Inspection on 12/01/09 for Camelot Lodge Residential Care Home

This inspection was carried out on 12th January 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Camelot Lodge Residential Care... 01/02/07

Camelot Lodge Residential Care... 12/12/05

Camelot Lodge Residential Care... 27/07/05

Camelot Lodge Residential Care... 12/01/05

Camelot Lodge Residential Care... 25/08/04

Camelot Lodge Residential Care... 17/02/04

Camelot Lodge Residential Care... 04/11/03

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Camelot Lodge Residential Care Home 19 Christchurch Road Folkestone Kent CT20 2SJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mark Hemmings     Date: 1 2 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 35 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: Camelot Lodge Residential Care Home 19 Christchurch Road Folkestone Kent CT20 2SJ 01303251215 01303267886 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ACL Care Homes Ltd Name of registered manager (if applicable) Mrs Linda Patricia Davis Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Ten people who need to be supported to care for their mental health can live in Camelot Lodge (the Service). The premises are a two storey detached property. The accommodation is on the ground floor, the first floor and the second floor. There is also a basement floor. When full one of the bedrooms can be shared by two people. All of the other bedrooms are singles. All of the bedrooms have a wash hand basin. There are two bedrooms on the basement floor. Both of them have natural light. On the ground floor there is a main lounge and there is the dining room. The kitchen is also on Care Homes for Adults (18-65 years) Page 4 of 35 care home 10 Over 65 0 10 Brief description of the care home this floor. There are enough bathrooms and toilets. At present, the Service is full. Nearly everyone has lived in the Service for some years. They are settled and there are no plans for anyone to move on. The Service is in a residential street that is quite close to the centre of Folkestone. The town centre is only a short walk away. The Service doesnt have its own car. The Registered Provider is private company. It runs another larger residential service just across the road. People who might want to move in can find out things about the Service. There is a Service Users Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This is more detailed than the Guide. If you want to find out more about Camelot Lodge you can also have a chat with the Manager. Care Homes for Adults (18-65 years) Page 5 of 35 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. Since 1 April 2006 we have developed the way we do our inspection of care services. This inspection of the Service was a Key Inspection. We arrived at the Service at about 10 oclock and were there for about nine hours. It was a thorough look at how well things are going. We took into account detailed information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, we considered any information that we have received about the Service since the last inspection. We spoke with most of the people who live there. Also, we spoke with one of the two Directors of the Company that is the Care Homes for Adults (18-65 years) Page 6 of 35 Registered Provider. For convenience in this Report we call him the Director. We spoke with the Manager, the assistant manager and with one of the support workers. For convenience again, in this Report we refer to the assistant manager and the support worker as being the support workers. We looked at some key records and documents and we had a look around the accommodation. Before we went to the Service we asked the people who live there to fill out a questionnaire for us. We wanted them to tell us what they think of their home. Were pleased to say that everyone who lives in the Service kindly filled out our questionnaire. We will tell you what they have said as we go through this Report. We were helped in our inspection by an Expert by Experience. This is someone who has a special knowledge of and a special interest in the way residential care services support people who have problems with their mental health. Our Expert by Experience spent about three hours with us in the Service. During this time, she spoke with quite a few of the people who live there and generally she had a look around. She also looked at some records such as what things people talk about at the regular house meetings. You will be able to see what her observations and conclusions are as you read through this Report. What the care home does well: What has improved since the last inspection? What they could do better: Some people say that they would like to have the opportunity to do more and different social things. Some of the records that we need to see are not kept in the Service. This means that we cant confirm some of the things that we need to. Support workers have done a good deal of training in relevant subjects. However, parts of the training system can be developed further to make sure that there are no gaps. Since our inspection, the Registered Provider has appointed a training officer who will be attending to this matter. People are asked what they think about their home. However, the quality assurance system can be developed more. This may enable some of the people who live in the Service to have a more direct voice in how their home is run. The fire safety training system needs to be more organised. This is so that all members Care Homes for Adults (18-65 years) Page 8 of 35 of staff are checked to make sure that they know what to do in the event of a fire. