Inspection on 29/01/07 for Camber Lodge

This inspection was carried out on 29th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Camber Lodge 18/06/08

Camber Lodge 14/09/07

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

CARE HOME ADULTS 18-65 Camber Lodge 93 Lydd Road Camber Rye East Sussex TN31 7RS Lead Inspector Jason Denny Key Unannounced Inspection 29th January 2007 10:30 Camber Lodge DS0000067943.V326061.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 Camber Lodge DS0000067943.V326061.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. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camber Lodge Address 93 Lydd Road Camber Rye East Sussex TN31 7RS 01797 222360 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) camber.lodge@btconnect.com Nellsar Limited Mr Kevin Richard May Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is eight (8). Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Service users with a learning disability only to be accommodated. One named service user aged sixty-five (65) years on admission to be accommodated. NA Date of last inspection Brief Description of the Service: Camber Lodge is a large, modern two storey detached property sited on the Main road of Camber, a small holiday village 4 miles from Rye. Sand dunes are within a 100 yards of the home accessible by crossing the Main road. A small general shop is within walking distance of the home along with a bus stop, which provides public transport to historic Rye several times daily. Rye has a mainline train station. The nearest large town of Ashford is within 20 miles of the home. The home has ample off road parking facilities within its own enclosed grounds. Camber lodge was originally a Motel and has been renovated, redecorated, and refurbished to a good standard in order to provided residential care for up to 8 adults. Bedrooms are of a good size with ground floor bedrooms sufficient in size for wheelchair users. All rooms have en-suite facilities. Communal areas such as the lounge, reception, dining, and kitchen areas are spacious. Camber Lodge has been under new ownership Nellsar ltd since August 2006. The home first opened in the summer of 2005 when the Winders owned it. Mr Arinesarajah Ragumoonthy is the Responsible Person and the operations director Ms Glenda Osmothherly visits the home on monthly basis to carry out inspections and support the manager. Current fees charged ranges from £860 to £1187 per week. Inspection reports are routinely sent out to families and advocates who express an interest in the home or who specifically request a report. A copy is contained with the home’s guide [service User guide] kept on display in the reception area of the home. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Key Inspection, which took place between 10.30am and 2.30pm on January 29, 2007, and the first since the home was taken over by Nellsar Ltd in August 2006. The manager is unchanged since the last key inspection under the previous owners, which took place May 17, 2006 and when the home originally opened In the Summer of 2005. This inspection was a fresh and new look at all Main areas to reflect that this is new service due to change of ownership. The main purpose of this inspection was to find out how new residents were settling in, assessing the impact of the new ownership, and seeing how the home was progressing since the last inspection. The visit covered key areas such as how the home is managed, staffed, how care is given and recorded, activities, food, health, environment and complaints systems. Current Resident’s [service users] staff on duty and then the home’s manager were spoken with. The lifestyle and care of Residents along with Meal and medication arrangements, current staff training plans and records, were all looked at. Comment cards and comments from Resident’s families and social services, were sought, with all comments positive. Four outcome areas are Good, and Four are Adequate [ok] and in need of some improvement. What the service does well: The home provides good care with positive comments from families and social services. All Residents have settled into the home and get on well with each other as well as staff. All receive prompt meeting of health needs, which has led to some clear improvements. Staff are experienced and dedicated to their work. Assessments on prospective new Residents are detailed where compatibility and suitability is thoroughly assessed to ensure no disruption to existing Residents. Useful care-plans have been developed, with a stress on improving communication and personal care, with detailed guidance Record keeping is of a good standard. Residents live in a spacious, modern, and nice, environment. Residents are supported to personalise their new home. The manager is experienced and popular with staff and gives the home a clear sense of direction and focus on Resident’s needs Staff are closely supervised by an attentive manager who has developed a good relationship with relatives and social services. Relatives spoken with indicated how well the home maintains contact with them and support Residents to maintain relationships and create a good clean and friendly atmosphere. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Camber Lodge DS0000067943.V326061.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 Camber Lodge DS0000067943.V326061.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): 1,2,3,4, & 5. