Inspection on 13/02/09 for Liberty Lodge

This is the latest available inspection report for this service, carried out on 13th February 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

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Cherry Tree House

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: Liberty Lodge 13 Grasmere Road Purley Surrey CR8 1DY     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: Emma Dove     Date: 1 3 0 2 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 28 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 28 Information about the care home Name of care home: Address: Liberty Lodge 13 Grasmere Road Purley Surrey CR8 1DY 02082534310 02086860068 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Supreme Care Services Limited care home 6 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 6 The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding Learning Disability or Dementia - Code MD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Liberty Lodge is a registered care home for up to six people with mental health problems. The home is owned and managed by a local organisation who are in the process of registering two similar services and operate two domiciliary care agencies in the local area. The service is in a residential area of Purley, close to local shops, leisure facilities and public transport systems. The ground floor has a lounge, dining room, kitchen and two single bedrooms. The first floor has four single bedrooms and an activity room. The staff room and office are on the third floor. The fees for the service are from 700.00 per week, depending on individuals needs. Care Homes for Adults (18-65 years) Page 4 of 28 Care Homes for Adults (18-65 years) Page 5 of 28 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 inspection was announced at short notice and carried out over five hours on the 13th February 2009 by one regulation inspector. We spoke to people who use the service, the manager, staff and the owner. We received an annual quality assurance assessment (AQAA) from the manager in November 2008. This gave us good information about the service and how they planned to provide services when people moved in. We looked at information received from the service since it was registered in August 2008. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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 8 of 28 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 28 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. The home understands the importance of having sufficient information when choosing a care home. Assessments are completed before admission, to ensure that the service is appropriate for the individual. Evidence: We saw the home has developed a clear Statement of Purpose and detailed Service Users Guide which are made available to people looking at the home with a view to moving in. The Statement of Purpose includes information about the organisation, the home, the review process, residents meetings, the systems the home uses to support people who use the services, the care programme approach (CPA) and wellness recovery action plan (WRAP), staffing and training staff will attend. The manager told us that people will be invited to visit and meet staff and other people using the service before they make the decision to move in. We saw that this had Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: happened. We saw assessments from placing social workers or health professionals completed before admission. Care Homes for Adults (18-65 years) Page 11 of 28 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. People who use the service are invovled in planning their care and support, developing care plans and decision making for the future. Care plans are person centred and include the details required for staff to provide appropriate support. Evidence: We saw care plans in place. The manager told us people who use the service are involved in developing care plans. Individuals we spoke to confirmed that they get the support they need and require and are involved in developing care plans. We saw information from assessments used in care plans. One care plan needed updating in one area to ensure staff offer the appropriate care. Daily recording is detailed, including what the individual has done, any contact with family, friends or professionals and any health appointments. Staff told us they are going to start regular key working sessions and write monthly reports for placing authorities. This will ensure social workers are kept up to date with any changes for Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: people who use the service and any improvements. We saw risk assessments. The manager said they plan to keep risk assessments up to date by reviewing and checking them regularly. Care Homes for Adults (18-65 years) Page 13 of 28 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 service has a commitment to enabling people who use the service to maintain and develop social, emotional, communication and independent living skills. People who use the service take part in activities of their choice. People are supported to maintain and develop important relationships. A varied menu is provided and people are encouraged to be invovled in all areas of food preparation. Evidence: The manager said they will encourage people who use the service into education and paid or unpaid employment, depending on their needs and preferences. We saw people enrolled on college courses and to be involved in community groups and clubs. The manager said that the organisation could introduce a resource centre where people who use the service can be supported to take up employment to benefit their Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: life in the community in the future. This has not been developed at the time of our visit and the organisation do not feel this is required at this point. The manager said people will be supported to maintain important relationships with family and friends. People told us they are able to have visitors and keep in contact with friends and family members on the telephone, email and visits. The menu is varied and reflects peoples preferences, religious and cultural needs. The manager and staff told us people are involved in all areas of meals, from menu planning and shopping to cooking and clearing away. People told us they eat the food they like. The manager told us they will look at training in food hygiene for people who use the service. Care Homes for Adults (18-65 years) Page 15 of 28 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 use the service receive appropriate support with personal and health care. Health care needs are well met. Medication is well managed. Evidence: The manager told us staff will emphasise the importance of well being in