Inspection on 17/02/06 for Apple Blossom Lodge

This inspection was carried out on 17th February 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also 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 01/06/06

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 Helen Carton Unannounced Inspection 17th February 2006 10:30 Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 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.V287418.R01.S.doc Version 5.1 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.V287418.R01.S.doc Version 5.1 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.V287418.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person over 65 years old can be accommodated Date of last inspection 7th November 2005 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 a larger garden area is situated to the rear. There is some on road parking available to the front of the home. There are 12 single bedrooms and one double room 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.V287418.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were 13 residents’, living at Apple Blossom Lodge at the time of the visit the inspection was unannounced and took approximately 4 hours. The inspector spoke to six residents’, the manager and members of the staff team. What the service does well: What has improved since the last inspection? The manager has worked hard to set up residents’ meetings to find out what is important to them and if the home is providing them with the things they want and need. This compliments the home’s use of an in house pictorial/large print questionnaire to assist residents to make their views heard. The manager has also asked other people who support the residents outside the home to help them complete questionnaires, which ask them questions about the home and how it is run and staffed. The staff team have taken part in training about protecting vulnerable people from abuse and poor care practices. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 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.V287418.R01.S.doc Version 5.1 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. The home’s Statement of Purpose and Service User Guide provides good information for residents, prospective residents and their representatives about the home. Contracts provided to residents are detailed and provide residents’ and their representatives clear information regarding their terms of residency. The manager has the necessary skills, competencies and tools to ensure prospective residents needs are fully assessed. EVIDENCE: The home has produced a detailed Statement of Purpose and service user guide. To assist prospective residents’ and their relatives and representatives to decide if Apple Blossom Lodge is the right home for them. In the last inspection report a requirement was made to include greater detail regarding the ethos and care practices within the home. During this inspection the manager asked for clarification as to the level of detail the Commission felt needed to be in this document. Following the discussion the manager told the inspector the Statement of Purpose would be reviewed and greater detailed added with regard to the type and level of support the home could provide. Since the inspection visit this document has been amended. Residents contracts provide detailed information with copies of residents’ care plans and risk assessments attached to ensure the resident, their Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 9 representatives and the placing authority are fully aware of the care and support to be provided. The home has a comprehensive pre admission assessment tool that gains detailed information regarding prospective residents care and behavioural needs. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 10 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 The care planning and risk management strategies in place are good and provide the staff team with the information they need to satisfactorily meet residents’ needs. The home seeks the views of residents’ in decision making about their personal lives and how the home is run. EVIDENCE: The home has detailed care plans, risk assessments and management plans, which provide the staff team with good information and guidance as to the most appropriate care and support to be provided to residents’. The staff team have received restraint training carried out by a British Institute of Learning Disabilities (BILD) accredited trainer. The inspectors’ asked members of the staff team to demonstrate the techniques they had been taught they appeared to be safe and used minimal force to restrain. All members of the staff team told the inspectors they would only use restraint if all other methods of support had failed such as diverting techniques. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 11 Care plans and risk assessments detail if there is a possibility that physical restraint may be used. The manager told the inspector residents’ reviews would include information regarding restraint used or infringement on residents’ 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. Since the last visit to the home the manager has received advice from MENCAP and has introduced residents’ meetings. At the moment a member of the staff team is facilitating them until the group is established these meetings are recorded. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 12 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): 11, 12, 13,14 & 16 Links with the community are good and support residents’ social opportunities. Consultation with service users is improving with documentary indicating residents’ views are sought and acted upon. The manager and staff team have a good understanding of residents’ support needs, which has resulted in positive relationships between them. EVIDENCE: The home offers residents’ the opportunity to take part in a range of community activities at a local leisure centre. Residents are able to attend a range of evening clubs run by members of MENCAP. A number of the residents’ attend soft play sessions for sensory stimulation and enjoyment. Residents’ are able to attend numeracy and literacy sessions at the other home owned by the owners’ twice a week. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 13 The manager told the inspectors’ residents’ will access community events as and when they happen. Since the last visit to the home the manager has produced a clear policy and procedure with regard to the use of mobile phones by members of the staff team while out in the community with residents’. The manager discussed with the inspector the difficulty the home as in supporting residents’ to access further education facilities. As there is a time limit of three years for free and open access to courses for adults with a learning disability. The manager told the inspector she would continue to seek out enjoyable and challenging activities for residents’. The inspector spent time alone with a number of residents’ who were happy to discuss what they liked about the home and things they might like to change. They told the inspector there were residents’ meetings and that the manager talked to them about the things they enjoyed doing and things they might like to try. Residents’ appeared relaxed and were able to offer opinions on a wide range of things relating to them as individuals and as a group of people living together. They named individual staff members who they said they liked and made them laugh and feel good about themselves. Two residents’ told the inspector they liked the manager because she was straight with them. The home has records regarding activities undertaken by residents’ regular meetings take place to ensure the activities undertaken remain appropriate to the residents needs. Discussions with residents confirmed these meetings take place. The manager told the inspector coffee afternoons are being held once a month with relatives and friends invited to by word of mouth. Since the last visit to the home the manager has sent out questionnaires to clubs and training centres attended by residents’ and asked them to support the individuals to complete them. The manager hopes this will give a more accurate picture about how residents’ view the home. The inspector viewed a residents’ holiday file which indicates the home have supported the individual to make an informed choice about where to go on holiday. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 14 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 The home endeavours to meet the emotional and health care needs of residents’. The home’s care planning systems provide the staff team with good information enabling them to provide personal care in the most appropriate manner. EVIDENCE: Care plans provide 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. Members of the staff team spoken to demonstrated a good awareness of residents’ emotional well-being and physical health needs including strategies to be used to support residents’ during periods of high emotion. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 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 The home has a satisfactory complaints system with some evidence that residents’ concerns are listened to and acted upon. The home’s policy and procedures protect residents’ from abuse, neglect and self-harm. EVIDENCE: The manager has carried out a piece of work to produce the Younger Adults National Minimum Standards in a user-friendly format for residents’. She has also produced a complaints procedure in a similar format and intends to add photographs of the management team and owners’ to enable residents to know who to talk to if they are worried about anything. Since the last visit the manager, one of the directors of the company and the staff team have undertaken protection of vulnerable adults training. The staff team are also undertaking NVQ level 3 training which covers issues of abuse and the impact of poor practice on residents’. Members of the staff team spoken to during the visit told the inspection they found the above training useful and made them look at their own practice and the impact they as individuals have on the quality of residents’ lives. They were able to demonstrate to the inspector a clear understanding of their role as alerter to incidents or allegations of abuse. The manager informed the inspector she had received the revised Wirral social services Protection of Vulnerable Adults policy and procedure guide and subsequent training had been undertaken. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 16 Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 17 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 & 30. Continuing investment is having a positive impact on the appearance of the home creating a comfortable environment for those living there. EVIDENCE: All areas of the home viewed during this visit were clean and tidy and well furnished and decorated. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. The staff morale is high with them demonstrating a clear understanding of their roles. The home demonstrates a commitment to continuing professional development through the training being undertaken. The recruitment and selection policies and procedures protect residents’ from the risk of abuse or poor practice. EVIDENCE: Since the last visit to the home four members of the staff team have successfully completed NVQ level 3. With the remaining members of the staff team undertaking NVQ level three with specific units in supporting adults with a learning disability being included. The staff team and one director of the company have undertaken protection of vulnerable adults training. The staff team and one director of the company have undertaken restraint training provided by a BILD accredited trainer. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 19 Members of the staff team told the inspectors’ they were well supported by the manager and senior support workers and were very clear on what their roles are within the home. They told the inspectors’ at the beginning of each shift they are given information about each resident so they know the best way to approach and support them. A selection of staff files were looked all check required to be made prior to the offer of employment being made had carried out with detailed and appropriate records being maintained. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 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 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. The manager is committed to supporting staff to undertake appropriate training with an expectation that staff members attend training to allow them to reflect on their practice and to improve their skills and knowledge. Residents told the manager they liked the manager and the staff team and felt able to go to the manager if they had any problems. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 21 No issues of health and safety were raised during this inspection with the fire logbook and accident records being well maintained. Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 3 X X 3 3 Apple Blossom Lodge DS0000018861.V287418.R01.S.doc Version 5.1 Page 23 Yes 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 persons must ensure the Statement of Purpose provides detailed information regarding the range and complexity of needs they can provide for. Timescale for action 28/02/06 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.V287418.R01.S.doc Version 5.1 Page 24 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.V287418.R01.S.doc Version 5.1 Page 25 - 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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