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are some minor gaps and improvements needed to information given to Service Users but this is not affecting outcomes with all carefully assessed before moving in, all of whom continue to have their needs well met. EVIDENCE: The inspector examined the home’s service user guide and statement of purpose, which has now been updated following the last inspection and reflects the service since the home opened. The home has since clarified its admittance policy with reference to a clearer statement of purpose, which states that the home is suitable for those with a moderate to severe learning disability. This clarity ensures that the home will not allow itself to try and cater for too diverse a range of learning disabilities therefore reducing the risk of incompatibility. Some minor areas within the range of needs to be met section need clarifying as they are confusing and could lead to inappropriate admissions. The section states that the home is suitable for mental health needs which needs clarifying to state that learning disability is the prime need which can be met. Further clarity is needed around what type of challenging behaviour could be managed as severe challenging or aggression would place current Residents at risk. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 9 The statement should also make clear that emergency admissions are not appropriate. None of these shortfalls were found to be affecting outcomes for current Service Users but is useful to address to prevent the risk of any future inappropriate admission. The manager is committed to creating a compatible home around the needs of current service users and stated that he has turned down most referrals made to the home despite the financial need to fill vacancies. Relatives and social workers spoken with identified the manager’s caution in this respect as one of the best and most reassuring aspects about the home. The statement of purpose and service user guide was found to be well organised covering all areas with clearer information on staffing qualifications along with Local social service contact numbers were missing. The current Service Users group were observed to be relaxed around one another with the last two admissions being people who have known each other for 25 years and who moved in together. A newer Resident had several overnight stays before deciding to move in and had time to see other homes. The manager again agreed to look at how this important information contained in the guide could be better presented to learning disabled adults such as in the use of digital photography and a talking or videotape. Some work has started on producing staff photographs with a plan to provide profile’s and views of existing residents to be sent out to prospective future residents. Detailed assessments by the home manager were found on all current service users. These assessments included trial visits to the home and the manager going out to visit the person in their previous home and collecting extensive information from the family in one instance. These assessments were complemented by social care assessments. It is evident that any decision to move someone into the home is carefully planned involving a number of trial visits. Most recent social service reviews of current service users showed satisfaction by both the family and the social worker in relation to the placement. This was confirmed in survey cards phone calls and an inspection of records. The inspector communicated with the social worker who placed the two newest Service Users who confirmed that he had no concerns about the home and would be reviewing again shortly. One of these Service Users was able to clearly explain to the inspectors how suitable the home was for them and identified some improvements in comparison with their last placement, such as receiving more attention and the new home being less busy. Another area not affecting outcomes but which needs tightening to strengthen Service Users rights and transparency is around contracts/terms and conditions. These need to show the fee and room to be occupied along with clearer information about what additional charges are made on Service Users such as holidays. Such contracts will also benefit by being signed by an independent advocate given the learning disabilities of some Service Users. Camber Lodge DS0000067943.V326061.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, & 9 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Care-plans contain useful and updated information, which are carried out in practice to the benefit of Service Users. EVIDENCE: The inspector examined the care-plan’s of the two newest service users and one established Service Users were there has been a query about Moving and Handling, along with talking to all service users and the staff on duty. The care-plan’s have developed from the original assessment information. The care-plan’s was found to be well presented and fully detailed subject to regular updating in the case of the newest people who moved into the home in the Summer of 2006.The social workers for service users confirmed satisfaction with the service. A range of guidelines was found to be in place including detailed information on supporting personal care routines. Staff were interviewed as to their understanding of these plans, and how the service users had developed since moving in. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 11 Staff were found to have good understanding of service users including the best way to support them. The only area of concern identified related to how to support someone when they choose to remain on the floor. Some staff and manager confirmed that there have been occasions when two staff have lifted this person without equipment and consent. No such procedure was found in the persons guidelines this is referred too in more detail in the management section of this report. It is positively noted that one Service Users who had a known behaviour of crawling has improved in this respect on the basis of receiving more attention in the new service. It was evident that both new Service Users have been carefully supported to achieve a number of health goals such as loosing weight and reducing medication in one case. Relatives confirmed in survey cards that they were pleased with the care and believed that service users liked the staff. Both new Service Users were reviewed in July 2006 by social services with positive comment and clear plans established which by the time of the inspection the home had gone a long way to achieving. It was evident from observation and discussion that service user’s are comfortable in the home and are being encouraged to make informed choices. It was also evident from records and discussions how the manager ensures that all staff support service user’s in the most appropriate manner including how they are spoken too. Relatives and socials services confirmed how staff had developed a good understanding of a service user with limited verbal communication with reference to non-verbal communication. This information was found to be being transferred to the care-plan with a future plan to develop communication aids, which will be explored at the next inspection. It was recommended to the home that independent advocacy links are developed to ensure that service users have someone outside the home and family who they can ask advice from and have a voice on their behalf. This is particularly relevant as some current service user’s have no peer relationships and rely solely on staff and family for company. Service user’s was found to have a range of useful risk assessments to protect their interests, and clearly presented missing persons procedures including useful profiles. Camber Lodge DS0000067943.V326061.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): 12,13,14,15,16, & 17. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The home has developed clearer and wider ranging routines of activities although they are increasingly affected by resources. EVIDENCE: The inspection took place during on Monday between 10.30am-2.30pm. On arrival two Service Users were found to be at a local gym and two were in the home and spent the morning using their own activity aids to occupy themselves whilst the staff person on shift attended to housework and lunch preparation. The manager was out of the home during the morning buying essentials for the home. After lunch one of the Service Users who had spent the morning in the home went out to a local swimming pool as per schedule to have a coffee. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 13 The other service user who spent the morning in the home was due in the afternoon to have a foot massage with his next planed opportunity to go out being the Wednesday. The manager explained that he would try and organise ad-hoc activities and outings where possible, relying on himself to go on shift due to reductions in staffing numbers. It is positively noted that each Service User now has activity programmes advertised in the home although for two this is still quite limited and needs clearer definition. For example the Service User described as going to swimming activity is going to the pool for a coffee as he is not ready yet to swim. It is positively noted that one Service User described at the last inspection as lacking a wider range of activities was found to have clear schedule and routine and now has some morning activities other than cleaning such as college and new activities like horse- riding. One of the newest Service Users commented that they were happy with activities although there routine of going to church every Sunday was found to be now under threat as the third person rostered on shift on a Sunday has been cut by the organisation as evidenced in January and February 2007 rotas examined. Minutes of recent team meeting [November 13,2006] by the manager has made it clear to staff that due to cuts in resources any additional mini bus leisure outings for Service Users have to be agreed by the manager.. One of the Service Users has higher physical needs and with the reduction of staffing makes leisure trips outside the home more difficult to occur regularly. At the last inspection under the previous owners this Service User had at least 1:1 staffing as 2 staff were on shift for 2 Service Users plus the manager and team leader at times. The service is required to ensure that all diverse needs are met. Records, menus, discussions and observations showed that service user’s enjoy a varied and tasty diet based on healthy eating advice and seasonal menus which are regularly reviewed with service users. Newer and existing Service Users who could verbalise an opinion confirmed they liked the food. Care-plans were found to have clear information of likes and dislikes. Camber Lodge DS0000067943.V326061.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, & 20. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The health needs of Service Users are carefully addressed leading to improvements and clear benefits. EVIDENCE: Personal care guidelines were examined which included looking at detailed bathing and showering guidelines, which showed service user’s preference, along with what they could do for themselves, and what support they required. Care-plans itemised health needs with records kept of health appointments and follow up action. Records showed a significant focus on long-standing health issues for current service user’s. It is evident that within a short space of time when Service Users have moved in the new service that some immediate improvements have occurred. One new Service User confirmed in conversation what was seen in records that a medication review has led to them coming off a medication which had been wrongly prescribed in a previous placement. This has led to a reduction in falls. This person evidenced in conversations with themselves and staff and shown in records that they now have more energy as result of these improvements. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 15 This person has also successfully lost weight as part of goal plan. Another new Service Users was found to have had greater focus on nail care and opportunity for other tests such as for diabetes. The home in relation to another Service User has initiated blood tests with the local medical services to assist Thyroxin levels, which the home manager discovered was affecting weight management. This intervention has resulted in the service user continuing to positively lose weight, which is closely monitored. Medication stocks and records were examined along with staff being observed giving medication. All staff were found to have completed appropriate training. Non-service user medications are now stored in a separate cabinet. The home has also sought continence advice from a specialist in relation to one Service User with a record in the visitor’s book showing a recent visit. Camber Lodge DS0000067943.V326061.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, & 23. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home operates in an open manner and has no complaints recorded about the care of Service Users since it opened. EVIDENCE: It was evident from records and discussions with the manger that no recorded complaints have been made to the home in respect of service users. The manager demonstrated through discussion and by reference to a new recording form how any complaint would be dealt with and investigated including any complainant being written to with the outcome. Over the last year the manager has introduced a complaint recording form to ensure that all staff would process a complaint in the same way regardless of who initially took the complaint. The manager confirmed that he is organising a refresher Protection of Vulnerable Adults course for all staff. All staff have previously covered adult protection training in their previous jobs. The home was found to have adult protection prevention of abuse policy and reporting procedure with local contact numbers now on the policy and procedure as well in the homes guide [see Standard 1]. Staff have previously shown through discussion a sound understanding of how to both identify and report suspected abuse. One concern has been made to the Commission by someone who may have worked in the home, about lifting procedures although this related more to the risk of staff back injuries rather than the welfare of the Service User. [Explored in management section of report] Staff do any lifting at their own risk. Camber Lodge DS0000067943.V326061.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 29, & 30. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The home is spacious for the current number of Service Users and bedrooms and most communal areas meet needs. Some areas of the environment need prompt attention such as safety and accessibility EVIDENCE: The inspector toured all communal areas. The bedroom of two Service Users were looked at on the last inspection. The home has ample off road parking facilities within its own enclosed grounds. Camber lodge was originally a Motel and has been renovated, redecorated, and refurbished to a good standard in order to provide residential care for up to 8 adults. Bedrooms are of a good size with ground floor bedrooms sufficient in size for wheelchair users. All rooms have en-suite facilities. Communal areas such as the lounge, reception, dining, and kitchen areas are spacious. One of the current service user’s uses part of the large lounge to facilitate a snooker table. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 18 The three rooms on the ground floor are at least 12 square meters and meet needs The driveway around the side and rear of the home has a sizable crack and is dangerous with the Inspector having difficulty driving around it. The home does not have a garden so Service Users rely on having safe access to the external grounds to the rear of the property which is enclosed. The cracked drive makes this hazardous especially for wheelchair users who have electric wheelchairs which occasionally can got of control. Service Users are therefore not allowed at present to access this area The manager reported that the crack has been there since October 2006 and was not clear when the organisation will be repairing it. The manager explained this has affected outcomes for one Service User who enjoys spending time in that area and getting fresh air and exercise, who now cannot access this area out due to safety issues. It was positively noted that the remaining electrical work was observed to be taking place. The home has organised an assessment by a occupational therapist of the home resulting in one adaptations in relation to a bathroom and the possibility of others or people with physical disabilities. This could include making access outside the rear of the home level for wheelchairs The home was observed to be spacious enough for all 4 Service Users when they were present at lunchtime together. The manager will carefully observe this as a numbers of service users increase. The home was found to be clean, modernly equipped, and free from offensive odours. Camber Lodge DS0000067943.V326061.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35, & 36. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Staff are developing in terms of training and deliver good care but there is not enough of them with low morale and turnover starting to affect outcomes for Service Users and the stability of the home. EVIDENCE: The rota was found to be followed with the rota identifying the role and capacity of each person working. The home was found to have two staff on each shift and two sleep-in [for 4 service users]. The team leader gives some admin support to the home and mainly care support, with the manager also assists on the care-side where necessary. With the exception of two sleep-ins this is similar to the staffing levels when the home had 2 service users. When the 2 newest Service Users moved in before the new organisation took over staffing increased to provide an extra 100 hours per month to meet assessed needs and provide activities. It is concerning to find that this 100 hours is now cut from the month of the inspection as confirmed in rotas, team meeting minutes and discussions with staff and manager. The effect is less activities/ outings and cuts to diverse activities such as church for a Service User. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 20 The administration of the home has also increased with the increased number of Service Users, which makes managements flexibility to assist staffing the home more difficult. A resignation letter dated 5th January 2007 from a staff person indicated the affect on morale of these cuts in resources, staff discussions also confirmed they were looking at alternative employment as they did not feel “they could do the right job for Service Users”. This was also evidenced in team meeting minutes December 2006. The manager indicated that the activity programme could not be achieved such as cinema trips. The Inspector advised that whilst further discussion with the organisation takes place re staffing levels that the home does as mush as they can to look at flexibility in order to prioritise Service Users doing activities and going out. A staff member indicated how the lack of enough staff affects attention given to Service User as staff also have to clean the home and prepare meals. The organisation are advised to restore existing staffing levels when the two newest Service Users moved in line with agreements, needs, and numbers of Service Users Staffing files on 2 staff were examined with Police CRB and references along with all other information in place. Both staff persons was found to have started work in the home only after a Protection of Vulnerable Persons Register first [check against a register] had been sought with a full Police CRB disclosure subsequently in place for both staff. 3 staff were found to achieved a National Vocational Qualification in Care at level 2 or 3 and who were funded by the previous organisation, raising the overall percentage to 40 . Concern was expressed by staff who have not yet had this opportunity with the manager confirming that he is awaiting for the organisation to approve costs and fund training overall. Some Staff who have joined the home over the last year have not had updated moving and Handling training despite supporting Service Users who require physical support. The organisation is advised to send the Commission a training plan to show how staff will be fully trained. Written staff inductions based on National guidance were being followed and are now being completed on schedule as evidenced in one looked at. A newer member of staff was not found to have the full induction [Common Induction Standards] book in place which the manager rectified during the Inspection . Flexibility was afforded given the experience of this staff person. Staff indicated that they felt well supported by the manager Supervision records for staff showed that they were occurring regularly although the manager indicated that staffing levels have made this more difficult to keep on track every 2 months although he observes staff on a daily basis. The manager maintains a disciplined staff team with a staff member recently dismissed for poor team- working and unprofessional conduct although there was no evidence that Service Users were put at risk. Camber Lodge DS0000067943.V326061.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, & 42. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Management and support from the organisation needs to improve in the best interests of Service Users. Health and safety matters need closer attention and staff need to ensure that all practices are safe whatever the time pressures. EVIDENCE: The experienced manager has previously managed similar services. The manager has a National Vocational Qualification level 4 in management and education and was working towards the relevant Care qualification as part of his Registered Manager Award course. The manager confirmed that he has not completed the course as expected due to the new organisation declining to fund the course, which he had started under the previous owners. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 22 The organisation have confirmed in a monthly report that he can now resume the course. This delay is disappointing and the manager is expected to compete this qualification as soon as possible in line with expectations when registered in 2005. The home was found to operate in an open manner towards service users and staff with regular team meetings taking place, as shown in minutes. Families and social services spoken with indicated satisfaction in relation to the manager and his concern to create the right type of home. The manager has introduced task sheets for staff to ensure good routines for Service Users and to improve quality of outcomes. The owners of the home [new organisation] did not initially conduct monthly visit/ inspections [regulation 26] . The Inspector needed to contact the home to get this process resumed. Reports are now being sent to the Commission on a monthly basis since December 2006 and highlight what areas need to improve with more focus beginning to be placed on environment and outstanding health and safety areas. These reports did not indicate the planed staffing cuts