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 35 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standard 2. People who might want to move in are asked about what support they want. They are then helped to settle in. Evidence: The Manager says that if someone is thinking of moving into the Service, she will speak with them to find out what support they want and what sort of life they want to follow. She will also speak with other people such as family members and care managers (social workers). This will be done so that she can check out points of detail that help her to be clear about what is needed. After this is done, the person will be invited to visit the Service. This is so that they can get a first hand feeling of what Camelot Lodge is like. Also its done so that they can meet the other people who have already made the Service their home. The Manager recognises that moving into a new home is a big step for everyone Care Homes for Adults (18-65 years) Page 11 of 35 Evidence: involved and of course mostly for the person doing the moving. She emphasises that the Service wants to do everything possible to make the move a positive experience for everyone. We looked at some of the information that was collected to support someone who has moved into the Service recently. There is lots of useful stuff. For example, about their family and the contacts they have with them. There is also information about the support they need, about their health and about the sorts of social life they enjoy. The Manager says that she shares this information with the support workers. This is done so that they can support the person in the right way from the point they move in. After this, they can get to know them better as time goes by. We asked support workers about how all of this works out in practice. They say that they are fully involved in the steps taken to help someone move in. We asked one person about how things went when they first came to the Service. They say, I came to have a look around and (the Manager) came to see me at (another residential care service). I had a good look around and liked this place because its friendly and Im okay here. I dont want to have to move again. In our questionnaire we ask, did you receive enough information about this home before you moved in so you could decide if it was the right place for you? Everyone says that yes they did have enough information. One person sums up the general mood when they say, (the Manager) showed me my room before I moved in. I was pleased with it and I still am. Care Homes for Adults (18-65 years) Page 12 of 35 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7 and 9. People who use the Service experience good quality outcomes. There are individual written plans of support. There is a sensible approach to everyday risk taking. Evidence: People say that the support workers offer them all the assistance they need. There is a written individual plan of support for each person. These are important documents. This is because they are one of the means by which people can decide about the support they need. Also, they are a way for them to show their agreement with how this is going to be done. The plans are a source of information for support workers. This then helps them to provide support in the right way. We looked in some detail at four of these plans. They have information about a number of relevant things. For example, there is information about how to help the people say what they want and Care Homes for Adults (18-65 years) Page 13 of 35 Evidence: about how to support them in managing parts of how they go about things. There is stuff about how to help them with practical things such as using the bathroom and keeping their bedrooms how they want them. In more detail, there are arrangements to help one person stay safe when they are out of the Service. For another person, there is a sensible plan to help them deal with their habit of saving lots of things. We spoke with two support workers about whats in these plans. They know it. They also know how to use the information in practice to give people the support they need. We saw them using this knowledge to good effect. For example, the person noted above was beginning to talk about buying some more stuff to save. The support worker acknowledged this and then pointed out that the person already has more than enough materials to finish their current craft project. This reassured the person who then carried on with their craft work. The plans are kept up to date so that they are accurate. This involves support workers making daily notes about how things are going. There are then monthly reviews. These are where the Manager has time with each person to see how theyre doing. This is so that she can find out if they need more or different support in the future. About once a year there is a larger review. This is where people like psychiatrists, care managers and family members are invited to meet with the person to see how things are going. As weve said, the support plans are detailed and comprehensive. This might make it difficult for some of the people who live in the Service to fully take part in their preparation and review. The Manager says that she is going to bear this in mind. This so that people who are interested can be helped to look into their plans. Some of the people who live in the Service are helped to manage their financial affairs. This is because they find all of the paperwork involved quite difficult to keep on top of. This help is done by family members or by the local authority. The Registered Provider doesnt get directly involved. This is a good idea. Otherwise, it can result in awkward situations where there are disputes about who should be handling what money and where it should be going. All but one person has their own bank account that they run like we all do. They take money out as and when they need it to buy things. The Registered Provider has been asked to hold some money for one person. The arrangement is that the cash is given to them each week in two amounts. This is done because otherwise the person concerned finds it really hard to budget. If there