Inspection on 06/01/06 for Camellia Lodge

This inspection was carried out on 6th January 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Camellia Lodge 31/05/07

Camellia Lodge 30/06/06

Camellia Lodge 27/06/05

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 Norfolk NR10 3DW Lead Inspector Mrs Dorothy Binns Unannounced Inspection 6th January 2006 10:00 Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Camellia Lodge Address 134 Holt Road Horsford Norwich Norfolk NR10 3DW 01603 890733 NO FAX # 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) www.caremanagementgroup.com Care Management Group Limited Position Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three (3) people with Learning Disability may be accommodated. Date of last inspection 27th June 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 DS0000027558.V276947.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection lasting two and half hours. The requirements of the last inspection were discussed and some records were inspected. Two of the service users were seen as they passed the morning in the home and the one staff on duty was spoken to. Only some of the standards were inspected and in some cases not all aspects of the standards were examined. What the service does well: What has improved since the last inspection? What they could do better: The organisation must do something about how it handles the service users money and have a clearer system. Training must be provided in a more systematic way to staff and they should be put forward for a national care qualification. The way the home reviews what kind of service it offers and whether there are improvements to be made should be more thorough with a clear plan about improvements to the service. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 6 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 DS0000027558.V276947.R01.S.doc Version 5.1 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 Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 the following standard(s): 2 Each service user has a full assessment detailing their needs and aspirations and helping staff to support them in an individual way. EVIDENCE: The care records showed full assessments of the service users covering a wide range of topics, from health to interests to how they communicated. This information allowed the staff to see where they could best support the service users and formed the basis of a care plan. Information from outside agencies was also provided and liaison with doctors and social workers helped to keep the assessments up to date. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 the following standard(s): 6 and 7 Care records are very detailed and reflect the changing needs of the service users enabling staff to properly support them. Service users’ finances are not properly accounted for and fuller records need to be available and clear. EVIDENCE: Two care records were inspected and found to have full details of the needs and abilities of the service users and what assistance and encouragement they needed from staff and how best to help them. The record shows details of the activities of the service users and the risk assessments for those areas where there is a concern. For example one showed a risk assessment regarding horse riding, another for road awareness. Staff write daily notes on the progress of each service user and mention any issues that occur during their time on shift. The care plan is reviewed every three months to ensure it is relevant. These are good records and provide staff with a lot of information to help them assist the service users in an informed way. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 10 The service users are not able to look after their own finances and staff have to help them. The benefits received on behalf of each service user are not recorded in the home but kept elsewhere in the organisation. The only money staff are sent on behalf of a service user are funds taken out of their allowances twice a month. There is no record of the total money looked after by the organisation and no way it can be checked in the home. The money received into the home and how it is spent can be inspected and both records were checked against the cash held and found to be correct. Money is kept safely locked and receipts are kept. However the record was only for the month of January so only a few days were shown, the record for previous months being located elsewhere in the organisation. The financial records and accounting for the money collected and looked after on a service users behalf is not satisfactory with this organisation and requirements have been made in all the homes. The organisation must provide a transparent system which clearly states what is happening to all the money of service users and how it is looked after. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 the following standard(s): 12, 15 and 17 Service users are not able to take part in jobs or training but are given opportunities within their abilities. Service users are assisted to stay in touch with family and continue to see them where possible. Service users receive a varied diet and are assisted and monitored by staff to ensure they enjoy and benefit from their food. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 12 EVIDENCE: Service users are not able to take part in any employment or training because of their disabilities. They do attend the organisation’s own skill centre two days a week where they can participate in activities which they like. The service users are encouraged to maintain contact with their families and staff assist by keeping in touch by phone. The family of one service user has a weekly report on what activities he has been doing. Holidays with family are also encouraged. Service users do not have any outside contact with people except the service users from other homes but they enjoy their company and there is a lot of visiting between homes. A four weekly rotating menu is used and the menu for the day was fish and chips. Service users are not able to make an active choice because of their disabilities but staff said that they knew by other signs what service users liked. Staff make sure they receive plenty of choice and fresh ingredients are used. A take away meal is purchased every now and then. A selection of cereals are kept in the cupboard for breakfast and toast and fruit juice are provided. There were mainly sandwiches on the menu for lunch which the inspector queried. A greater choice should be able to be provided. There are no special diets and service users can feed themselves though require supervision by staff. There was evidence that there is contact with the dietician for one service user with his food intake monitored. Staff completed food charts as part of that monitoring. In general apart from lunch, the food looked good and staff were monitoring how the service users received it. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 the following standard(s): 20 Service users have help with their medication and this is administered safely and carefully by staff. EVIDENCE: The medication records for the service users were inspected. The daily administration records were initialled appropriately by staff and were correct when checked against the tablets. A monitored dosage system is used where the tablets are pre packed by the pharmacist. These are stored appropriately in a locked cupboard. Stock control was also recorded appropriately. Staff are trained in giving out medication and have also been trained in the treatment of epilepsy. A care plan written by the GP was seen on how to administer this medication. It is not given very often and the record showed when it had been given. Training for this procedure is topped up every year. The staff are able to suggest a review of medication if they have observed any deterioration in a service user. An example was given by the staff member of a medication review providing a better outcome for the service user. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were inspected. EVIDENCE: None of these standards were inspected. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 the following standard(s): 26, 28 and 30 Service users have single rooms and can use them at any time allowing them independence. However an armchair is needed in one room. There is sufficient communal space for the service users to be together and it is reasonably comfortable though could be brightened up. The home is clean and has no offensive odours. Laundry facilities are domestic in nature are currently quite adequate. EVIDENCE: Only two bedrooms are being used at the moment as some building work to enlarge the home is underway. One of the bedrooms is quite large and the service user in there uses a wheelchair. The other bedroom is smaller. Both rooms are individual and had lots of evidence of the service users possessions and tastes. Bedrooms were equipped with appropriate furniture except for the supply of armchairs. Only one room had an armchair. Both had covered radiators. Decoration was acceptable. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 16 The service users share a small sitting room which is comfortable and cosy and has a television. There is an extra bit of space through an archway but this had no focus and was rather wasted. There is a separate dining room with table and chairs where service users mainly eat. Lighting is domestic in character and radiators are covered to prevent the risk of burning. Overall the rooms were comfortable but lacked sparkle. Outside the garden is still a mess but as building work is going on, progress has been delayed. However the Commission would expect that the garden would be made attractive and accessible as soon as work is completed, in line with the requirement in the previous inspection report. There is no separate laundry and the washing machine and dryer are in the kitchen. There is some incontinence to consider and care needs to be taken transferring laundry in food areas. However appropriate containers and protective clothing were provided in the bathroom with very little being brought through the kitchen. There was no offensive odour in the house and it was clean and hygienic. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 and 34 The service users are supported by committed staff who need to be offered much more training. Staffing is considered to be satisfactory though will need to be increased if the number of service users goes up. EVIDENCE: The care staff are experienced and mature and the one staff on duty conveyed confidence and knowledge of the service users. The principles of dignity and independence are given full acknowledgement by staff. This home has a small permanent group of staff (4) and needs the help of one regular agency staff to man the home. They have received the basic training by the organisation and such training as medication and the prevention of abuse though had not received specialist training on learning disability or communication. Nor had any staff completed an NVQ course. The standard for NVQ training is that 50 of staff should have completed NVQ2 or 3 by 2005. Clearly this home is not meeting this standard at all. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 18 There was only one staff on duty at the time of the inspection and she reported that with only two service users currently living in the home, only one staff was on at any time. Both service users were mobile and could manage quite a lot of their own personal care. There were no reported difficulties with challenging behaviour. The activities of the service users also mean that on two days a week neither of the service users are at home for some hours during the day and on another day only one service user is at home. Staff confirmed she was able to take both service users out but also linked with the other small homes in the organisation. This allowed two staff with service users to link up and give support to each other. When the building work is completed and a third service user returns, it is expected that the staffing will increase so that there are always two staff on duty. A requirement had been made at the last inspection for tighter procedures when recruiting staff. It was not possible to check whether this had been completed as none of the staff records were located in the home and the manager was not available to bring them. This will have to be carried over to the next inspection. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 There is not a functioning system of self monitoring, review and development in the home which fully safeguards the service users best interests. A more active system is required. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 20 EVIDENCE: The home has some elements of a quality assurance system and a policy statement tells of the commitment to quality. Some service user questionnaires were seen which were illustrated with pictures to make them more understandable but these applied to a conference set up by the national organisation the year before and were not to do with this home at all. Staff confirmed that she had never been given a questionnaire to complete nor assisted a service user to complete one either. There was no action plan showing what actions were being implemented as a result of the findings of the survey. A much more localised quality assurance system is needed that clearly sets out the standards for quality and how it will be measured. Surveys need to be local to service users, relatives staff and other professionals associated with the home. The findings should be published and an action plan documented so that improvements can be made. In future the quality assurance system fully operating in the home will be an indicator to the Commission of whether the home is functioning well. Currently this is not in place. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 2 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 3 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 x X X 1 X X X X Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA7 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. Previous timescale 31/08/05 not complied 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. Second timescale 31/08/05 not complied with. The registered person must ensure that all the information specified in the regulations including a criminal records check is obtained before employing that person. The registered person must ensure that staff receive training appropriate to the work they are to perform, in this case training in learning disability and a national care qualification, and receive suitable assistance including time off in order to obtain further qualifications. Timescale for action 31/03/06 2. YA24 23(2)(b) 31/03/06 3. YA34 19(1) 31/03/06 4. YA32 18(1)(c) 30/04/06 Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 23 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 YA32 YA26 YA28 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. It is recommended that the provision of an armchair is considered in each service user’s room. It is recommended that communal space is brightened up. Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Norfolk Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Camellia Lodge DS0000027558.V276947.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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