Inspection on 12/03/09 for Dover Lodge

This is the latest available inspection report for this service, carried out on 12th March 2009.

CSCI 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.

Other inspections for this house

Dover Lodge 31/10/05

Dover Lodge 15/07/05

Dover Lodge 23/11/04

Dover Lodge 27/05/04

Similar services:

Ashlong House

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Edenvale

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Chatsworth Care - Dawson House

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Townley Road, 2-3

Chatsworth Care - Tudor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Dover Lodge 41 Wood Vale London SE23 3DS     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jon Fry     Date: 1 2 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 24 Information about the care home Name of care home: Address: Dover Lodge 41 Wood Vale London SE23 3DS 02086935460 02088638476 hazel@odysseycsft.org www.odyssey-csft.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Odyssey Care Solutions for Today care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia sensory impairment Additional conditions: Date of last inspection Brief description of the care home Dover Lodge is a large detached Victorian house situated in a residential road in Forest Hill. It is similar to other properties in the road and is not identifiable as a care home. This is one of a number of homes run by the voluntary organisation Odyssey. home is not wheelchair accessible and does not have a lift. Up to 7 female service users with learning disabilities can live at the home. The ground floor has 2 sitting areas and a kitchen with dining area. The bedrooms and The 7 2 1 Over 65 0 0 0 Care Homes for Adults (18-65 years) Page 4 of 24 Brief description of the care home bathrooms are on the 1st and 2nd floors. There is a large well-maintained garden at the back. Care Homes for Adults (18-65 years) Page 5 of 24 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: We spent approximately six hours at the home. We spoke to three people who live there, the manager and four staff members. We received two completed surveys from relatives, friends or advocates. We looked at a number of documents including two peoples care plans. The manager completed an Annual Quality Assurance Assessment (AQAA) that gave us information about the service and outcomes for the people who live there. Care Homes for Adults (18-65 years) Page 6 of 24 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 set out 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 7 of 24 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 8 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information in user friendly formats is made available about the home. Peoples needs are assessed and reviewed regularly. Evidence: I like it here and I like it alot were comments from people living at the home. A Relative, friend or advocate said generally I am satisfied. The service has a user guide that gives good information about what is provided. This is made available on DVD and in a user-friendly printed format using pictures and photographs. In the AQAA, the service told us that individual needs have been individually assessed to ensure their needs are being met. We looked at the care files for two people and saw that assessment information was there for both of these individuals. One person has moved out of the home recently due their changing needs. We saw that this move had been managed well by the service in difficult circumstances. Care Homes for Adults (18-65 years) Page 9 of 24 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. Care plans give some good information about peoples support needs but are in need of further development. Evidence: Comments from relatives, friends and advocates included very satisfied - systems seem to be in place to give support and care quickly and effectively and they endeavour to do their best for them. The AQAA said that personal goals of each service user where possible have been discussed with them and implemented where possible with resources available. The manager told us that the care plans were a work in progress as a new system had been introduced at the end of 2008. We looked at the care plans for two people and saw that there was some good information recorded about the person and their support needs. The plans were in the process of being updated and put into a new individual support agreement format Care Homes for Adults (18-65 years) Page 10 of 24 Evidence: operated by the organisation. These clearly give the persons support needs in a number of different areas and also list short and long term goals. It is clear that work on these care plans has progressed slowly in recent months due to the intensive work being done with one individual and some ongoing staffing issues. We have recommended that the home look at writing the care plans in the first person - this what I like to do and this is what I want you to help me with. This may help people living there take more ownership of their support agreement. Risk assessments are completed for each person to help keep them safe and we saw that these are kept under review. A key worker system is in place and people we spoke to knew who their worker was. One person said that their key worker helped them sort any problems out. Care Homes for Adults (18-65 years) Page 11 of 24 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 home offers a good range of leisure and educational opportunities. Individuals are supported to keep in contact with family and friends but this area could be developed. The home provides people with meals they enjoy. Evidence: People who live there told us I like doing pottery, I go to college and I go out to Peckham. A Comment from a relative, friend or advocate was they participate in social activities which they enjoy - due to staffing issues, this is not always possible but they do what they can. In the AQAA, the home told us that service user weekly activity plans are in place and working well and all service users have chosen a menu that meets their preferences. We saw that these documents were in use when we visited. Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: Staff members we spoke with said the people who live there do lots and were an active bunch. The majority of individuals were out at day activities on the day we visited returning home in the late afternoon. Comments from people who live there about the meals included I cook my own food, I like the food and I like the fish and chips. Staff we spoke to said that individuals were supported to choose meals informallly - we sit round and talk with people. We saw that there were picture menus available to visually show whats being cooked for each meal. Individuals are helped to stay in touch with their family and friends. Comments in surveys included usually I am kept well informed and sometimes they telephone me when prompted to do so by a member of staff. One relative, friend or advocate said that they would welcome more regular contact from the home saying they would appreciate receiving a periodic contact from the home manager. We have recommended that the home look at ways to develop the service in this area. Care Homes for Adults (18-65 years) Page 13 of 24 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. Personal support is provided to meet peoples individual needs and their privacy and dignity is