wasnt this system they might well run out and then not be able to buy what they want. We asked the person concerned about this arrangement. They say that they are quite happy with it. We looked at some of the records that are kept of the various transactions that are done for this arrangement. Things seem to be okay. However, we Care Homes for Adults (18-65 years) Page 14 of 35 Evidence: werent able to see some of the records we asked for. This is because they are kept at the Registered Providers head office. In future, we will need to see them. This is so that we can confirm for you that everything is indeed above board. Sensible consideration is given to peoples personal safety. They are not over-the-top and so people are still free to do things that they want to. There are written plans that say what potential risk is being considered and what needs to be done. For example, people are encouraged to do things for themselves and this can involve going in the kitchen. Support workers have thought about this. For each person they have taken into account if theyre okay with using ordinary kitchen equipment. Another thing they have thought about is how safe people are when they go out and about in the local community. There are arrangements for each person that give support workers guidance about how to respond if someone is late coming home. Care Homes for Adults (18-65 years) Page 15 of 35 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 14, 15, 16 and 17. People can do occupational and social things that interest them. However, some people might like to do more. People are helped to keep in touch with their families. They can spend their days as they wish. Good quality meals are served. Evidence: People are free to do things that interest them. Some of these things involve helping out a little bit and in their own way around the house. Over time, each person has developed their own things that they like to do each week. This includes going out to a local resource centre where they can do various activities. They also do everyday things such as going to the shops to buy what they need. There are various things organised in the Service such as craft sessions. Last year arrangements were made for Care Homes for Adults (18-65 years) Page 16 of 35 Evidence: people who wanted to go away on holiday. Five people went with staff support to Cyprus. The Registered Provider met most of the cost of this holiday. In our questionnaire we ask, can you do what you want to during the day, in the evening and at the weekend. Everyone says that they always do. Part of the support plans we have already mentioned, looks at occupational and social activities. The Assessment says that this part of the plans has been made more detailed in the last year. There is evidence that what each person does is being thought about. For example, for one person the notes read, (the person) will often request ideas for activities and then says I cant be bothered. I have offered to support (the person) with an activity (and) again I am met with a negative attitude. When we were in the Service, we asked people about this and we got different replies. One person says, I can do what I want. I dont get bored at all. Ive got lots to do. However, someone else says, I do sometimes get a bit bored with just being about town and doing the same things. I wouldnt mind doing more things like swimming but I find it hard to get going. Its easier to do ordinary things I suppose. Our Expert by Experience talked with people about this whole subject. She listened carefully to the different accounts people were giving. She thinks that on balance, some people would welcome the chance to do more activities that involve them leaving the Service. She also thinks that some people would like to do more things at home such as cooking. The Assessment recognises the need to keep this sort of thing under review. In line with this and as recommended by our Expert by Experience, we have asked the Manager to talk with each person who lives in the Service to see if they would like to do more social and occupational things. She is going to do this by 1 June 2009. People are helped to keep in touch with members of their families. Family members and friends are welcome to call to the Service whenever they want. We looked at the records about this. They show that support workers contact family members to tell them how things are going. People say that they have good quality meals and that they have enough to eat. One person summarises the general mood when they say, the food is very good and we have always have plenty to eat. I eat too much sometimes because I like food and then I put on weight. I look forward to the meals. Support workers do most of the main cooking, but some of the people do help with bits of it. There is a weekly menu. However, this is not too rigid. People can and do change it if they want something different. Over time, everyone has got to know what each other likes and dislikes. The menu pretty much reflects this. We looked at the menu for lunch and dinner over a period of two recent days. The main dishes served include cheese and onion pie, beef Care Homes for Adults (18-65 years) Page 17 of 35 Evidence: burgers, chicken curry, sausages, tuna bake, shepherds pie and meat balls. The Manager says that there is a choice at each meal time. There is a small tea bar affair where people can make themselves a cup of tea. We saw this being used quite a lot. The Service only uses long life milk. This has got rather an odd taste to it. One person commented on this to us. They say, it tastes not right. Id rather have ordinary milk, also it runs out and then you have to wait for the jug (at the tea bar) to be filled up. It can be a longish wait if staff are busy. Care Homes for Adults (18-65 years) Page 18 of 35 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 18, 19 and 20. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: People are helped in ways that are right for them. A good sign is when people want to talk about things that interest them rather than wait to answer our questions. This happened all the time to us when were in the Service. People talked about their friends, about their families and about things they like doing. They take for granted that their home is how they like it and that support workers are their friends. The support workers are relaxed and informal in how they are. Things are orderly without being too much so. When things look like they might be getting a bit too much, they gently point people in a different direction. This isnt done in an obvious or bossy way. For example, when we were there one person was getting worried about the phone because they thought it might ring for them. A support worker quietly Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: reassured the person that there wasnt a call for them at the moment. People are helped to wear neat and clean clothes so that they can look how they want. They are helped to sort out any post they get and they can use the phone when they want. In our questionnaire we ask, do the carers listen and act on what you say? Five people say that they always do, three people say usually and two people say sometimes. Those who say usually and sometimes dont add any more information about why they are answering in this way. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. A new system has been introduced to help support workers when doing this. In effect, this gives them a series of prompts about things that they should be considering for each person. Since our last inspection, a number of people have seen their doctors, some on more than one occasion. There have also been visits by other professionals such as the chiropodist. One person has a special medical need. We looked in detail about how they are being helped to deal with this. They have seen their doctor and they have had a special dressing used to help a surgical wound to heal. People are also helped to take care of themselves in a positive way. For example, one person tends to have high cholesterol and a weight management issue. They are being helped to avoid fatty foods. We asked the person about this matter. They say that support workers are helping them with this. At the moment, no ones doing their own medication. Support workers are managing it for them. There is a system to check that the correct medicines are received from the chemist. Once in the Service, they are stored securely. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. We looked at three sets of these records. They are correctly completed. We looked at two medicines in more detail. We wanted to see if the remaining stock matches what should be there. It does. Care Homes for Adults (18-65 years) Page 20 of 35 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 22 and 23. People are free to make a complaint if they want to. People are kept safe. Evidence: There is a written complaints procedure. The Manager says that the Registered Provider has not received any since we were last in the Service. We havent either. The Manager says that minor concerns are sorted out there and then so that things are put right as soon possible. We asked people who live in the Service about this. No one spoke about it directly. They say that they dont have anything concerning them at the moment. In our questionnaires we ask, do you know who to speak to if you are not happy? Also we ask, do you know how to make a complaint? Everyone answers yes to both questions. People say and show by their relaxed manner that they feel safe living in Camelot Lodge. In our questionnaires we ask, do the staff treat you well? Nine people say that they always do and one person says that they usually do. The person who says usually doesnt give us any more information about their thoughts on this. One person sums up the general mood when they say, (support workers) are very good, they sort out my problems. Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: The Registered Provider has a written policy and procedure that tells support workers what to do if they become concerned about someones wellbeing. For example, what they should do if someone is being bullied or pushed around in some way. The training records we talk about later on, show that everyone has done training about this matter. We spoke with two support workers about safeguarding people who live in the Service. They know what to look out for and who to contact if they become concerned. They say that they havent seen or heard anything to worry them. Indeed, they are confident that the people who live in the Service are safe and are well supported. However, our Expert by Experience suggests that it would be useful to have an extra safeguard in place in the form of an advocate. By this, we mean someone whos independent of the Registered Provider and who can support people to make sure that their voice is heard if theres something thats concerning someone. Care Homes for Adults (18-65 years) Page 22 of 35 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 24 and 30. People live in a comfortable setting that generally promotes their independence. Parts of the accommodation are a bit cool. The kitchen is clean and well equipped. There is a separate laundry but theres no indoor drying facility. Evidence: The accommodation is comfortable and homely. In general, its like anyones home is. Something a bit out of the ordinary is some of the signs that have been put up. For example, there is a no smoking sign on the front door. Then in the foyer there are various health and safety type things. There are also certificates that show what courses some of the members of staff have completed. The Director says that the Service has been asked to display these things in the past by official type