Inspection on 19/08/05 for Benham Lodge

This inspection was carried out on 19th August 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Benham Lodge 16/05/07

Benham Lodge 14/02/06

Benham Lodge 14/10/04

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

CARE HOME ADULTS 18-65 Benham Lodge 42 Pelham Road Gravesend Kent DA11 0HZ Lead Inspector Eamonn Kelly Announced 19 August 2005 15:00 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 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 Stationary 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. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Benham Lodge Address 42 Pelham Road Gravesend Kent DA11 0HZ 01474 533108 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) DGSM Limited Miss Sarah Ann Aldous CRH 9 Category(ies) of LD Learning disability (8) registration, with number LD(E) Learning disability (1) of places Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/10/04 Brief Description of the Service: The home provides accommodation and residential care for up to 9 people with learning disabilities. Twenty four hour supervision is provided. The premises are close to local facilities and public transport. The house is owned by Hyde Housing and leased to DGSM Ltd. The premises were purpose built and service users have their own bedrooms. At the rear is a conservatory and garden. There is car parking space at the front of the home. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of meeting with service users and members of staff. An inspection of the premises was made. Some of the home’s records were checked. The report uses information provided by the acting manager (Lisa Matthews) via a pre-inspection questionnaire that contained factual information about services and facilities. It also uses feedback from GP’s, service users and relatives, and care managers received via quality assurance CSCI questionnaires (“comment” cards). A brief summary of the requirements and recommendations to be contained in the inspection report was given to the acting manager at the end of the inspection visit. Copies of the Commission’s booklet “Is the care you get the care you need?” were left at the home. What the service does well: What has improved since the last inspection? Lounge furniture has been replaced. Tree surgery has been carried out at the front and rear of the premises. The acting manager has reviewed the effectiveness of service user care plan records. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 standard(s) 1, 2, 3, 4, 5 Prospective service users and their supporters do not receive the levels of assistance that is required at admission stage from current pre-admission documents. However, they receive the levels of pre-admission support that they need. EVIDENCE: Following an assessment in outline of the pre-admission written information available at the home to prospective service users and their supporters, it was agreed with the acting manager that the current documents do not contain appropriate information about the home’s services and facilities. The acting manager undertook to produce material that would be informative and accurate. The acting manager also undertook to review the current personal contract for service users and to have a revised contract available for any new service users. The shortfalls in the current personal contract for service users were discussed and ideas were exchanged to enable the new document to comply more fully with the requirements of national minimum standards. The revised personal contracts should contain more specific information regarding the service provision for individual service users. The current contract is an amended version of the (Hyde Housing) tenancy agreement. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 9 The admission procedure was discussed in some detail. The acting manager was confident that new admissions were based on detailed assessments and checking as far as practicable that the needs of prospective service users would be met. Some alterations were being made to the premises to accommodate the requirements of prospective service users. The assessment process followed by the home in the examples discussed was thorough. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 standard(s) 6, 7 & 9 Service users have opportunities for personal goals to be identified and to receive assistance in making decision about their lives. EVIDENCE: Service user’s care plan records checked during the inspection visit were broadly a reasonable reflection of the current care requirements of service users. However, the records have been found by the acting manager to be in need of updating. She outlined how this would be done. The revised service user care plan records are likely to more accurately reflect service users current and changing needs. There is considerable emphasis on involving service users in all aspects of how the home is run: their views are obtained and preferences recorded. The examples of how service users contributed to general and specific activities and routines were supported by accurate notes of service user/staff meetings. There is also emphasis on enabling service users to remain as independent as possible (eg. going out unaccompanied, taking part in paid and voluntary employment and by having front and bedroom door keys). Risk assessments are carried out to enable risks to be anticipated and minimised. The acting Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 11 manager outlined how this process would be enhanced by the revised care plan procedure. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 standard(s) 11, 14, 16 and 17 Service users have good opportunities for personal development and to avail of a range of leisure activities. Service users have the benefit of good meals at the home. EVIDENCE: Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 13 Service users have opportunities to learn and to obtain life skills (eg cooking). Personal development is progressed through attendance at college, paid employment/voluntary work, attendance at day centres and clubs, and maintenance of relationships with friends and family. Service users also receive guidance with development of skills within the home under the tuition of staff. Service users visit the cinema, restaurants, shops, leisure centres etc (they have the benefit of a minibus for outings). Most go to specialist clubs at least once a week. Service users are encouraged to part in household activities. Each service user has at least one weeklong holiday a year (which could include holidays abroad). From comments made by service users, they help to choose and plan holidays and outings. The home helps service users with their personal finances (e.g. to save money for holidays). Some service users maintain contact with members of their families. During the inspection visit, some service users telephoned members of their family. The involvement of service users in the planning and provision of activities was discussed in some detail during the inspection visit. Service users also added to this discussion. The provision of good food and meals was an example of the success of this involvement. This has been a commendable feature of life at the home noted on this and previous occasions. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 standard(s) 18 EVIDENCE: The social and healthcare needs of each service user were discussed in some detail during the inspection visit. In each case, members of staff knew service user’s preferences and their dependence on particular levels of personal care and support. The revised care plan records will also emphasise these dependencies and interventions required. There are separate bathrooms on the 1st floor for male and female service users. Whilst a series of activities have been arranged particularly during weekdays, there was evidence that times for getting up, going to bed, baths, meals and other activities were flexible. Flexible guidance is also provided in respect of choosing appropriate clothing and hairstyles and helping to ensure that service user’s appearance reflected their personality. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 standard(s) 22 & 23 The home has suitable measures in place to protect service users. EVIDENCE: The home has a complaints procedure (a précis being prepared by the acting manager will be prominently displayed). All members of staff have been checked under recruitment procedures applying within the homes owned by DGS Mencap. (ie. references, application form, CRB/POVA check, probation, induction training, supervision). The home follows the Kent & Medway Policy for Adult Protection. Service users are confident in expressing their views to members of staff, visitors and day centre staff. They are regularly involved in discussions with staff about their preferences and expectations. The home has procedures in place for listening to the views of service users and their supporters and for taking expressed views into consideration. The acting manager made good use of the CSCI “comment” cards (ie. quality assurance questionnaires) to obtain the views of care managers, GP’s, service users and relatives. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 standard(s) 24, 27, 28 and 30 The premises are suitable for the needs of service users who benefit from good kitchen, lounge, dining room facilities, bedrooms and external facilities. EVIDENCE: The premises were purpose built for providing residential care. All service users occupy single bedrooms. Their bedroom doors are lockable and some service users keep their own keys as part of encouragement to maintain independence. Bedrooms are comfortable, very well equipped and each reflects the interests of its occupant. There are separate bathrooms on the 1st floor for male and female service users. There is good communal space (including a garden and conservatory) for service users, staff and visitors. Bedrooms and communal areas are equipped with call-bells. A manual hoist is fitted in a bathroom (some alterations are being made to assist a new service Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 17 user with potential mobility difficulties). The home does not have a shaft or stair lift. Doors are of a width suitable for wheelchair access. There are good laundry facilities (which are used under supervision by some service users). The premises were clean, well maintained and free from odours on the day of the inspection visit. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x These Standards were not assessed on this occasion. EVIDENCE: Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 Service users benefit from a well run home. EVIDENCE: The registered manager is currently not in charge of the home. The acting manager has relevant experience of service provision for older people and for people with learning disabilities. There was a positive atmosphere at the home and service users were comfortable and at ease and were happy to speak about their activities and other topics. The acting manager submits occasional reports to the CSCI under Regulation 24 (care home regulations): she outlined how these reports will concentrate in the future on specific strategic and operational issues. The acting manager will now have the benefit of inspection visits and reports each month (under Regulation 26) produced by the DGS Mencap services manager. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 20 A declaration by the acting manager about maintenance certificates and associated safety checks was made in the pre-inspection questionnaire: copies of some records were seen during the inspection visit and these were satisfactory. The acting manager has consulted with health and social care agencies and service users (and their supporters) as part of quality assurance measures. The feedback was extensive and positive. The method followed by the home in involving service users in all aspects of routine and activities at the home helps underpin the development of the home to the advantage of service users. The decision by the acting manager to review and revise service users care plan records is also likely to contribute to the organisation and management of the home which will benefit service users. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 x x 3 x 3 4 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Benham Lodge Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 22 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 1 Regulation 4&5 Requirement The registered person shall produce a written guide to the care home... The current guide is acknowledged but the improvements discussed are necessary to enable prospective service users and their supporters to obtain specific and objective information about the homes services and facilities. Timescale for action 15/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 5 6 Good Practice Recommendations Revised personal contracts should contain more specific information regarding the service provision for individual service users. The decision by the acting manager to introduce replacement service user care plan records is acknowledged and this initiative is requested to be implemented as soon as possible. Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Benham Lodge H56-H06 S59579 Benham Lodge V234787 190805 Stage 4.doc Version 1.30 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. 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