Inspection on 01/06/06 for Apple Blossom Lodge

This inspection was carried out on 1st June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Apple Blossom Lodge 01/10/08

Apple Blossom Lodge 17/02/06

Apple Blossom Lodge 07/11/05

Apple Blossom Lodge 16/03/05

Apple Blossom Lodge 15/09/04

Apple Blossom Lodge 11/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Apple Blossom Lodge 8 St James Road Wallasey Wirral CH45 9LS Lead Inspector Lynn Sharples Key Unannounced Inspection 1st June 2006 09:30 Apple Blossom Lodge DS0000018861.V289506.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 Apple Blossom Lodge DS0000018861.V289506.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. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Apple Blossom Lodge Address 8 St James Road Wallasey Wirral CH45 9LS 0151 639 1218 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) Apple Blossom Lodge Limited Mrs Doris Cave Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person over 65 years old can be accommodated Date of last inspection 17th February 2006 Brief Description of the Service: Apple Blossom Lodge is a large detached three-storey house set in a residential area in Wallasey Wirral. It is close to New Brighton amenities including shops, cafes, pubs, train station, sporting facilities and the promenade. To the front of the home there is a small railed garden area leading to the front door and there is a larger garden area situated to the rear. There is some on road parking available to the front of the home. Residents’ bedrooms are all single rooms with a number of communal lounges being available on the ground and basement area. The main dining room is situated in the basement area. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were 13 service users living at Apple Blossom Lodge at the time of the visit. The home did not know about the visit and took four hours. The inspector spoke with the five service users in the house and two staff and read files and the feedback from professionals and relatives. A tour of the premises was also undertaken. What the service does well: What has improved since the last inspection? What they could do better: The manager should continue to actively seek the views of service users and to discuss packages of care with the placing authorities. The Statement of Purpose should be available for service users, staff and any representative of a service user to read at all times. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 6 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. Apple Blossom Lodge DS0000018861.V289506.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 Apple Blossom Lodge DS0000018861.V289506.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose should be available at all times. The homes Statement of Purpose and Service User guide provide service users and prospective service users with details of the services the homes provides enabling an informed decision about admission to the home. EVIDENCE: The staff could not access the Statement of Purpose or Service User Guide as the manager was on leave and the office was locked. Some documentation should be available to the service users, service users representative and staff and these include the Statement of Purpose and the Service User Guide. The inspector went back the next week and the manager located the Statement of Purpose in the file and explained that it should have been available on the day of the inspection the manager will address this. The home has a comprehensive pre admission assessment tool that gains detailed information regarding prospective residents care and behavioural needs. A sample of service users contracts were examined and found to provide detailed information with copies of service users care plans and risk assessments attached to ensure the service user, their representatives and the placing authority are fully aware of the care and support to be provided. Apple Blossom Lodge DS0000018861.V289506.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. There is a clear care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: A sample of service user plans were examined and contained detailed and clear information to enable staff to provide appropriate support around day-to-day living and personal goals. These plans are reviewed regularly. Service users were observed making some choices; this included what to have for lunch and what activities to participate in. Care plans and risk assessments detail if there is a possibility that physical restraint may be used. Service user reviews would include information regarding restraint used or infringement on service users choices due to risk factors being too great. This information will be shared with all appropriate parties with a copy of the minutes and care plans being forwarded to the placing authority if they are unable to attend the review. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 10 The staff said that service users meetings are held regularly and are chaired by a member of staff. Risk assessments are undertaken and recorded for all situations that are potentially hazardous for service users and staff. Apple Blossom Lodge DS0000018861.V289506.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Service users engage in community and leisure activities appropriate to their age. Service users are encouraged to meet with their family and friends. This ensures that the service users lifestyle aspirations are addressed. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: On the day of the visit 8 service users were out in the local community, in three separate groups; the five remaining service users were relaxing in the home. Two service users were observed playing pool, which they appeared to enjoy. In each service users file there is an activity chart that indicated that the service users access a variety of community based activities and the daily records indicate that service users go out regularly. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 12 The service users files indicate that some service users have regular contact with their family, some service users have independent advocates. The home has tried to access more advocates but this has proved problematic. Service users said that they enjoyed living in the home and that the staff were “nice”. Some service users had just been on holiday and said that they had really enjoyed the experience. The home attempted to involve other people to assist service users to complete the service users surveys. These service users did not attend a day service and the care managers were unavailable. This task was given to a member of staff as part of their NVQ training. The surveys indicated that they were happy living at the home. The home has produced a pictorial representation of the National Minimum Standards, which assisted in this process. At lunch the service users had a choice of sandwiches and fruit. The meal was served in a quiet environment, the staff sat with the service users, discussing various topics. The Pre Inspection Questionnaire included two sample menus, the cupboards and fridge were examined and the menu for that day and the next, which demonstrated that service users have a varied and nutritional diet. Apple Blossom Lodge DS0000018861.V289506.