visitors. He says that hell be pleased to take them down now. If they are really necessary they can be put up somewhere less obvious. As we have said earlier, two people share a bedroom. They have done this for quite a few years now. Its important that people only share when they want to and not because theres no other option. The Manager says that both of the people concerned Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: have said that they like the present arrangement. We spoke with one of the people. They said the same thing to us. People say their home is kept warm enough in winter. When we there the weather outside was very cold indeed. The lounge and the dining room were quite warm. However, the bathrooms, the corridors and the stairwells were too cool for comfort. We checked two radiators in these areas and they were both cold. The Director says that this matter will be sorted out. This means that in future all areas of the accommodation will be kept comfortably warm. The hot water service seems to be working okay. We went to the top of the house furthest away from the boiler and there was plenty of hot water. The premises are fitted with an automatic fire detection system. This provides a high level of fire safety protection. We understand that the fire brigade people say that the fire safety measures in place meet the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system continues to work as intended. This is about to be updated. Once this is done, the Director is going to send the assessment to the fire brigade people. This is so that they can check that the fire safety things in the Camelot Lodge are still up to the national standard. This will be done by 1 April 2009. The people from the local Department of Environmental Health called to the Service last year. They say that things in the kitchen are running okay. We looked at the kitchen too. Its quite small but its neat and clean. It looks well used like anyones kitchen. Theres a system to make sure that the refrigerators are cold enough to store foods safely. Sensible steps are taken to promote good hygiene. For example, support workers know about the importance of washing hands. In particular, if theyve been doing other things like working in the laundry. Once foods are opened they are date marked. This is done so they arent allowed to hang around for too long before they are used. At the moment, none of the people who live in the Service need a lot of help in the bathroom. Several need a steadying hand to get into and out of the bath. The Director recognises that more things may need to be provided in the future if people become less able than they are at the moment. He says that there are plans to create a walk in shower, but there is no set timescale yet for this. Our Expert by Experience noticed that only one of the baths has a shower attachment. Its one of those rubber things that pushes over the taps. She thinks that a real shower would enable people to wash and rinse off in more comfort. Five people when speaking with our Expert by Experience asked for a shower facility to be provided. We think that this is a reasonable thing to have. The Director has assured us that he will look into this matter Care Homes for Adults (18-65 years) Page 24 of 35 Evidence: to see what can now be done in each of the bathrooms. The laundry is very small and really theres only enough space for a washing machine. Theres no dryer. The Director says that he plans to extend the laundry in the near future. As part of this work he anticipates that an indoor drying facility will be created. There are new regulations that have been introduced to ensure that used water doesnt leak back into the main pipe-work. The Director is going to check with the local water supply company to make sure that the Service meets whats needed. This will be done by 1 May 2009. Care Homes for Adults (18-65 years) Page 25 of 35 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 32, 33, 34 and 35. There are enough support workers around to make sure that people get the help they need. Security checks are completed on staff. Support workers know what they are doing. However, bits of the training arrangements are rather muddled. Evidence: There are always two workers on duty from early in the morning until the evening time. The Manager says that there are also times when additional support workers are around to help people on a one to one basis. There is a waking staff presence in the Service at night. Also, there are special security arrangements at night. We looked at the roster in some detail for three recent days. We wanted to see if the various shifts are being filled reliably. We found that they are. However, the extra periods of one to one time are not being recorded. They will need to be in future. This is because the roster needs to give us an accurate account of the way staffing resources are actually used in the Service. Its very important that all of the support workers are honest people who can be trusted to spend lots of time with the people who live in the Service. With this in mind, Care Homes for Adults (18-65 years) Page 26 of 35 Evidence: the Registered Provider completes a number of security checks for new support workers. These include checking the persons identity and their employment history, getting references and doing a police check. No new members of staff have been appointed since out last inspection. Therefore, we cant tell you how well this security system is working. However, when we were last in the Service we thought that some fine tuning was needed. This was about the need to take more detailed employment histories. This is important because its only when you have a full account of the jobs someone has already done that you know what references are needed. The Manager says that arrangements are now in place to make sure that full histories are indeed taken for all new members