CARE HOME ADULTS 18-65
Charnwood Lodge CBU Woodhouse Lane Nanpantan Loughborough Leicestershire LE11 3TG Lead Inspector
Mrs Carole Burgess Key Unannounced Inspection 10th October 2007 10:00 Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Charnwood Lodge CBU Address Woodhouse Lane Nanpantan Loughborough Leicestershire LE11 3TG 01509 890184 01509 891446 charnwood.lodge@craegmoor.co.uk 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) Lansdowne Road Limited Vacant Care Home 18 Category(ies) of Learning disability (18), Mental disorder, registration, with number excluding learning disability or dementia (18) of places Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service User Numbers. No person falling within category MD may be admitted to the home unless that person also falls within category LD - i.e. dual disability. Date of last inspection 22nd June 2006 Brief Description of the Service: Charnwood Lodge CBU is registered for eighteen residents with learning disabilities and associated challenging behaviour. The registration also includes those with mental health problems in addition to their learning disability. The property is a large building set in extensive well-maintained grounds. The home is divided into two units, Elm Unit and Oak Unit. A programme of renovation and decoration is being carried out and is improving both shared and private living accommodation for the clients. The Statement of Purpose, Service Users’ Guide & Inspection Report are available on request (these provide information on how the home is organised and what services they provide). The Statement of Purpose and Service Users’ Guide are provided for new clients and include some pictorial information. Monthly Fees at the time of inspection were: £1420 - £2389.84 per week. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over four hours. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff. The primary method of inspection used was ‘case tracking’ which involved selecting three clients and tracking the care they receive through a review of their records, discussion with care staff and observation of care practices. A number of clients were seen during the inspection. The clients appeared contented and well cared for. Those spoken with were positive about the care and support they received at Charnwood CBU. The term client is used throughout the report, as this is how service users are referred to within the home. What the service does well:
Charnwood Lodge CBU provides a good standard of care based on normal living principles and community integration, for people who have significant learning and behavioural problems. They prioritise clients’ needs ensuring that their wishes and feelings are respected. They provide individualised care planning documents and risk assessments for each client, demonstrating a commitment to enabling clients to have some control over their lives. Personalised, weekly activities plans, devised with the client and their key worker ensure that clients are support and are able to take acceptable risks to meet their specific life goals. The new manger provides effective leadership and is committed to improving the home for the benefit of the clients and staff. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better:
Requirements and recommendations from the previous inspection have been met. Four recommendations were made following the inspection: The Statement of Purpose, as well as the Service Users Guide should be provided in a pictorial format to provide this information fro persons with a learning disability. The cook should be provided with specific guidance in relation to clients’ special dietary requirements such as diabetic and wheat free diets to ensure that they receive a medically approved and well balanced diet. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 7 There should be clearer information provided for carers regarding clients who may choose not to take some medicines. The cracked safety glass in the entrance hall should be replaced as soon as possible to ensure the safety of clients and staff. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective clients are provided with information about the home, and have their health, welfare and social care needs assessed, so that these can be met once the client moves into the home. EVIDENCE: The home provides prospective clients and their relatives with a Statement of Purpose and Service Users Guide (both give information about the home) to help them decide if the home is the right one for them. This includes some information in a pictorial format for prospective clients who have a learning disability. However, it would be helpful if the Statement of Purpose, as well as the Service Users Guide, were in a pictorial format to provide this information for clients with a learning disability. The Manager undertakes the pre-assessment process for prospective new clients. This and regular reviews ensure that clients’ needs are met. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients are looked after in respect of their personal and social requirements. EVIDENCE: All care plans had been updated and Person Centred Care Plans implemented to assess and reflect the changing needs of the clients. These were very detailed and covered every aspect of the client’s health, welfare and social life, providing a complete picture of the client’s background ‘Life Story’, health and welfare needs, ‘Health and Keeping Safe’ and ‘Mental Health and Behaviour’. In addition there was information about friends, advocates, relationships and social contacts. Observation, daily records and clients spoken with confirmed that clients are supported in their daily lives choices. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 11 Clients have a minuted ‘residents’ meeting’ every six week to enable them to take part in the day to day running of the home. All personal client information is kept secure in a locked office. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff ensure that clients experience a safe and homely life style which is appropriate to their age and ability. EVIDENCE: Each client has a personalised weekly activities plan, devised with their key worker, that includes such things as independent living skills, cooking, washing, shopping and going to day care or college. Communal activities are also arranged such as watching DVD’s, trips to the cinema, bowling and playing golf and the occasional ‘Take Away’ night. Activities are risk assessed to ensure that clients are safe but are able to take acceptable risks to support their independence.
Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 13 All of the clients had been away on holiday this year. Two clients, supported by carers, were on holiday at Butlins at the time of the inspection. Clients’ religious needs are recorded and supported where necessary. One client regularly attends a local church to ensure that their religious needs are met. Clients’ rooms were personalised and indicative of their personal tastes and lifestyles, which are encouraged and supported by staff. Family and friends are able to visit at any time. Menus are rotated three weekly and include a healthy variety of food. Menus are flexible to meet the individual needs and preferences of the clients. Clients choose what they would like if they require a for a packed lunch Special requirements are provided for individual clients, such as diabetic and wheat free diets and residents are encouraged to eat healthily and maintain a healthy weight. Both staff and clients commented that the food was very good. However, although the cook was aware of clients specific dietary needs there was no information provided in the kitchen regarding the special diets required by a small number of clients to ensure that they were receiving a medically approved and well balanced diet. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health and personal care. EVIDENCE: Clients’ Person Centred Care Plans contained details about individual healthcare needs. There are regular reviews and a range of health and social care professionals provide specialist support to ensure that the clients’ needs are fully met. Medication policies and procedures were satisfactory and residents receive their medication as prescribed. Medication is stored safely and staff receive medication training, which is regularly updated. One client had medication information that stated that he could refuse to take medication if he so chose. This needed further clarification, stating what medication/s this referred to and
Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 15 what effect, if any, this would have on the client. This should be provided for carers to ensure that they have clear information to keep clients safe. No clients were self-medicating at the time of the inspection. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are satisfactory resulting in protection of residents’ rights. EVIDENCE: We have not received any complaints regarding the home. The home has not received any complaints from clients or their relatives since the last inspection. The home’s complaints and safeguarding policies and procedures reflect the current local Multi Agency Policy & Procedure For The Protection of Vulnerable Adults from Abuse, No Secrets’ publication to ensure that staff have access to guidance on safeguarding vulnerable adults. Staff were aware of Adult Safeguarding procedures, and how to manage allegations and complaints. Training sessions for staff are provided to ensure that clients are protected from harm. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 17 The complaints policy is displayed in the entrance hall and clients are provided with a pictorial version to ensure that they are able to make a complaint should the which to do so. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A comfortable, clean, homely and safe standard of accommodation is provided for the clients. EVIDENCE: The home is safe and generally well maintained but requires redecoration and refurbishment to maintain a homely environment. some There is a refurbishment programme, which is improving the standard of accommodation in the home. New kitchenettes have been provided for clients to use; two newly decorated dining areas, new furniture, and pictures painted by the clients have upgraded the old refectory style dinning room. The reception area has been repainted and new furniture provided in the sitting
Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 19 room. In addition, the activities room is being redecorated. Clients have been involved in choosing colour schemes and said they liked the changes. There are no en suite room but there are sufficient bathing and toilet facilities in both units. Individual bedrooms were colourfully decorated to reflect the gender and personalities of the clients who live there. The home was fresh and clean on the day of the site visit. The entrance hall had some cracked safety glass that needs replacing. This was pointed out the Manager and should be attended to as soon as possible to ensure the safety of the clients and staff. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 20 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are competent and sufficient in numbers to meet the clients’ needs. EVIDENCE: Staff rotas demonstrated that there were sufficient staff to meet the needs of the clients. There are also a cook, two maintenance personnel and a cleaner (one other cleaner is to be employed). The manager currently has four vacancies and is currently advertising for staff. Shortfalls are covered by regular agency staff to ensure continuity of care for the clients. Three staff files were checked and demonstrated a robust and safe recruitment process to ensure that clients are well protected. There is a satisfactory induction and training programme available to staff. Three staff files demonstrated that staff receive regular and relevant training,
Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 21 including mandatory training/updates i.e. adult protection, first aid, food hygiene and moving and handling. Certificates of attendance were seen. A fairly new member of staff confirmed that she had received a satisfactory induction and had attended a number of training sessions including safeguarding vulnerable adults and restraint training. The Manager said that 50 of staff have achieved National Vocational Qualification (NVQ) in Care Level 2/3 and other staff will be doing NVQ’s to ensure that they have the necessary skill to care for the clients. Clients who spoke with the inspector stated they felt supported by the Manager, their key worker and the staff team. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager provides supportive and effective leadership to staff, ensuring that clients receive a good standard of care. EVIDENCE: The home has a Manager who has many years of experience in care and has made an excellent and energetic start in improving the home’s environment, care, record keeping and staffing levels. She hopes to apply for registration with the CSCI in the near future. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 23 There is an ethos of openness in the home and staff deliver a good standard of care and support, and appear well organised and well supported by the team leaders and Manager. Health and Safety Policies and Procedures, and regular maintenance checks such as weekly fire alarm testing are completed, to ensure the health and safety of the clients and staff. Quality assurance of the service is monitored through regular review of clients’ files, regular internal audits and bi-annual questionnaires (just being implemented) to be completed by clients and sent to relatives to obtain their views about the care provided. Clients personal allowance money is kept in separate plastic wallets for each client, and records maintained, and stored in a safe in a locked office. The clients’ personal allowances were observed being checked by two members of staff to ensure that clients’ money is kept safe. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 3 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 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 3
Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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. 4. Refer to Standard YA1 YA17 YA20 YA24 Good Practice Recommendations It is recommended that the Statement of Purpose, as well as the Service Users Guide be provided in a pictorial format. It is recommended that the cook be provided with specific guidance in relation to clients’ special dietary requirements such as diabetic and wheat free diets. It is recommended that clearer information is provided for carers regarding clients who may choose not to take some medicines. It is recommended that the cracked safety glass in the entrance hall is replaced as soon as possible. Charnwood Lodge CBU DS0000001794.V341774.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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