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The service users receive the appropriate personal support in the way they prefer and require. The service users’ physical and health needs met, care plans are in place for service users and appropriate health care services are made available. Service users are protected by the home’s policies and procedures for handling and administrating medicines. EVIDENCE: The care plans read provided detailed information regarding the personal care needs of residents’ this includes information about the level of personal care support needed from verbal prompting to total support. These are reviewed regularly and amended accordingly. Services users are registered with local general practitioners and some are linked to the specialist learning disability services at Ashton House. There was evidence that the service users visit a variety of health professionals including: - chiropodist, dentist and opticians. All service users in the home can access their NHS entitlements. The surveys completed by some of the General Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 14 Practioners indicate that they are satisfied with the care provided to service users at the home. “Blister packs” are used and the staff that administer medicines are trained to do so. The Medication Administration Records were examined and some of the medication in the medicine cabinet. The home has a medication policy; observations of staff administering medication indicated that they are following this procedure. Medication is stored securely. The staff who administer medication have received training from a pharmacist. None of the current service users would be able to manage their own medicines. Apple Blossom Lodge DS0000018861.V289506.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. There is a complaints process with information that ensures complaints and concerns will be listened to, taken seriously and acted upon. EVIDENCE: The organisation has a complaints policy and procedure. There have been no complaints/concerns received since the last inspection. There is an Adult Protection policy that including a whistle blowing procedure. There is also a copy of the “No Secrets” policy. The staff have received training regarding Protection of Vulnerable Adults. They were able to demonstrate to the inspector a clear understanding of their role as alerter to incidents or allegations of abuse. Apple Blossom Lodge DS0000018861.V289506.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,30 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The standard of the décor and furnishing within the home creates a comfortable environment for service users. EVIDENCE: On the day of the visit the home was clean and tidy. There were no offensive odours. The home has a good allocation of housekeeping time and staff work hard to maintain the environment to a good standard of cleanliness. The home is continually being updated and there is a record of redecoration. There are new dining room tables and chairs. Communal lounges are all furnished with comfortable furniture with television and music facilities provided. Bedrooms that were seen, demonstrated that service users lived in clean, safe rooms that also showed that they had been personalised in relation to furnishings and decoration. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The recruitment and selection policies and procedures protect residents’ from the risk of abuse or poor practice. EVIDENCE: The staff were observed to listen and communicate well with the service users. Some of the staff team have the NVQ 3, the remaining staff are registered to commence the training but are awaiting funding. The staff have all undertaken a British Institute of Learning Disabilities (BILD) accredited physical intervention training. The staff rotas indicate that there are adequate staff to ensure the needs of the service users are met. There are staff meetings every two weeks and once a month there are senior staff meetings, which is attended by staff from the other home. Individual staff files examined contained all the relevant required documents. The staff receive an induction and statements of terms and conditions. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 18 The staff have received training on Alzheimer’s and Downs Syndrome, adult, protection physical intervention and medication. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. The manager has a clear plan and vision for the home, which she has effectively communicated to the service users, staff and relatives. The record of self-review by the registered provider provides the home with quality assurance. The home promotes and protects residents’ health and safety. EVIDENCE: The manager has worked at the home for approximately eight years and has over 16 years experience of working with adults with learning disabilities. The record keeping within the home is of a good standard providing the staff team with detailed information about residents care needs and risk factors they need Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 20 to be aware of. This ensures the most appropriate support is provided to residents’ on a daily basis and during incidents of inappropriate or aggressive behaviour. Service users and staff all spoke highly about the manager and said that they were approachable and listened to concerns. The surveys completed by some relatives indicate that they are informed about the care their relative receives. The responsible individual visits regularly and records their visits once a month. The accident/incident book was well maintained. The fire logbook was maintained with all checks and drills being carried out within the stated timescales. Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 21 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 2 2 3 3 X 4 X 5 3 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 3 25 3 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 3 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 Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 22 No 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. 1 Standard YA1 Regulation 4 Requirement The registered person must ensure that the Statement of Purpose is available for service users, staff and service users representatives. Timescale for action 23/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Apple Blossom Lodge DS0000018861.V289506.R01.S.doc Version 5.2 Page 24 - 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. 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