Inspection on 13/09/06 for Bowmans Lodge

This inspection was carried out on 13th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bowmans Lodge 14/12/09

Bowmans Lodge 13/08/09

Bowmans Lodge 20/08/07

Bowmans Lodge 24/01/06

Bowmans Lodge 05/07/05

Bowmans Lodge 10/01/05

Bowmans Lodge 13/09/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Bowmans Lodge 46 Coombes Road London Colney Hertfordshire AL2 1ND Lead Inspector Mrs Jan Sheppard Unannounced Inspection 13 September 2006 16.00 Bowmans Lodge DS0000019340.V306453.R02.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 Bowmans Lodge DS0000019340.V306453.R02.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. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bowmans Lodge Address 46 Coombes Road London Colney Hertfordshire AL2 1ND 01727 823273 01727 823273 FP 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) Mr V Pyneandee Mrs M Pyneandee Mr V Pyneandee Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: Bowmans Lodge is a privately owned and run care home, registered to provide care and accommodation for up to three younger adults with a learning disability or with a mental health disorder. The home aims to offer a supportive environment, to enable service users to gain or regain skills and to recover the confidence necessary for them to be able to move on and live independently within the community. The home is a semi-detached house, situated in a residential area of London Colney. The accommodation is on two floors and includes communal areas and office/sleep-in provision for staff. The home operates a no smoking policy although a covered area is provided adjacent to the garden, where residents may smoke if they choose to. The front garden has hard standing for car parking; the rear garden provides additional seating areas for residents. The current fees for the residents who are all sponsored by a local authority range from £600 to £703 per week. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced at 4.00pm and provided the opportunity to speak with all the residents as they returned to the home from their various day activities. The staff member on duty was also spoken with along with the homes owner and the registered manager. The comments in this report reflect the findings made by the inspector during this visit and also take account of information and reports that were periodically sent to the Commission by the homes manager. Twenty-three standards were examined during this inspection. Both the recommendations made following the previous inspection have been acted upon. The residents appeared to be relaxed and happy and to be very much in charge of their own environment. What the service does well: What has improved since the last inspection? What they could do better: There are currently no major areas of concern. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 6 The manager recognises the importance of maintaining the current good standards of care, this to enable the residents who wish to do so to develop further their skills and abilities, which will enhance their prospects for a move to a more independent living setting. 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. Bowmans Lodge DS0000019340.V306453.R02.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 Bowmans Lodge DS0000019340.V306453.R02.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has policies and procedures that meet the requirements of these standards for the needs assessment of new residents and appropriate visiting arrangements for their gradual introduction to the home. EVIDENCE: No new residents have been admitted to the home since the last inspection. All three residents confirmed that they were able to visit the home and meet the existing residents before making any decision about moving in. They also confirmed that they continue to be fully involved in the development and review of their care plans. One resident told the inspector that they chose this home because of its small size and homeliness and because it appeared to be very clean and well organised and to have good facilities this being in contrast with their previous places of abode. Bowmans Lodge DS0000019340.V306453.R02.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home maintains detailed individual care plans for each resident, which were seen to reflect personal needs and aspirations. The key worker and care planning systems in place support the rights of the residents to be involved in making choices about their own lives. The well-being and safety of the residents in the home and while out in the community are supported by risk assessments. EVIDENCE: The care plans examined were found to be well kept with good detail as to how care needs should be met, to have a regular pattern of review and to contain risk assessments. Records of recent multi agency reviews of residents care plans were seen and evidence of the residents involvement with these meetings was confirmed by them signing the plans. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 10 The residents spoken with confirmed that the home continues to actively support them to acquire the necessary skills and experience they need to make the transition to more independent living settings if they so wish. Bowmans Lodge DS0000019340.V306453.R02.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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents day centre and attendance at other activity programmes offer them the opportunity for personal development and recreation alongside peers of similar ages abilities and interests. Weekend and evening events in the local community are also enjoyed. Staff offer support to service users in maintaining links with family and friends. The home offers a nutritious and varied menu chosen by the residents, which offers fresh ingredients and home cooking on a daily basis. EVIDENCE: Residents confirmed that their routine activities in day centres and other community settings were of their choosing and were varied to meet their changing needs interests and wishes. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 12 One resident explained to the inspector that some of their day centre classes would shortly be closing and that they were discussing with the Manager what alternative classes they would like to choose. Another resident explained that their recent request to stop attending so many therapy classes had been allowed and that their new programme focused mainly around a local drop in centre was meeting their needs and interests much better. The homes food shopping arrangements involve all the residents helping in turn with the major monthly visit to a local supermarket and then visiting local stores as and when required in between to replenish stocks. All the residents confirmed that the menus, which they choose with the homes manager, suit their tastes and that the meals are very good; a curry dish a speciality of the manager was mentioned as particularly delicious. They said that menu choices and meal times are flexible to meet their individual requirements. During this inspection it was seen that all the residents were familiar with the kitchen arrangements and were confident in tasks of food preparation. One resident offered the inspector a cup of coffee on her arrival at the home. The manager now maintains daily records of both the chosen menu and of the food actually served. Fresh fruit was seen to be freely available in the dining room. Bowmans Lodge DS0000019340.V306453.R02.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 and 21. Quality in this outcome area is good. This judgement is based on evidence received and includes a visit to the service. Personal care and health care is offered to the residents in an individually planned manner so as best to meet their needs. Specialist assessments are arranged for residents whose care needs change. Residents are assisted and encouraged to understand and maintain their own health pattern health including where appropriate being responsible for their own medication. EVIDENCE: The residents all confirmed that they have good access to their local GP and regularly see their Consultant. None expressed any problems with this area of their care; one spoke appreciatively of how the staff had helped them to learn to manage and understand the pattern of their own illness, which they recognised as an essential prerequisite for moving out to live more independently in the community. Another resident mentioned the chiropody services that they now regularly access. The third resident said that care is offered in the home in a flexible manner, offered only when it is needed and that this has enabled them to further develop their own skills. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 14 The two residents who manage their own medication described to the inspector the pattern of this arrangement about which they both spoke with confidence. Care plans provided evidence of adequate protocols and risk assessments covering this aspect of self-medication. The manager discussed with the inspector the ways in which she maintains discrete surveillance to ensure that the residents health is not prejudiced by any non-compliance with their medication routines. The residents wishes for the arrangements to be made to cover any final illness and funeral plans were seen to be recorded on their care plans. Bowmans Lodge DS0000019340.V306453.R02.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has a robust complaints procedure and follows the Adult Protection Procedures as set out in the Hertfordshire County Council Joint Agency Guidelines. The welfare and protection of the service users is supported by the policies and procedures in place, reporting and investigation of any incidents and by the regular supervision of staff. EVIDENCE: There have been neither complaints nor any incidents concerning Adult Protection since the last inspection. The residents were all fully aware of the homes complaints procedure and of how they could activate this. Two residents said, “ if these was a problem they would go straight to the Manager”. The residents are articulate and capable of making their views known. All have good links with other professional workers outside of the home and with a variety of family members. Staff receive protection of Vulnerable Adults training as part of their induction and on going training on this subject. The owner and manager had attended further training on this subject on the 4th May last. The staff being professionally qualified and many working in other health settings as well as at Bowmans Lodge undertake training in that setting also. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 16 The manager discussed with the inspector how she could ensure that all the staff are fully aware of their roles and responsibilities concerning the identification and reporting of abuse in the event that this is suspected. Residents retain full control over their own finances, but the manager will, if requested, assist with budgetary advice. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. This home, which is essentially domestic in scale, meets the space and environmental requirements of these standards and provides a safe and comfortable home for its residents. EVIDENCE: A number of works of repair and environmental improvement have been completed following the last inspection. During this unannounced inspection the home was found to be fresh and clean, and to be attractively and appropriately decorated. Residents confirmed that the home is always kept to this standard and expressed their appreciation of this. The manager confirmed that she has a programme of routine maintenance for the home and that all the residents and staff take their share of the domestic cleaning duties. The residents spoken with all said that they were happy with their rooms and the accommodation provided. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 18 The inspector was invited to visit one bedroom, which was found to be very well personalised to have good storage facilities and to be of a sufficient size to accommodate the residents musical instruments along with their personal training gym equipment. The home has an appropriate awareness of the need to prevent cross infection and there are suitable systems in place to enable the residents to manage their laundry hygienically. The manager is aware that the arrangements concerning the location of the washing machines may need to be reviewed if the care needs of the residents changed. A satisfactory inspection report following an Environmental Health and Safety Inspection made on 30/08/06 was seen. No requirements were made following that visit. One resident commented to the inspector, “ Bowmans Lodge is like a real home small and comfortable that’s what I like about it”. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 19 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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has a stable staff team sufficient to meet the care needs of the residents. Staff are qualified and experienced and are well supported by their managers. The homes recruitment and training practices provide protection for the service users and ensure the maintenance of the good quality of their care. EVIDENCE: All managers and staff have considerable experience of working with this service user group. The majority of the staff are part time and currently work at other times within the public mental health services. This provides them with opportunities for additional training and for keeping up to date with current best practice. Since the last inspection various training courses have been attended including Food and Hygiene and Drug Administration attended by all staff on 17/1/06. In addition the following courses have also been accessed by one or two staff members including the managers; Drug and Alcohol 26/1/06, Supporting People in Crisis 27/1/06, Doing Things Differently 31/1/06, First Aid at Work 16/2/06, Dual Diagnosis Addiction, Infection Control 15/3/06, Safer Better Food Business 6/2/06, Protection of Vulnerable Adults4/5/06 and Supervision and Appraisal 9/5/06. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 20 Because of the numbers of part time staff arranging a time when they can all meet together for a staff meeting can be problematic but the staff member spoken with confirmed that good attendance is usually achieved. The minutes of these meetings were seen and evidenced their regularity and content. Records relating to staff supervision were seen and the recent introduction of Staff Appraisals was described by the manager. The records relating to the recruitment of the most recently appointed staff member evidenced that the appropriate checks and scrutiny of documents had been carried out. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 21 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 and 42 Quality in this outcome area is good this judgement is based on evidence received including a visit to the service. The home has a well qualified manager and a stable staff group. The homes records are adequately maintained so that the health and safety of the service users is assured. The home operates regular quality assurance checks. EVIDENCE: The staff and residents spoken with confirmed that the homes management is consistent and the residents said that as far as it was appropriate for them to do so, they understood the various management systems in place and had confidence that comments made by them to the staff about the running of their home and the quality of service would be listened to and acted upon. One resident said, “ we all feel involved with the running of our home”. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 22 Surveys from relatives confirmed their opinion that the home is well run, although one reply did make mention of the fact that service users are expected to be out attending day activity programmes during the day rather than remaining in the home. A number of records were examined and found to be well maintained, including fire evacuation and alarm testing systems, water temperature monitoring, health and safety checks last recorded 4/9/06 and risk assessments being regularly reviewed, all these records promoting the safety of the residents. A Certificate of Maintenance concerning Fire Risk Assessment was issued following an inspection on 16/8/06, and a satisfactory report following the Environmental Health and Safety inspection on 30/8/06 was seen. Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 23 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 3 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 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 x 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 3 3 x 3 x x 3 x Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 Bowmans Lodge DS0000019340.V306453.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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