Inspection on 05/07/05 for Bowmans Lodge

This inspection was carried out on 5th July 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 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 13/09/06

Bowmans Lodge 24/01/06

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 Herts AL2 1ND Lead Inspector Jeffrey Orange Unannounced 05 July 2005 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. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Bowmans Lodge Address 46 Coombes Road London Colney Herts AL2 1ND 01727 823273 01727 823273 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) Mr V Pyneandee Mr V Pyneandee Care Home only 3 Category(ies) of LD 3 registration, with number MD 3 of places Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are none. Date of last inspection 10 January 2005 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. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and lasted for approximately three hours, commencing at 7.25 am. It provided an opportunity to speak to the member of staff who had been on duty overnight, as well as to the three residents, one at some length, the other two more briefly before they left for day centres or visits to family and friends. The manager and proprietors were present for most of the inspection and useful discussions took place on development plan for the service. It was possible to case-track both staff and resident’s records as well as training and maintenance/insurance records. What the service does well: 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. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 6 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 Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 7 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) 2,3,4 The home works closely with its service users and their health and social care professionals to provide person centred care through the Care Programme Approach. EVIDENCE: Service users have confirmed that they are involved in the development and review of their care plans and the way that their needs are met. Care plan and review documents were seen to be comprehensive and up to date. There have not been any new admissions since the previous inspection; residents have previously confirmed that they were able to visit the home and to meet existing residents before making any decision about moving in. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 8 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 The home demonstrates the capacity to involve residents in decisions about their care and development and actively supports them to acquire the necessary skills and experience they need to make the transition to more independent living settings wherever possible. EVIDENCE: Past residents have been enabled to move into more independent settings in the community. Records of recent multi agency reviews of residents’ care plans were seen, it would be helpful if the involvement of residents could be further confirmed by signing their review notes in the spaces provided. A robust and realistic system of risk assessments was seen to be in place. Recently one resident has been helped to take further steps towards full selfmedication within a risk assessment framework. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 9 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) 12,15,17 Service users are able to develop interests, build relationships and pursue leisure activities in the home and community. EVIDENCE: Residents confirmed their routine activities in day centres and other community settings. One resident went off to spend the day with members of his family, travelling by public transport. The routine of the home in respect of food and resident’s choice were discussed. It was agreed that as each resident tends to make an individual choice from what food is available on a daily basis, and also participates in shopping selections, that the manager will in future record what has been eaten retrospectively and monitor the choice for nutritional and dietary value and appropriateness, rather than have a menu choice displayed which often bears no relation to what the residents actually end up eating. (In the event that residents have or develop specific dietary needs, their choice will of course have to be informed and guided accordingly) Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 10 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) 18,19,20 Residents are assisted and encouraged to maintain their health, including complying with their medication and to have access to those community healthcare services they require. EVIDENCE: Medication records were checked and discreet self-medication monitoring observed. Care plans contain considerable evidence of the involvement with residents of a range of community healthcare services such as general practitioners, dentists and opticians. Residents are prompted and assisted to make and keep healthcare appointments, whilst retaining responsibility themselves as appropriate. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 11 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 Residents are provided with opportunity to appropriately influence and control their own lives, with support and guidance and are offered protection from abuse by policies, procedures and staff training along with independent contact with a range of interested parties outside of the home. EVIDENCE: Policies and procedures and staff training records have been seen which provide for the identification and reporting of abuse in the event that it is suspected. Residents are articulate and capable of making their views known and all have a range of family and professional contacts outside of the home, including advocacy services. Residents retain full control over their own finances, the manager will, if requested, assist with budgetary advice. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 12 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) 24,27,30 The home is essentially domestic in scale and layout and provides a comfortable and safe environment for residents, within the constraints of its size. EVIDENCE: A recent satisfactory environmental health report by St. Albans’ District Council was seen. The home was clean and well presented throughout the inspection. The manager is having wash hand basins installed in all bedrooms over the next 16 weeks in order to provide enhanced washing facilities for all residents. Up to date gas equipment and fire check certificates were seen. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 13 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) 34,35 The home’s recruitment and training practice provides competent and qualified staff to meet the needs of its residents. EVIDENCE: The recruitment file for one member of staff was inspected in detail and found to be in order. All managers and staff have considerable experience of working with this service user group. The majority of staff are part-time and currently work at other times within the public mental health services, which provide an opportunity for additional training and for keeping up to date with current best practice. This should be beneficial for all residents and the quality of care that they receive. It would improve the accessibility of staff records if they could be consolidated for ease of reference. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 14 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) 37,38,39,41,42 The home is well managed and provides a safe and supportive environment for its residents. EVIDENCE: Residents were very positive about the home and its management. Care plans, reviews, records of equipment servicing and insurance cover in place all provide evidence of a robust and genuine concern for the holistic welfare of residents. The standard of record keeping seen on this occasion, including that for medication, was good. Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 15 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 x 3 3 3 x 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 3 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x 3 x 2 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bowmans Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 2 3 x I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 16 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 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 6.10 Good Practice Recommendations Service user involvement in the review process should, in each case, be confirmed by their signature unless they choose not to sign, or are unable to do so, in which case that should be recorded. Recognising that the homes routine makes provision for residents to have an appropriate degree of choice and control over what and when they eat, the manager should ensure that records are kept to show what residents have eaten, so that it can be demonstrated that a nutritious, varied, well balanced and appropriate diet has been provided in each case. Consideration should be given to the consolidation of staff recruitment, training and supervision records. 2. 17 3. 34&35&41 Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 17 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Herts 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. Extracts may not be used or reproduced without the express permission of CSCI Bowmans Lodge I52_s19340_Bowmans Lodge_v237003_050705_stage 2.doc Version 1.40 Page 18 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!