the daily life of people who use the service and will offer support with attending health appointments. Staff confirmed that they talk with people about well being and are available to attend health appointments if needed. We saw case files include medical details and information about the individuals health needs. Appropriate policies and procedures are in place for the storage and administration of medication. The manager said they will support people to administer their own medication. If people do administer their own medication, a risk assessment should be completed and kept under review. Care Homes for Adults (18-65 years) Page 16 of 28 Care Homes for Adults (18-65 years) Page 17 of 28 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. The service has a clear accessible complaints procedure. Policies are in place for the protection of vulnerable adults. Evidence: People who use the service are aware of how to make a complaint and did not raise any issues during our visit. We have not received any complaints about the service since it was registered in August 2008. The manager told us there have not received any complaints and confirmed he is aware of the records to be kept and how to respond to complaints. The manager told us staff are trained in how to manage complaints and will be re-assessed annually on their ability to deal with complaints. The manager is aware of his responsibilities regarding safeguarding. Staff have not completed the local authorities training in safeguarding but have had a session on adult protection as a part of their induction. All staff should complete training in the protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 18 of 28 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 home is appropriate to meet the needs of the people who live there. Bedrooms are single and can be decorated and personalised to the individuals choice. Sufficient bathrooms and toilets are provided. All areas of the home are clean and fresh. Evidence: People who use the service have access to a lounge, dining room and kitchen on the ground floor. An activity room is being developed on the first floor which will have a library area, computer and other resources for people to use. Bedrooms are single and we saw they have been personalised to individuals taste and preference. Four of the bedrooms have ensuite toilet and bath or shower. The other two bedrooms share a bathroom with shower. All areas were found to be maintained to a good standard. The manager told us that they have a maintenance person who is available to attend to minor repairs when necessary. All areas of the home were clean and fresh. Policies are in place for infection control. Staff are aware of the need for good hygiene standards. Care Homes for Adults (18-65 years) Page 19 of 28 Care Homes for Adults (18-65 years) Page 20 of 28 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. People have confidence in the staff who support them. Staffing levels are sufficient to meet the needs of people currently using the service. Staff recruitment is generally in line with regulations. Staff have access to training and development and could have more specialist training in working with people with mental health needs. Evidence: We saw enough staff to meet the needs of the people living at the home. Staff say there are enough staff and people who live there are satisfied with the level of staff support available to them. Staff said they had appropriate checks before they started work at the service. Staff files confirm that references are taken up, evidence of identity is checked and for one member of staff, a Criminal Records Bureau (CRB) check had been completed before they started work. One member of staff had a CRB check for employment at another service. The organisation must apply for a CRB check, complete a POVA first check and have clear details of the supervision in place before new staff start work. Recruitment information about all staff employed at the home must be available at the home, or a list of the checks completed be available for inspection. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: The manager told us that the organisation trains, develops and empowers staff to make decisions. Staff told us that they completed induction training when they started work with the organisation, although they havent completed any specialist training in working with people who have mental health needs. The manager told us staff have supervision every month. Staff told us they feel supported in their work and meet with the manager every month. Care Homes for Adults (18-65 years) Page 22 of 28 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 manager has the experience needed to run the home. The service is run in the interests of the people who live there. There are quality assurance systems in place to monitor the services provided. Health and safety is well managed. Evidence: The manager has worked with the organisation for the last year and has been fully involved in developing the home. The manager has previous experience working in similar services on contracts through an agency. The organisation has quality assurance systems in place to monitor the quality of care provided. This system includes asking the people who use the service and their representatives about their experiences at the home. The manager told us they will have regular meetings with the people who use the service and that they tend to do this on an individual basis at the moment. We saw health and safety checks have been completed at the required intervals with Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: the exception of the gas safety which was checked in December 2007 and should be done annually. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 20 13 Risk assessments must be completed when people self medicate. To ensure people are protected from harm. 10/04/2009 2 23 13 All staff must complete training in the protection of vulnerable adults. To ensure they are aware of their responsibilities and how to respond to allegations. 24/04/2009 3 34 18 All staff must have a clear enhanced CRB check before they start work, or appropriate measures be in place to protect the people who use the service if staff start without a CRB check. To ensure people who use the service are protected from harm. 10/04/2009 4 42 13 The gas safety should be checked annually. 17/04/2009 Care Homes for Adults (18-65 years) Page 26 of 28 To ensure the people who use the service, staff and visitors are protected from harm. 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 35 Staff should have access to specialist training in working with people with mental health needs, to improve the information they have and enable them to meet the needs of the people who use the service. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!