Inspection on 20/08/07 for Bowmans Lodge

This inspection was carried out on 20th August 2007.

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 13/09/06

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 30th August 2007 12.00 Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bowmans Lodge DS0000019340.V349944.R01.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.V349944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 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 £717 per week. Information regarding the service is available in the Statement of Purpose and Service User Guide, these and a copy of the most recent CSCI inspection report are available on request from the service provider. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection commenced at 12.00 pm to enable the inspector to spend time talking with the managers and staff, examining documents and making spot checks of various records before the residents returned home from their various day activities at 4 pm. A tour of the premises was also made. The comments in this report reflect the findings made during that visit and also take account of information sent periodically to the Commission by the manager, and other information from the residents their relatives and stakeholders in the home. This was a positive inspection with the key standards examined all met. The residents spoke very positively about their life in the home and the manner in which their care is delivered. What the service does well: What has improved since the last inspection? Since the last inspection a number of works of improvement have been carried out to the building including the upgrading of facilities in the kitchen including new worktops and some new equipment. New carpeting and some new items of furniture and redecorations have been provided in two of the resident’s bedrooms. Since the last inspection the improvements made by two residents in the regaining of social skills and their progress with rehabilitation has enabled them to move on to another less sheltered setting. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. People who use this service experience good quality outcomes in this area. This judgement has been made using a variety of evidence including a visit to the service. The home has policies and procedures that meet the requirements of these standards concerning the needs assessment of new residents and appropriate visiting arrangements for their gradual introduction into the home. Before their move into the home the resident’s needs were fully assessed ensuring that the service is able to meet their needs. There is an up to date Statement of Purpose and Service Users Guide so that people using the service or who may wish to use the service can obtain relevant and accurate information about Bowmans Lodge. EVIDENCE: One new resident has been admitted to the home since the last inspection. Examination of their records evidenced that the home had properly followed its admission procedures and that the needs assessment and introduction to the home had proceeded at a pace that suited them. They told the inspector about their gradual introduction to the home, was happy with the sensitive manner in which this had been conducted and confirmed that they had quickly settled Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 9 very happily into the home. They said “ This is the best place that I have lived in for a long while”. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to the service. The residents care plans are individually focussed and provide an up to date record of their needs, how these may be changing and how they will continue to be met. Comprehensive risk assessments to keep people safe are regularly reviewed to accommodate changing ability and need. EVIDENCE: Both care plans were examined and were 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 (CPA) reviews of these plans were seen, as was evidence of the residents involvement in their compiling confirmed by them signing them. The residents confirmed that they Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 11 felt themselves to be properly involved with the composition and maintenance of their care plan records. The well-being and safety of the residents in the home and while out in the community are supported by risk assessments. The homes records were kept securely with confidentiality being properly observed. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. Residents take part in a varied range of activities based upon their individual needs and choices and are supported appropriately by staff to use local community facilities. The residents receive a healthy diet of freshly prepared good quality food. EVIDENCE: Both the residents have an individually planned day activity programme encompassing five weekdays and some evenings. Both confirmed that they are happy with these arrangements, that they give an opportunity for personal development and a time to meet peers and friends. Subjects covered include relaxation techniques, creative writing, computer studies, art, music appreciation and movement and trips around the area. One resident explained that they has also joined two classes studying subjects of their choice Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 13 gardening and the history of London. The residents said that they felt confident that the staff would assist them to undertake any other activities of their choosing if they so wished. The manager explained how he arranges weekend activities shopping trips or outings to places of interest in conjunction with the residents’ wishes and interests. Both residents maintain good relationships with their families one visiting their father’s home for part of most weekends whilst the other often takes Sunday lunch with their mother in a local Inn. Both residents told the inspector that one of the managers is a very good cook. She explained that she encourages residents to assist with the cooking process and this was seen to be happening on the day of this inspection when a delicious smelling curry was being prepared. New dishes and fresh foods are also being introduced to the residents to widen their food appreciation; poached salmon was a recent well-appreciated new dish. Along with this the need to develop healthy eating habits so as to maintain an appropriate weight are being encouraged (assistance with this is being given by the community nursing service). Bowls of fresh fruit were seen to be freely available in the lounge and dining room. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,and 20. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Personal care is provided for the residents in a way that meets their needs and takes account of their own preferences and expressed choices. To ensure continued well-being residents have good access to all health services. The medication system is robust thereby ensuring safety for the residents. EVIDENCE: Personal care and health care is offered to the residents in an individually planned manner so as best to meet their changing needs. Specialist assessments are arranged for residents whose care needs change. Staff were seen to have a very thorough understanding of the residents care needs and of how these should best be met. Care and assistance was being delivered in a very kind and homely manner. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 15 Residents are assisted and encouraged to understand and maintain their own health patterns. They are also encouraged to take as much responsibility as it is safely possible for them in being responsible for their own medication. The signing and surveillance procedures that are being followed by the staff were seen to be giving appropriate protection to the residents whilst at the same time giving residents the opportunity to take as much personal responsibility for this aspect of their care as it is safely possible to so do. The medication storage and administration arrangements were found to be secure and with one minor exception to meet the required standards. However there are no facilities for the storage of controlled medication. Although no controlled medication is currently being prescribed for any resident in the home this situation could change suddenly and without any warning. The managers must satisfy themselves that in such an eventuality legally acceptable storage and administration arrangements for the storage and administration of such controlled medication would be met in a timely manner. The residents confirmed to the inspector that they were happy with the flexible manner in which their care is delivered to them. The wishes of one resident concerning the arrangements to be made to cover any final illness and funeral plans were seen to be recorded on their care plan. The manager confirmed that discussions concerning this area are had with all residents when an appropriate opportunity arises. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to the service. For the protection of residents there is a robust complaints procedure and the Hertfordshire County Council joint agency Guidelines would be followed in the event of a Safeguarding Adults issue. The welfare and protection of the residents is supported by the policies and procedures in place in the home, reporting and investigation of any incidents and by regular supervision of staff. EVIDENCE: There have been neither any complaints nor any incidents concerning safeguarding adults (adult protection) since the last inspection. Residents spoken with were familiar with the homes complaints procedures and would be well able to discuss any concerns with the homes managers. Staff receive protection of Vulnerable Adults training as part of their induction and on going training on this subject. The owner and manager have attended further training on this subject also. 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.V349944.R01.S.doc Version 5.2 Page 17 The residents confirmed that their views are regularly asked for, listened to and when ever possible acted upon. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using a range of 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: Both residents commented to the inspector on the homeliness and good appointment of the facilities of their home. One recently admitted resident said “ it is a pleasure to come home here”. Individual bedrooms were very well appointed with furnishings and fittings chosen by the residents to enhance their interests and individual life styles. On the day of this inspection the home was found to be very clean and tidy. The residents confirmed that it is always kept to this good standard and that they take their share of the domestic cleaning duties. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 19 The home is subject to a programme of regular maintenance and since the last inspection improvements have been made to the kitchen, the provision of new work surfaces and new carpeting and redecorations in two of the residents bedrooms. Appropriate infection control measures were being followed. The residents manage their own laundry. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a stable, experienced and qualified 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 residents and ensure the maintenance of the good quality of their care. EVIDENCE: The home retains a very stable workforce there having been no changes since the last inspection. The managers and all the staff have considerable experience of working with this service user group. Several are qualified nurses ( RMN) and the others hold NVQ qualifications. 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 Safer Food Better Business , POVA training, Medication storage and administration, understanding Personality Disorder, Moving and Handling, Health and safety, Infection Control Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 21 and a Gas Safety course. The owner attended a Fire Risk assessment course run by the Hertfordshire Fire and Rescue Services in January 2007 and is booked to do Fire Marshall Training in October. Staff confirmed that they are well supported by the managers and the homes records evidenced that regular staff meetings are held along with individual supervision meetings and an annual appraisal. No new staff have been recruited since the last inspection when an examination of the recruitment records evidenced that the appropriate checks and scrutiny of documents had been properly carried out. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using this service are safeguarded by a sound management approach led by an experienced and trained manager whose open approach encourages the residents’ independence and choices. There is an established system of quality assurance in place to gain the views of the people using the service. EVIDENCE: The owner and owner manager in their discussions with the inspector were able to demonstrate a clear sense of direction for the home and to evidence how the good maintenance of the homes records and the following of their own policies and procedures enables this to be achieved. Operational Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 23 procedures of the home were found to be working smoothly; accurate records were maintained with close attention to detail. Spot checks made by the inspector on records including fire alarm testing and evacuation procedures, accident recording, health and safety checks and staff meeting and management meeting records found these to all be in good order. This good record keeping promotes the safety and protection of the residents’ health and welfare. The managers appeared to have a good understanding of equality and diversity issues and a grasp of the complexity and varying strands of these issues. 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. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 24 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x x 3 x Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 25 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. 1 Refer to Standard YA20 Good Practice Recommendations The manager should review the arrangements for the safe keeping of controlled medications. Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Bowmans Lodge DS0000019340.V349944.R01.S.doc Version 5.2 Page 27 - 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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