Inspection on 21/04/05 for Burntwood Lodge

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Burntwood Lodge 08/07/08

Burntwood Lodge 09/07/07

Burntwood Lodge 07/08/06

Burntwood Lodge 19/01/06

Burntwood Lodge 16/11/04

Burntwood Lodge 26/07/04

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Thorndene

Insight - Eastchurch

Southfields

Sutton Lodge Nursing Home

Magenta

Seabourne House

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Dovedale Court

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

CARE HOME ADULTS 18-65 Burntwood Lodge 84 Burntwood Lane Caterham-on-the-Hill Surrey CR3 6TA Lead Inspector Joe Croft Unannounced 21 April 2005 10.30 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. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Burntwood Lodge Address 84 Burntwood Lane Caterham-on-the-Hill Surrey CR3 6TA 01883 330525 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 Abdulha Aziz Coowar To be confirmed CRH 6 Category(ies) of LD Learning Disability 5 registration, with number LD(E) Learning Disability - over 65 of places 1 Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 One (1) named resident may also fall into category PD(E) (Physical Disability - over 65) One (1) named resident may also fall into category PD(E) (Physical Disability - over 65) 2 One (1) named resident may also fall into category MD (Mental Disorder) One (1) named resident may also fall into category MD (Mental Disorder) 3 Two (2) named residents may also fall into category SI (Sensory Impairment) Two (2) named residents may also fall into category SI (Sensory Impairment) 4 The age range of those accommodated shall be 43 - 65 years of age and 1 resident over 65 years of age The age range of those accommodated shall be 43 - 65 years of age and 1 resident over 65 years of age Date of last inspection 16 November 2004 Brief Description of the Service: Burntwood Lodge is a registered care home , providing care and accommodation for up to six adults with learning difficulties. The home is set in a quiet residential area, with shops and other amenities a short drive away.All six rooms were occupied, one single room with ensuite facilities, one double shared room, and four single rooms. Communal rooms comprise a spacious lounge, dining room, kitchen and bath/shower room. The area to the rear of the main house has a patio area and a large garden. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection lasted five hours. The acting manager and deputy manager assisted the inspectors. It was noted that the acting manager had commenced employment at the home the previous day and stated that the home was short of staff and that this was going to be addressed immediately with the provider. The proprietor was asked for copies of the acting manager’s references and application form, as they were not evidenced during the inspection. The residents stated that they were happy and they were well presented and dressed smartly. They attended activities both in and outside the home. One resident said ‘I like it a lot here’, and goes out to Redhill shopping and stops for coffee. The home has large communal areas and the residents were very comfortable and took pride in their bedrooms, having chosen the colour of decorations and lighting. The kitchen was clean and tidy with food stored in cupboards. Care plans, risk assessments, medication records were inspected and found in good order. Service user guide was comprehensive and written in a language that the residents could understand. What the service does well: The home was friendly and staff were observed to be supportive towards the residents, in a homely atmosphere. Residents have opportunities to access activities inside and outside the home. The residents spoken to stated that they enjoyed living in the home. Activities include attending college, leisure centres, day centres and music therapy. One of the staff said that a resident played the trumpet, and enjoyed dancing. Work was underway to further improve the home, including redecoration of the dining room. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Residents have opportunities to make choices and have access to outside activities. The staff work hard, but are short of resources. The inspection took place on the second day of employment in the home for the acting manager. Requirements have been made which are as follows: Staffing levels must be reviewed and increased to meet the needs of the residents, with immediate effect. Formal supervision must take place six times per year, with immediate effect. The COSHH shed door must be repaired and a lock installed, with immediate effect. References must be provided on the staff member discussed with immediate effect. A Complaints Policy and Procedure must be written and a complaint book must be kept. Policies and procedures must be written and a training programme for all staff must include Protection of Vulnerable Adults, Food Hygiene and Safe Administration of Medicines. The garden must be cleared of all hazardous material and tidied, with immediate effect. Regulation 37 Notification must be forwarded to CSCI Local Surrey Office, with immediate effect. Fire officers report to be forwarded to CSCI Local Surrey Office after the Fire Safety Inspection on the 22/04/05. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 7 The acting manager must submit an application and fee for Registered Manager and the proprietor must make an application for a minor variation in the registration, as there are now two residents living in the home who are over the age of 65, whereas the registration at present states one person. It is recommended that the laundry be moved to another room Pre-admission assessments must be undertaken to ensure that the home is able to meet the resident’s needs. 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. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 8 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 Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 9 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, 2,4 No formal assessment of new admissions was evidenced at this inspection. Care plans were in place, which were comprehensive and updated monthly. Residents’ goals and aspirations were clearly written and a service user guide was evidenced. Prospective residents were encouraged to visit the home and stay overnight before admission. EVIDENCE: A new resident had recently been admitted to the home. He had visited the home on several occasions and knew which room was going to be his. A comprehensive service user guide was evidenced, and included all information about the home, and staff. One new resident recently admitted to the home, stated that the home was ‘much better’ than his last one, much quieter. No pre admission assessment was evidenced for this resident. A requirement has been made in respect of this. Is this the only evidence you have and are you relying on only one resident’s views of the admission procedure??? Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 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 The home encourages independence and enables residents to live active and full lives with staff support where needed. EVIDENCE: Care plans included daily living skills of cooking, personal care and bath/showering. They were updated monthly. Risk assessments were in place and reviewed regularly. One risk assessment included the risks that could be taken for a resident using the kitchen to help with cooking a meal. This risk assessment included actions to be taken to ensure the safety and choice of the resident. Residents’ records included goals that the resident wanted to achieve. Notes from care reviews were evidenced, including a resident’s responsibilities regarding care for the house pet. The records were signed by the resident. Within one resident’s care plan it stated that her favourite activity was drawing, and she was observed doing this activity during the inspection. What about resident’s comments??? Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 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 standard(s) 11,12,13,15,17 The home offers varied activities for the residents to choose regarding their lifestyles. They were able to access community resources with staff assistance. What about diet?? EVIDENCE: The residents stated that they liked going out shopping and having a coffee. When asked, one resident stated that that she liked to buy ‘everything!’ She attends a day centre and meets her friends there. One of the residents likes to play the trumpet in music therapy on Tuesdays and likes to dance. One of the residents was busy drawing with crayons and when the inspector asked her what she was drawing, she said: ’you!’ During a discussion with one resident about her meals, she stated that she liked the food, and had eaten jacket potato with tuna. She was asked that if she didn’t like something that was on the menu, could she ask for something different and she said yes, but she liked everything. No residents in this home were in full time employment. This is not enough evidence to cover all these standards??? Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 12 Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 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 standard(s) 18,19,20, The home offers individualised care to residents, and include personal care plans which were evidenced to be clearly written and concise. No, this text does not mirror the standard concerned sufficiently??? EVIDENCE: Care plans included clear evidence of person centred care, and included GP, Optician and Chiropody visits. Emotional and physical needs were detailed in care plans and records. Care reviews had been carried out and were evidenced. I am not clear that this small amount of text demonstrates how the home meets the standard??? The homes medication was kept securely, and the written administration records were evidenced and were in order. No resident self-medicated. A requirement was made for the home to arrange for the staff to be trained in the Safe Administration of Medicines. Residents were unable to respond to questions regarding medication. Staff discussions confirmed that residents were unable to self-medicate due to their levels of understanding. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 14 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 were not aware of a complaints procedure, but, when asked, they knew to whom they could complain. EVIDENCE: The home has had no complaints recorded since the last inspection. (Have you made a previous requirement?? If so say so???) The residents spoken to had nothing to complain aboutand knew who to go to if they had a problem. A requirement has been made for the home to keep a complaints book, to write a complaints policy, and give a copy to each of the residents. The acting manager, when asked about reporting abuse, knew the procedure to follow in the event that abuse was reported. A requirement has been made that all staff are provided with training on Protection of Vulnerable Adults training. Evidence of the complaints policy was not seen, as this documentation could not be found during the inspection. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 15 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) 24,25,26,27,28,29,30 The home offered a spacious comfortable environment. The outside of the premises was hazardous, and requirements have been made to make it safe for the residents to use. EVIDENCE: The home was very spacious and comfortable for the residents. Three residents stated that the home was comfortable with no restriction of movements within the home. Improvements have been made to the home such as new carpets, new flooring in the hallway and a new entrance had been made to access the office, which is currently being refurbished. One of the residents had an extremely large, comfortable room, together with a large ensuite bathroom. She had chosen the colour of the decoration and lighting. Two residents have been sharing a room for many years, and staff stated that they are happy to continue to do so. This will be followed up with the residents concerned, as one of the residents had a doctor’s appointment, and was not communicative on her return. The kitchen was adequate for the home’s needs, and was kept very clean and tidy, with fridge temperatures measured daily. Immediately outside the kitchen Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 16 was a laundry room. Staff walk through the dining room for access to this. A recommendation has been made that the laundry room be moved to another part of the home. The outside of the premises contained a patio, accessed by a ramp, a large garden, and out buildings. The garden was accessed by a long ramp. At the end of the ramp was a tree, which was hazardous to anyone using the garden because the tree was leaning across the end of the ramp and anyone using the ramp could accidentally come into contact with it. The garden was untidy; the inspectors observed a large pane of glass leaning up against a wall. Immediate requirements were made to remove the hazards and tidy the garden The home had a shed in the outside premises, which houses COSHH substances. This door was warped, and was unable to be locked. An immediate requirement was made to repair the door and provide a lock. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 17 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) 31,32,33,34,35,36 The home employed a small core of staff, and use agency staff to fill in vacancies. Staffing levels must be reviewed and increased accordingly in order to meet the assessed needs of residents. What about the recruitment policy etc??? EVIDENCE: At present, the home employs a total of three staff working during the day, one acting manager and one deputy manager. At night the home employs agency staff, one sleeping duty, and one waking duty. A requirement has been made that staffing levels are reviewed to meet the needs of the residents, and increased accordingly. This is an immediate requirement. The Provider must forward evidence of the names, numbers and experience of staff to be on duty both day and night for the next 4 weeks on receipt of this report and thereafter to the CSCI Surrey Local office. The recruitment procedures were not robust and did not provide the safeguards to offer protection to people living in the home. A requirement has been made that a Recruitment Policy and Procedure be written. Two written references must be taken up on the staff member discussed, and all staff records must be held on the premises. The acting manager told the inspectors that his deputy manager was supervising him while he waits for his CRB check Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 18 to come through. The acting manager should not have been offered employment until the CRB check had been received. Staff must have formal supervision six times per year, which was a requirement from the last inspection. Failure to continue not to comply with this requirement will result in legal action being taken. A training programme must be formulated to include Protection of Vulnerable Adults, Food Hygiene, and Safe Administration of Medication. The staff spoken to reported they enjoyed their jobs, and had a good relationship with the manager How did they know they liked the manager if it was only his second day??? and the residents. They told the inspector that they were glad that a new manager was in place, to make changes for the better. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 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) 37,38,40,41,42,43 An acting manager was in place in the home and the inspection was carried out on the second day of employment. The application form and details of the acting manager were not available at the time of inspection. The proprietor must make records available for inspection in the home at all times. The acting manager cannot work in the home until all matters are met as stated under Schedule 2 of The Care Homes Regulations 2001. This is not part of a judgement?? EVIDENCE: The proprietor is to submit a copy of the duty rota to the CSCI Surrey Local office. The staffing levels are very low unsatisfactory?? What are the Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 20 numbers currently and why are we stating they are insufficient? but are being reassessed according to the needs of the residents. A requirement has been made for the acting manager to submit his application and fee for registration to The CSCI Surrey Local office immediately. The residents all spoke well of the staff and were happy and content. The medication was given on time and recorded well, and the documents evidenced that the residents lead a full and satisfying life. How do we know this??? Requirements have been made for policies to be written what policies?? and Regulation 37 Notifications be sent to the CSCI Surrey Local office. Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score 1 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 1 1 1 1 1 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Burntwood Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 1 1 x 1 1 1 1 H58 S13582 Burntwood Lodge v222152 210405 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. 2. 3. 4. 5. 6. 7. 8. Standard 33 36 42 34 22 34 22 40 Regulation 18 18 16 19 22 19 22 17 Requirement Staffing levels must be reviewed and increased to meet the needs of the service users. Formal supervision for care staff must take place 6 times a year The outbuildings that contain COSHH substances must be repaired and kept locked. Two references must be obtained for all staff members A Complaints Policy and Procedure to be written. A Recruitment Policy and Procedure must be written. A complaints book must be kept. Policies and procedures must be written as recommended in appendix 3 of The National Minimum Standards for Care Homes for Adults 18-65. A training programme for all staff must be written, including Protection of Vulnerable Adults, Food Hygiene, and Safe Administration of Medicines. The garden must be cleared of all hazards and tidied. Regulation 37 notification must be forwarded to CSCI Surrey Local Office. The Fire officers report must be H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Timescale for action Immediate 21/04/05 Immediate 21/04/05 Immediate 21/04/05 Immediate 21/04/05 21.05/05 21/05/05 21/05/05 21/08/05 9. 35 18 21/06/05 10. 11. 12. 24 43 42 13 37 23 Immediate 21/04/05 Immediate 21/04/05 Burntwood Lodge Version 1.30 Page 23 13. 14. 15. 37 33 37 4 18 23 forwarded to CSCI Surrey Local Office The acting manager must submit application for Registered Manager The proprietor must submit copy of staff rota to CSCI Surrey Local Office. The proprietor must apply for a minor variation in the registration of the home, as there are now 2 people living in the home who are over the age of 65 Immediate 21/04/05 Immediate 21/04/05 immediate 21/04/05 21/05/05 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. Refer to Standard 24 Good Practice Recommendations The laundry room to be moved to another area of the home Burntwood Lodge H58 S13582 Burntwood Lodge v222152 210405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection The Wharf Abbey Mill Eashing Surrey GU7 2QN 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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