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Inspection on 31/01/06 for Beech Lodge - Deaf-initely Independent

Also see our care home review for Beech Lodge - Deaf-initely Independent for more information

This inspection was carried out on 31st January 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.

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

What the care home does well

What has improved since the last inspection?

At the last inspection a number of care plans had not been dated. A sample examination of care plans and review documents indicate that this has been addressed and care plan review notes are being properly dated. Good work has taken place to refurbish a downstairs bedroom at the home since the last inspection. The chief executive explained that this room is to be used for people to use, as and when their own bedrooms are being decorated.

What the care home could do better:

The manager for Beech Lodge has recently stepped down from his post and a new manager is to be recruited and registered for this position. The chief executive explained that this is to be discussed at an impending board meeting. In the meantime the chief executive has taken on responsibility for ensuring that the home operates satisfactorily.

CARE HOME ADULTS 18-65 Beech Lodge - Deaf-initely Independent 28 Warwick New Road Leamington Spa Warwickshire CV32 5JJ Lead Inspector Kevin Ward Unannounced Inspection 31st January 2006 01:00 Beech Lodge - Deaf-initely Independent DS0000004233.V281195.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 Beech Lodge - Deaf-initely Independent DS0000004233.V281195.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. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Beech Lodge - Deaf-initely Independent Address 28 Warwick New Road Leamington Spa Warwickshire CV32 5JJ 01926 337743 01926 337743 di@leamspa282.freeserve.co.uk 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) Deafinitely Independent Mr Karl M Davis Care Home 8 Category(ies) of Learning disability (8), Physical disability (8), registration, with number Sensory impairment (8) of places Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. All service users must have a learning disability and a hearing disability. That Karl Davis successfully completes the NVQ Registered Managers` Award by 1 April 2006. That Karl Davis successfully completes the NVQ in Care at level 4 (or whatever title that the GSCC may give to this award in its review of 2005) by 1 April 2006. That Karl Davis notifies the Commission for Social Care Inspection when he has achieved these qualifications. The home may also provide care for one person over the age of 65 who is named in the application for variation dated 28th October 2005. 23rd August 2005 Date of last inspection Brief Description of the Service: Beech Lodge is a parent led voluntary organisation that provides 24-hour personal care for eight adults who are deaf and also have a learning disability. It is a large detached property, formerly a hotel. It is on a busy main road, near to a college of further education, shops and parks. It has gardens to the front and a tarmac drive leading to a large space for cars and a small courtyard garden at the rear and an enclosed garden to the side. On ground floor level there is a hall, a spacious lounge, a large dining room, an equally large communal kitchen/dining room and two staff offices. Leading to the rear of the building there is a short flight of steps into the back corridor. Here there are two bedrooms with en-suite facilities, suitable for people with physical disabilities. The staff sleeping-in room is situated in the same area. A large, new laundry has been created. The corridor ends in a back door straight out onto the tarmac parking area. There is a double garage and a walled courtyard garden with barbecue. There are large, dry cellars at the bottom of a flight of stairs. On the first floor there are two bedrooms with en-suite facilities for residents and another staff office. There is a flight of stairs leading to the top floor. There is a small seating area on the landing and a door leads through to a lobby with four more bedrooms off this, with en-suite bathrooms. There is a small, shared kitchen off the lobby that is suitable for making snacks and drinks. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection focused on assessing a small number of key Standards that were not assessed at the last inspection, 23/8/05. The inspection involved meeting with service users individually and seeing their bedrooms. The inspection also included meeting with staff and the chief executive of the service. A number of records were examined, including a sample of care plans, health records and policies. The inspection was carried out with the full cooperation of everyone at the home. A British Sign Language interpreter was present for the majority of the inspection to help the inspector to communicate more effectively with service users and staff at the home. What the service does well: People’s needs are being well planned for and reviewed by the home. This includes supporting service users to complete a review form, providing an opportunity for them to contribute to their review meetings. Similarly service users are assisted to make video recordings of the things they like at the home to present at their reviews, e.g. their favourite activities. A sample examination of people’s health records indicates that the home continues to support people to access local community health service and to make use of relevant health professionals’ advice and support where necessary, e.g. consultant psychiatrist and epilepsy nurse specialist. The home keeps good records of the outcomes