of staff. New support workers have introductory training before they begin supporting people. After their introduction to the Service, they start completing a more detailed training programme. This involves them filling out a workbook. When doing this, they have to read various guidelines. They also have to make sure that they understand things such as how to support people to take everyday risks in a sensible way. Another thing that they need to know is what support each person needs with their health care. Their progress through the workbook is checked by the Manager. This is so that she can be sure that they have the knowledge and skills they need by the time they finish it. We think that this is an excellent idea. This is because its all about what support workers actually know in practice. Its this that makes a difference to the people theyre supporting. We asked one support worker about how all of this works out in practice. They say, when I came here I got lots of training about the residents, about how to care for their mental health and like that. I got to know them as individuals and about the need to respect their choices and such like. I felt confident that I could manage before I worked on my own. This is a good place to work. The Manager says that in addition to this, a new support worker completes a number of relevant training courses. For example, they are expected to do courses in things such as first aid, health and safety and food hygiene. These courses are then repeated regularly for existing support workers. She said that this is done to make sure that all support workers keep up to date with what is seen to be good practice. We looked at the records of who has done what courses in the past few years. There appeared to be some gaps where people had not done some of the training intended for them. Since our inspection, the Director has assured us that all of the support workers have received organised training in all of the subjects they need. However, we think that it would be a good idea for the Registered Provider to take a fresh look at how things are going with the training system. The Director says that he will now do this by assessing in an organised way what skills and knowledge support workers currently have. He is going to do this using a version of a national model that Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: we think is well done. Once this assessment is complete, the Director and the Manager will have a much better idea of what additional training each member of staff may need. The Director says that he hopes to complete this review by 1 October 2009. The Assessment says that all support workers are encouraged to complete a relevant National Vocational Qualification (NVQ). This is a good idea because the qualification is designed to support people being helped in ways that are right for them. At the moment, there are eight support workers employed in the Service. The Manager says that six of the support workers currently hold the award. She says that the two who dont will hopefully start working for it this year. When we spoke with support workers we asked them about points of detail to do with their work. We wanted to see what they know about a range of things likely to be relevant to working in Camelot Lodge. They have a sound understanding of important things. For example, they know in some detail how individuals living in the Service prefer to express themselves. Also, they know that some people need to have a particular measure of routine and structure to their everyday lives. Care Homes for Adults (18-65 years) Page 28 of 35 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 37, 39 and 42. The Service is reliably managed. People are asked what they think about how things are going, but this could be a bit more developed. Peoples health and safety is promoted. Evidence: The Manager has been running Camelot Lodge for many years now. She knows lot about all of the people who live there and about the support workers. When we ask her questions she gives us answers without having to fiddle about looking at bits of paper or asking other people. She has the two formal qualifications that we expect. These qualifications are important. This is because they are intended to help managers ensure that people reliably receive high quality residential care services. Various things are done to help staff work as a team. There are handover meetings at the beginning and end of each shift. These are when support workers say how things are going and what needs to be done on the next shift. Also, there are staff meetings. We wanted to Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: look at the records of the most recent meeting but these couldnt be found. So we looked at the records of the last but one meeting. A number of important things that make a difference to peoples quality of life were discussed. For example, they talked about how to safely store things such as medical creams. Support workers say that there is good team work. We saw plenty of evidence of this. Support workers check out with each other who is going to do what, with whom and when. Also, they plan their work in advance so that they use their time to the best effect. For example, they have developed a weekly planner for each person. This says when they will help them with things such as doing their bedroom and with doing their laundry. People are asked about how well they think things are going in their home. These include informal everyday discussions. There are also each persons one to one sessions that we spoke about earlier. The Director says that at least once a year the Registered Provider sends each person a questionnaire. This asks them about all sorts of things to do with their home. For example, what they think of the support they receive and whether or not they are happy with their meals. The Director says that