are available from the office. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: At the last inspection we found the following: The environment is of a good standard. All of the bedrooms have en suite facilities and there is a large communal lounge and separate dining room. The garden to the rear is enclosed and private. Staff who work during the day have access to a comprehensive training programme which gives them the opportunity to gain the knowledge and skills to support people who will be living there. Staff were observed treating people with dignity and respect. People living at the home said they like the staff and were happy with their rooms. We have no reason to believe that this has changed. During our visit people said they had access to college and social clubs and were planning a holiday. They were observed making choices about their day and interacting positively with staff. Surveys said, there is a friendly atmosphere that makes all residents and visitors comfortable and welcome, and quality time is given to service users, their needs always come first. What the care home does well: This inspection took place in May 2010 and involved a visit to the home by one inspector on 13th May. The registered manager was present throughout. She had completed an AQAA (Annual Quality Assurance Assessment) as part of the inspection, providing information about the service and plans for further improvement. It also provided numerical information about the service (DataSet). We had received surveys from three staff and one person living in the home. This random inspection focused on the requirements issued at the last inspection, case tracking two people living in the home including their medication records,examining recruitment and selection documents for one new member of staff and notification and accident records. We were also shown around the communal areas of the home and looked at one persons room with their permission. We also checked to see whether the home had complied with requirements issued at the last inspection. There had been no new admissions to the service so we looked at records for two people currently living in the home and sampled the care plans for one person who was in hospital and due to move into nursing care. Each person had a current care plan which was person centred and indicated how they would like to be supported with their personal and health care needs. They had an assessment of their physical, emotional, social and intellectual needs in place from which care plans and risk assessments had been developed. People had signed their plans and one person said they had a key worker. Care plans clearly identified where other documents or systems were in place relating to them including risk assessments, staff support or training and policies and procedures. Each document had an evaluation sheet in place which key workers were completing monthly. Some of these evaluations were comprehensive but most indicated that there had been no change. Annual reviews were taking place and where needed people were having access to Community Psychiatric Nurses and a Care Programme Approach review. Where any restrictions were in place such as the use of lap belts this was recorded in care plans and risk assessments with the rationale for their use noted. Records for the person in hospital had been kept up to date whilst they were living at the home and indicated that there would be a review upon their return. The registered manager said that they Care Homes for Adults (18-65 years) Page 4 of 9 had been assessed as needing nursing care and she had been involved in supporting them to find suitable alternative accommodation. It was evident from records on their file that as their needs had changed the home had endeavored to provide access to the appropriate health care professionals and make the necessary adaptations to the home to enable them to remain there for as long as possible. Letters of thanks were examined from relatives and health care professionals. Records were being kept of health care appointments indicating people had regular access to a range of health care professionals. Outcomes of appointments were recorded. Systems for the administration of medication were found to be satisfactory. Staff had received training in the safe administration of medication and medication audits were in place. A monitored dosage system was in place and medication administration records were being correctly completed. Evidence was in place confirming that the General Practitioner had given permission that homely remedies could be used. The home does not have any controlled drugs. The home was pleasantly decorated and in good condition at the time of our visit. Communal areas had been redecorated and new fixtures and fittings had enhanced the general decor of the home since our last visit. The first floor bathroom had been refurbished complying with a requirement issued at the last inspection. The garden provides accessible areas for people and has a patio with tables and chairs. People were being supported to grow plants and vegetables. One new member of staff had been appointed since the last inspection. Their file confirmed that they had completed an application form and that any gaps in employment history had been queried and evidence was recorded by the registered manager to provide a full employment history. A checklist was used by the home to indicate when records were requested and when they were returned. Two references had been provided prior to employment and an additional reference had been sought from a previous social care employer to verify why they left their employment. Proof of identity had been obtained including a photograph and evidence that the birth certificate had been seen. The Criminal Records Bureau (CRB) check was examined. This was kept on the staff file. This is contrary to guidance under the Data Protection Act. The person had been appointed before the CRB check was returned. There was evidence that an ISA (Independent Safeguarding Authority) adult first check had been completed prior to employment. We discussed with the registered manager the restrictions put in place on staff until the CRB check was returned. These were in line with our guidance. A risk assessment had not been completed, although the registered manager said she would normally have produced one. Training records confirmed that staff had completed an induction programme and had access to mandatory training. Staff confirmed that the training programme was good and a survey indicated, we have plenty of training opportunities. Copies of training certificates were on file including training completed during the persons previous employment. Staff confirmed that staffing levels were being maintained enabling people to access a range of activities. The home had continued to develop their quality assurance process including obtaining feedback in April this year from people living in the home, their relatives, friends and health care professionals. Staff had also been involved in this process. A quality assurance review had been produced from these surveys in April 2010 and the registered manager confirmed she was in the process of identifying concerns and addressing these in an improvement/action plan. Care Homes for Adults (18-65 years) Page 5 of 9 We examined accident and incident records and found there had been 3 accidents over the last 12 months. These were not reportable under Regulation 37. The home had notified us about concerns about the health and wellbeing of one of the people living in the home and had kept us up to date with their progress. 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 set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Evaluation sheets for care plans and risk assessments should provide an overview of progress made or changes to needs. A risk assessment must be in place, describing duties and supervision, where new staff start work before their CRB check has been received. Copies of CRB checks should be kept securely and separately from other staff records. 2 34 3 34 Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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