Inspection on 27/06/05 for Camellia Lodge

This inspection was carried out on 27th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Camellia Lodge 31/05/07

Camellia Lodge 30/06/06

Camellia Lodge 06/01/06

Camellia Lodge 01/03/05

Camellia Lodge 13/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Camellia Lodge 134 Holt Road Horsford Norwich NR10 3DW Lead Inspector Dot Binns Announced 27 June 2005 3:00pm 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. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Camellia Lodge Address 134 Holt Road Horsford Norwich NR10 3DW 01603 890733 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) info@cmg-corporate.com Care Management Group Limited Andrew John Nelson Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Three (3) people with Learning Disability may be accommodated. Date of last inspection 1 March 2005 Brief Description of the Service: Camellia Lodge is a care home providing personal care and accommodation for up to 3 younger adults with a learning disability. The service user may also have a physical disability. Care Management Group Limited, whose registered office is located in London, owns Camellia Lodge. The home is located within the village of Horsford and close to the city of Norwich. Local amenities, shops and pubs are also close by. The home consists of an adapted bungalow and provides a domestic setting for the service users, each of whom has their own single bedroom. None of the bedrooms have en-suite facilities. There is ample communal space including a kitchen, dining room, lounge and lounge annex. There is an accessible rear garden and limited parking to the front of the home. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine announced inspection lasting six hours. Discussions were held with the acting manager (the registered manager having left) and the staff were interviewed. The service users were not able to interact with the inspector but time was spent observing them with the staff and their rooms were seen. Other areas of the premises were viewed as well as the garden which had at the last inspection been judged to need improvements to make it more accessible for the service users. Records and policies were also examined. What the service does well: What has improved since the last inspection? A new bathroom has been completed which is attractive and well fitted. The Home is looking into the provision of more training for staff. The garden has had some work on it but still needs more effort. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3 and 5 The information given out to service users is helpful and produced in a way to make it easier for them to understand. Staff are delivering the care which the service users need and service users can be reassured that the home is able to care for them satisfactorily. EVIDENCE: The statement of purpose was in place and the service users guide was also seen. This is very good with pictures to illustrate the text. The Home caters for people with quite complex needs but there are only three accommodated making it easier for staff to assist them in their needs. From observation on the day, the home is able to cater for the service users and keeps an eye on any deterioration which might indicate that more assistance is required. Three files were examined and each contained a terms and conditions statement outlining the costs and facilities of the home. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 The care plans are very good and reflect the service users changing needs which enables allows staff to look after them properly. Service users are not able to make many decisions but staff take care that the service users are happy and comfortable. Areas of risk are weighed up to make sure the service users can do as much as possible and as safely as possible. EVIDENCE: All three care records were examined. Each contained a full care plan covering different aspects of the care including their needs regarding communication, daily living needs, recreation, sleep and other areas. Care priorities and goals were recorded and reviews of the care were written up. Staff write full daily notes showing what the service users have done and how they have been. A programme of activities for each service user is also included. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 10 Service users need assistance with making decisions and staff have to take responsibility much of the time. They were seen talking to service users however explaining what was happening and they felt from their knowledge of the service users that they were able to tell what the service users liked or disliked. Service users are unable to handle their own money so staff have to look after it. This is done centrally with the benefits of the service users going into a collective account at head office and then transferred to Norfolk and put into an account shared with the service users of each of the five Homes this company has in the county. Such an account is not viewed as good practice by the Commission and the Home is already looking at how to change the system. It was not possible to verify the total benefits collected on the service users behalf and receipts for any goods bought on their behalf were held in another home where the administrator looks after the finances. All that could be seen in this home was money received on the service users behalf from the account and put in a purse. A tally was kept of how this money was spent. Two were checked against the cash held and were satisfactory. Whilst the cash in the Home looked properly looked after, much more individual accounting needs to be kept so that the home can account more clearly what has happened to all the money it collects and spends on behalf of the service users. A requirement has been made to sort this out. Risk assessments were seen to be in place to weigh the safety or otherwise of a service user in an activity eg, walking outside or using a vehicle. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 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) 13,14,16 and 17 Service users are taken into the local community as much as possible and helped to enjoy a range of activities with staff help. Staff are mindful of the rights of the service users and help them to make their own choices and decisions as far as they are able. A healthy diet and varied meals are offered to service users. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 12 EVIDENCE: The service users have complex needs and require a lot of support from staff not only in accessing facilities but also in interpreting the service users views. The inspector was very impressed with the way staff were able to say what each service user enjoyed and what worked for them. They had come to know the service users well and were able to interpret their limited communication. Within that context, service users are enabled to participate in community events as much as they are able. Two service users are able to attend day activities outside the home, one for four days a week, the other for two. On the other days service users are taken out in the Home’s transport to shops, to the coast, to other friends’ houses and to events in the community. One person also goes horse riding and another swimming. Overall staff gave a good account of the activities they provided and saw it as an important part of their work. The routines were flexible and there was evidence in the daily notes that someone was having a lie in or not sleeping. Service users can also get up in the night and mealtimes are flexible depending on what they doing. Each had their own bedroom and could spend time in there. Some decisions were not able to be made by the service users, for instance their mail had to be opened by staff and they were told what the letter said. However the staff commitment to the service users was in place and the policies of the home ensured that staff acted appropriately. The menus were checked and they looked tasty. Staff confirmed they knew what service users liked and they would note any dislikes. These were also seen in the care plans. Service users also had access to evening drinks and snacks and were seen being offered drinks during the day. It was not possible to ask the service users whether they liked the food but the menus looked varied and staff convinced the inspector that they would ensure that service users had food they liked. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 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 and 20 Service users receive personal support by staff in a sensitive way. Health needs are appropriately monitored and there are good links with the community medical services. Medication is satisfactorily administered. EVIDENCE: Service users are normally able to move around themselves but may need some help from staff in getting ready. Staff say they support the service users to keep to their own routines and help them with personal care in their bedrooms in private. The GP was surveyed for his views and confirmed he was satisfied with the overall care within the Home. The files showed that health matters were appropriately attended to with evidence of medical appointments, psychiatrist involvement, district nurse visits and chiropodist and optician calling. Weight was checked and continence was promoted. Annual flu injections were given. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 14 Service users also had an epilepsy record and care plans for the use of rectal diazepam which is used during seizures. All staff had received training on this by a qualified nurse and the evidence was on the staff records. This training is updated every year. Clear instructions on the use of the medication and what to do if it did not work were also recorded in a special care plan written by the GP. Overall the health of the service users was well maintained by staff support and monitoring. The medication records were scrutinised and found to be completed satisfactorily. Medication was appropriately stored and secured. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Procedures are in place to enable service users to make complaints though in reality it would probably be an advocate or a relative who complained. Service users are protected from abuse in that the Home has policies in place and has trained staff in its prevention. EVIDENCE: There is a complaints procedure in the service users guide which also contains the address of the Commission. A record of complaints is also kept but there had not been any since 2003. The Commission has not received any complaints about this home. Polices on abuse and whistle blowing were in place as well as a gifts policy ensuring service users were protected from financial abuse. Staff had received training on the prevention of abuse and were aware that any suspicion of abuse would be referred outside the home. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 16 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 and 27 The garden is a mess and should be made safe and pleasant for the service users. A new bathroom provides good accommodation for the service users. EVIDENCE: Only some of these standards were inspected. There had been a requirement made at the last inspection about covering hot radiators to prevent any burning of the service users. These have now been covered and were seen in all rooms. A further requirement had been made about making the garden safe and accessible, the paths and patio surfaces being broken and uneven and a lack of maintenance making the back garden spoilt. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 17 There had been no progress on this account with the surfaces still uneven, rubbish in evidence, a rusty swing taking up room, another wooden swing broken and on the ground and little evidence of making the garden into an attractive resource for the service users. A trampoline was dirty and there was little garden furniture. A further requirement has been made to sort out the garden. A bathroom has been newly renovated and had new tiles and equipment. There was a non slip floor and handles round the bath and WC. There was no hoist but at the moment service users can use an ordinary bath. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 18 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) 32,33,34 and 35 Staff in practice are caring, knowledgeable and committed. They could be better trained. The Home provides good staffing for the numbers of service users accommodated allowing them to provide stimulation and enjoyment as well as personal care. Recruitment procedures are correctly in place but some mistakes are made with regard to criminal records checks which may put service users at risk. These procedures must be tightened up. EVIDENCE: Staff were caring and committed and knew the service users well. This helped them to care for them well. There are currently no staff with an NVQ but this is reported to be starting later this year. This is definitely something the Commission would support. Staff do receive the basic training eg in food hygiene and emergency aid and evidence of induction was seen in the files. Some of the basic training was out of date however and requires updating. More planning of training should take place to ensure staff are competent. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 19 There are always two staff on duty in this home which for three service users is good support. Staff confirmed this allows them to go out most days with the service users and often to give them individual attention. Staff seemed able to work well together and also shared some activities with the other small homes belonging to the organisation. Recruitment files were examined. The Home has the correct procedures regarding the taking up of references and criminal records checks but one CRB was out of date and needs to be attended to and another staff had not yet received hers. This is not tight enough practice and could place the service users at risk. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 20 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) 42 Health and safety is taken seriously in the home and service users are protected by procedures and trained staff. EVIDENCE: There is currently no registered manager for this Home, the previous manager having recently left. Only the health and safety features of these standards were inspected. The Home has good policies in place dealing with fire, health and safety and the control of infection. The fire record was checked and found to be up to date in its tests and drills. Certificates were seen for gas safety and electrical appliances and water temperatures were checked. Staff files also showed that they had received training on moving and handling, fire procedures and on first aid. The accident record was completed satisfactorily. All of these demonstrated that health and safety was taken seriously by the provider and service users were protected. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 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 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x 3 x x x Standard No 11 12 13 14 15 16 17 x x 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 2 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Camellia Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x v228261 i55 s27558 camellia lodge v228261 270605 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. Standard 7 Regulation Sch4 No9 Requirement A record must be kept of all the money deposited on a service users behalf for safekeeping and how that money is dealt with. The registered person is required to ensure that the garden, pathways and patio are safe and accessible for the service users to use. Timescale not complied with April 2005. The registered person must ensure that all the information specified in the regulations including a criminal records check is obtained before employing that person. Timescale for action 31st August 2005 31st August 2005 2. 24 23(2)(b) 3. 34 19(1) 27/06/05 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 32 Good Practice Recommendations It is recommended that a training plan is devised showing what training staff have received and what they are expected to achieve in the coming 12 month period. Camellia Lodge v228261 i55 s27558 camellia lodge v228261 270605 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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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