questionnaires were sent out as normal in 2008 and that they have been returned. However, they werent to hand when we were there. This means that we cant tell you what they say. The Director says that the questionnaires are being looked at so that the Manager can be given a summary of what people think. The last questionnaires we could see are dated 2007. We looked at four of these and in general people are saying positive things about their home. Much as they are saying in our own questionnaires that we have been telling you about. Were not quite clear what happens to the summaries once they are prepared. It seems that they are used as a management thing. There is no real system to tell people who live in the Service what everyone has said and about what improvements have been suggested. We think that this is really important. This is because people have a right to know what is going to be done if theyve taken the time to think about and to fill out the questionnaires. Another thing is that at the moment, support workers are not asked to complete questionnaires. This is a pity because they know in detail how the place runs. We think that the present arrangements need to be developed to sort these points out. The Director says that he will do this in time for us to be told about what has been done when the Registered Provider sends us its next Annual Quality Assurance Assessment later this year. Theres a system of house meetings. These are when each month the people who live Care Homes for Adults (18-65 years) Page 30 of 35 Evidence: in the Service come together with a member of staff to say how things are going in their home. Our Expert by Experience looked into how these meetings work. She asked people about them and she looked at the records of the sorts of things that are talked about. All sorts of important things are being discussed such as the social activities some people would like to do. However, our Expert by Experience is not quite sure that when something is mentioned its then being followed through. For example, in a recent meeting some people said that they would like to go swimming. However, this then wasnt mentioned again by members of staff. As far as we can tell the people who said about it havent gone swimming yet. The Manager says that she will make sure that in future, things raised at meetings are acted on. Also, she says that people will be kept up to date with what is being done. We think that this will be helpful. This will especially need to be the case if future meetings are used to feedback what people have said in the questionnaires that we were talking about earlier. Regular checks are done to make sure that the Services fire safety equipment remains in good working order. This includes a weekly test of the fire alarm bells and regular more detailed checks completed by a contractor. There are unannounced fire drills. The Director says that there is a system for each member of staff to attend an annual fire lecture. This is very important. This is because the level of fire safety protection in the Service largely depends on staff doing the right thing at the right time. We looked at the records for three support workers to see who has done this training and when. One person isnt recorded as having done the training at all. The other two are recorded as having done it in 2006. Its just as well then that theres an additional system. This involves each support worker meeting regularly with the assistant manager to see how they are doing. The assistant manager says that as part of this, she checks out that they are able to work the Services fire safety procedure. We looked at the records of these meetings for two support workers and we found everything to be in order. The Manager says that she is now going to introduce a new system. This will take the place of what should be the annual training. It will combine this with the fire safety checks that are being done at the moment by the assistant manager. The new system will make sure that at least once every six months planned and definite checks are done to make sure that all support workers know how to use the Services fire safety procedure. The Manager is going to do this by 1 March 2009. The Assessment says that, regular servicing and maintenance of equipment and services is carried out. In more detail, the Director says that the gas-fired appliances have been seen in the past year by an engineer who has said that they are safe to use. We understand that the electrical wiring in the Service has also been passed. The Assessment says that these checks have been done within the correct timescales. However, theres no paperwork to confirm this. The Director is now going to find this and he is going to check to make sure that everything is indeed in order. Hes going to Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: tell us about this by 1 March 2009. He understands that in future the paperwork in question needs to be kept in the Service. This is so that we can tell you about what it says when we write our next report for you. We looked at the record of accidents and other untoward events that have occurred in the Service this year. There is nothing out of the ordinary in the sense that we need to make further enquiries. The handyman checks the place over regularly to make sure that theres nothing broken that needs fixing. He keeps his own records so we couldnt see what sorts of things he looks at. However, support workers say that everything is working okay at the moment. We didnt notice any particular hazards. Things like bleach are stored securely when not being used. This is so that people dont mistake them for something that can be drunk. Care Homes for Adults (18-65 years) Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 33 of 35 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 35 of 35 - 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!