of service users health appointments to demonstrate that people’s needs are being properly monitored and addressed. Service users made many positive, signed comments about the staff at the home, indicating that they feel well supported and listened to. The people living at the home looked very comfortable and at ease when approaching staff for support and staff were seen to respond to people in a warm and friendly manner. Service user meetings are taking at the home that are chaired by a person outside the home who is independent of the staff team, providing an opportunity for people to more freely raise any concerns they might have about the home, should this be necessary. People are being encouraged to make everyday decisions and choices within the context of group living. This includes support to shop for personal clothing, choose furniture and décor and to clean their personal space. Whilst there have been some new staff recently employed at the home there are a consistent core of people who have worked at the home for several years and are very familiar with service users’ needs. The home provides a good range of training opportunities for staff so that they are equipped to support people in a safe and sensitive manner. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.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 Beech Lodge - Deaf-initely Independent DS0000004233.V281195.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): These Standards were not assessed on this occasion. EVIDENCE: Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 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 People are encouraged to participate in the care planning process so that their needs and views are reflected in their care plans. EVIDENCE: A sample of people’s care plans was examined. These documents were seen to contain helpful information to advise staff on the appropriate care and support required by people. Further guidance and information was seen in people’s risk assessments and professional guidelines, e.g. one person has guidelines in place that have been drawn up with the involvement of a behaviour therapist. Service users have been issued copies of their care plans that they keep in their bedrooms. Care plan reviews are taking place and documents were seen that demonstrate that people are consulted before their reviews so that they can contribute to the review. Video recordings are also used to support people to contribute positively to their reviews, e.g. showing their bedrooms and participating in the activities they enjoy. Records of people’s reviews were seen to contain information to confirm that service users relatives are encouraged to participate in review meetings and that social work reviews are taking place periodically at the home. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 10 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): 16 The home encourages people to take part in everyday decisions and daily living activities so that they are able to exercise control over their daily lives. EVIDENCE: Comments made by service users and staff confirmed that people receive support to carry out living tasks within the group context at the home, such as cleaning, laundry and food preparation. People are also supported to go shopping for some groceries as well as to shop for their own clothing and toiletries. Service users have been provided with their own cupboard and fridge space for the storage of their own groceries and snack foods. People have been issued with keys to their bedrooms so that they are able to keep these spaces private. Comments made by service users confirmed that they are supported to choose their own décor colours and to shop for items of furniture when required. Service user meetings take place at the home on a regular basis, which provides an opportunity for people to take part in everyday decision making, such as planning holidays, or to raise any concerns they might hold. The meetings are recorded on videotape so that anyone unable to attend can catch up with events later if they choose to do so. A person who is not employed at the home, chairs these meetings to provide an element of independence from the staff team. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 11 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): 19 The home supports people to gain access to appropriate health professionals so that their healthcare needs are identified and addressed. EVIDENCE: Service users records were seen to contain information to demonstrate that people are being supported to access community health services, such as well person checks, dental check ups and opticians. Similarly good records are in place, detailing the outcomes of appointments with health consultants, such as consultant psychiatrist and other professionals. On the day of the inspection staff were seen to closely monitor and support a person who was not feeling unwell to attend the GP surgery for an examination. Records were seen on file confirming that service users have had health screening checks carried out with the involvement of the community nursing service within the last 18 months. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 12 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): These Standards were assessed at the last inspection and were not inspected on this occasion. EVIDENCE: Comments made by staff during the inspection demonstrated a good knowledge of the essential points of the prevention of abuse policy and people to whom they could raise concerns about practices in the home if this became necessary. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 13 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): Beech Lodge has appropriate cleaning regimes and procedures in place to ensure that the home is maintained in a clean and hygienic condition for people to live in. EVIDENCE: Beech Lodge is a very large Georgian house that is within reasonable walking distance of the local town. Overall the home is decorated and furnished to a satisfactory standard. Whilst further work is necessary to redecorate some rooms this is being appropriately addressed as part of the home’s maintenance and renewal programme. Good work has taken place to redecorate refurbish a downstairs room since the last inspection. Downstairs the building is accessible to people with disabilities and the home is equipped to meet the needs of all the people that currently live there, who are all ambulant and able to climb the stairs. The home is comfortable and homely and is equipped with domestic style furniture. People’s bedrooms are all of a good size and some are particularly spacious and well equipped. During the last year good work has recently taken place to refurbish and equip the main kitchen. Similarly work has taken place to refurbish kitchenette Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 14 facilities that are shared by two people and to fit a washing machine for their use. A patio door has also been fitted in one person’s room during the last year and the Director has previously explained work is ongoing to upgrade the sash windows in the home. The chief executive explained that following a flood at the organisation’s other home, priority is currently being given to addressing the damage that this has caused. The organisation employs a worker with particular responsibilities for addressing maintenance and repairs at the two homes. A comprehensive infection control policy and procedure is in place at the home. Some elements of the policy have recently been updated as part of the home’s quality assurance programme. The home has suitable laundry facilities in place that are situated away from the kitchen and dining area so there is no threat of contamination from laundry being carried through food preparation areas. The laundry was seen to be suitably equipped with washing machines and dryers. Service users needs are such that there is currently no requirement to wash incontinent laundry at the home. The chief executive has shared plans for an employee to take on specific responsibility for cleaning and hygiene issues within the home. Protective gloves and aprons are available in the home for staff to use where necessary. The provision of support for people to clean their bedrooms was also seen to feature as a prompt on the home’s shift handover records. Comments by service users confirmed that they receive the help they require with cleaning tasks. A cleaning schedule was seen in the kitchen that is used to underpin cleaning routines in the communal areas of the home. Overall the home was found to be clean and free from offensive odours. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 15 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 The home provides a satisfactory number of people on duty and a comprehensive range of training opportunities so that service users receive support from a competent and well-trained staff team. EVIDENCE: Beech Lodge rota provides three staff on duty morning and evening and an extra person throughout the day. This is sufficient to allow for service users to stay at home with support during the day where they need / wish to do so. Training information provided by the home earlier this year and comments made by staff confirm that they are supported to access a wide range of training, including health and safety related subjects, such as first aid, fire safety and food hygiene, as well as NVQ training courses. A new member of staff confirmed that they had been taken through a thorough induction process at the home and that plans were in place for him to start the Learning Disability Award Framework induction training shortly. Other care staff at the home have also completed this training. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 16 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 New management arrangements are necessary to ensure that service users continue to benefit from a well run home. EVIDENCE: The chief executive for Deaf-initely Independent has written to the Commission for Social Care Inspection to explain that the manager will be stepping down from this position, 6/2/06 and that new management arrangements are to be agreed at the organisation’s board meeting, to be held, 9th February 06. In the meantime the chief executive will be taking on more direct management control at the home. There is a core team of staff who have remained working at the home for several years and are very familiar with the needs of service users. This inspection was ably facilitated by a senior team member and supported by other staff on duty at the time. Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 17 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x 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 4 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 x x 2 x x x 3 x x Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 18 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 YA37 Regulation 8 Timescale for action Appoint and register a new home 30/09/05 manager with the Commission for Social care Inspection. Requirement 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 Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Beech Lodge - Deaf-initely Independent DS0000004233.V281195.R01.S.doc Version 5.1 Page 20 - 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. 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