or the reasons for them. The manager was advised to devise with the organisation an Annual Development plan for 2007 to show the goals of the home and how all outstanding areas will be met. Conversations with the manager and staff and inspection of team meeting minutes indicated that work is required by the new organisation to create a positive, inclusive, and supportive relationship with the home in the best interests of Service Users. The staff turnover in the home with 2 staff recently left and two more planned [one confirmed] is having an impact on a small home and work is needed to stabilise this. Some confusion was found in team meeting minutes dated October 133, 2006 with reference to decisions about whether a Service Users could be lifted from the floor by two staff. This Service Users can lift himself to his chair independently but will choose to decline on occasions. The manager confirmed that staff should not lift t[especially as no specialist equipment] unless someone is in danger. The minutes referred to a risk assessment and guidelines although none were not found in the Service Users care-plan. The manager was therefore advised to confirm in writing what the guidance is and get staff to sign an agreement in relation to this issue. The manager confirmed that staff sometime lift the Service Users when they feel rushed or in order to get everyone out which due to staff shortages can rely on this particular person going out also. The manager was advised and agreed that Service Users cannot be forced to move or pressured into going along with others wishes. Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 23 Portable Appliance testing safety certification has been achieved along with a Legionella risk assessment and Mains electricity work taking place during the inspection after a long delay. All other equipment was found to be tested as per schedule. Fire training for all staff recently took place January 15, 2007 as confirmed in records where a fire drill and alarm testing also took place. The home was found to have all necessary policies and procedures in a clear and accessible file produced by a leading care provider, with updates to the abuse reporting procedure now taken place. The manager was found to regularly update these polices with review dates entered. A visit by Environmental Health March 7,2006, produced a positive report and no requirements Camber Lodge DS0000067943.V326061.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 2 2 3 3 3 4 4 5 2 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 2 25 X 26 3 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 3 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 2 13 3 14 2 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 2 X Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 25 N/A 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 YA1 Regulation 4,5 Requirement That the Registered Person must ensure the homes Statement of Purpose appropriately and clearly defines the range of needs to be met and admissions criteria. That a copy is sent to the Commission by the date shown That the Registered Person must ensure that all Service Users have a contract/terms of conditions which is signed and sets out all the necessary information as included in amendments to standard 5, and Regulation 5 effective from September 1 2006. That the Registered Person / Responsible Individual must ensure that Service Users have a regular range of leisure and other stimulating opportunities which meets their diverse needs and preferences. That the Registered Person / Responsible Individual must ensure that the premises are kept in a good state of repair both externally and internally. With particular reference to the DS0000067943.V326061.R01.S.doc Timescale for action 29/05/07 2 YA5 5 29/05/07 3 YA14 16[m][n] 12[1][a] 29/04/07 4 YA24 23[2]b[] 13[4] 29/04/07 Camber Lodge Version 5.2 Page 26 Driveway. 5 YA32 18[c][1] That the Registered Person / Responsible Individual must ensure that a sufficient number of staff are enrolled on a National Vocational Qualification course in care. That the Registered Person/ Responsible Individual must ensure that staff are working in sufficient numbers at all times to meet assessed needs including activities and other choices. That the Registered Person / Responsible Individual must ensure that a staff training plan is developed which is costed and sent to the Commission by the date shown. That the Registered Person/Responsible Individual must ensure that the manager resumes the necessary qualification and achieves this as soon as possible. That the Registered Person/ Responsible Individual must ensure that an Annual development plan is developed for the home based on the needs and views of Service Users and stakeholders and which address all outstanding requirements. That this plan is sent to the Commission by the date shown and shows involvement by the managing organisation. That the Registered Person must ensure that all staff use appropriate Moving and Handing techniques. That guidance is clarified for staff and sent to the Commission in respect of a particular Service User, by the date shown. 29/06/07 6 YA33 18[1][a] 29/04/07 7 YA35 18[c][1] 29/05/07 8 YA37 18[c][1] 29/04/07 9 YA39 24 29/05/07 10 YA42 12[1][a] 13[4] 29/04/07 Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA1 YA7 YA24 Good Practice Recommendations That the service user guide is reproduced in a accessible format for existing and prospective Service Users That independent advocacy links are explored That level wheelchair access is fully available around the rear entrance to the property Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Camber Lodge DS0000067943.V326061.R01.S.doc Version 5.2 Page 29 - 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!