respected. Individuals are supported to attend appropriate healthcare services. Medication is well managed. Evidence: If I feel ill, I go to the doctor was the comment from one person who lives at the home. Records we saw showed that individuals are supported to see health professionals as required. As talked about previously, the care plans give some good information about support required but these are in need of updating. We looked at the way the home helps people to take their medication. The system in place clearly works well and we saw that people were getting the right medication at the right time. Medicines are stored in a secure cabinet and staff are trained to give out medication to individuals. Care Homes for Adults (18-65 years) Page 14 of 24 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. Complaints procedures are in place and people feel able to voice any concerns they have. Staff have training around the procedures to be followed should they suspect any abuse at the home, so helping to make sure that people were protected from abuse. Evidence: Id see the manager or my keyworker was the response from one person who lives at the home when asked what theyd do if they had any worries or concerns. The staff we spoke to said that the people who live at the home are very vocal if they are unhappy about something. We saw that record are kept of any concerns and complaints and that action is taken to respond to these promptly. The Safeguarding policies and procedures are available to the staff working there. Staff have undertaken Safeguarding Adults training, and the manager was able to show this by producing the training records kept at the service. Care Homes for Adults (18-65 years) Page 15 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is comfortable and homely. There are however a number of areas requiring repair or intensive cleaning. Evidence: Dover Lodge has a nice homely feel and provides a comfortable place to live. People we spoke to said that they liked their rooms. We saw two bedrooms that were personalised to the individual and were clearly their own space. The building is now quite old and some areas are in need of repair and decoration. The bathroom on the first floor was more noticeable as requiring attention but there are other hallway areas where paper is peeling or cracks are appearing. We have recommended that some intensive cleaning work is carried out as there are some places that are very dusty and have lots of cobwebs which are difficult to reach. Care Homes for Adults (18-65 years) Page 16 of 24 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. Staffing levels need to be reviewed to make sure that there are enough people on duty to meet individual needs. Staff receive good levels of training so they can support people effectively. Evidence: Comments from the people who live there were theyre alright and they help me with my medication. One relative, friend or advocate said most of the staff have been at Dover Lodge for some years and have acquired a knowledge over time of their service users. Another person said that they were concerned over staffing problems long term sickness etc. The manager told us that there have been staffing issues at the service and these were being addressed. The home has been using a team of locums to cover shifts and this had helped to provide consistency of care to the people living there. The staffing issues along with the increased support needs of one person have clearly put a strain on the service and have had an impact on areas such as care planning. We looked at the staff rota and saw that there were times on some days where there was just one member of staff on duty. This tended to be in the morning and the manager reported that this was enough to meet the needs of individuals on those Care Homes for Adults (18-65 years) Page 17 of 24 Evidence: days. We have made a Requirement for this to be reviewed with the placing authority to make sure they are satisfied with the staffing levels provided. Staff members told us that they felt well supported and received the training they needed to do their jobs. Comments included the training is fantastic and I have regular supervision. All the staff we spoke to talked about the recent period being stressful and that they were looking forward to doing more activities / 1-1 with people. We saw that individual records are kept of training and supervision. Recent training for one person included manual handling, foogd hygiene, medication and Safeguarding. We have recommended that the service works to increase the frequency of supervision for each member of staff. This should be at least every two months. Care Homes for Adults (18-65 years) Page 18 of 24 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. The home is managed well. Health and Safety systems are in need of further improvement. Evidence: Both the people who live there and staff members spoke positively about the manager. Comments included really supportive and very approachable. The manager told us the areas she thought needed more work and these were the same as those we found during our visit. It is important that staffing issues are resolved as soon as possible to allow the service to develop and grow. The manager and her staff team are clearly committed in providing a high quality service to the people living there. The manager needs to register with the CQC and she told us that she is in the process of doing this. Quality assurance procedures are in place and these include a monthly visit from Care Homes for Adults (18-65 years) Page 19 of 24 Evidence: someone senior within the organisation. Meetings take place with the people who live there and we saw that recent discussions have included planning holidays and social trips. We saw that improvements are needed in making sure that regular Health and Safety checks take place for Fire Safety, hot water temperatures and fridge/freezer temperatures. We have made a Requirement about this as it is very important that these checks take place. Care Homes for Adults (18-65 years) Page 20 of 24 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 21 of 24 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 33 18 Staffing levels must be 15/05/2009 reviewed to ensure there are sufficient numbers of staff on duty at all times. This is to make sure that the people living there receive the support they need at all times. 2 42 13 Regular Health and Safety 30/04/2009 checks must take place for Fire Safety, hot water temperatures and fridge/freezer temperatures. This is to make sure that people are kept safe. 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 7 The home should consider different ways of writing and presenting care plans to increase ownership by the person. This could be writing them in the first person or making them more visual. Page 22 of 24 Care Homes for Adults (18-65 years) 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 2 15 The service should look at how it involves relatives, friends and advocates in the service and keeps them up to date with events. The home would benefit from repair and intensive cleaning in places. This is particularly in communal areas and bathrooms. The service should look at increasing the number of 1-1 supervision sessions with each member of staff. 3 24 4 36 Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or 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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