Inspection on 17/01/06 for Cheddle Lodge

This inspection was carried out on 17th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cheddle Lodge 08/11/06

Cheddle Lodge 13/07/05

Cheddle Lodge 03/02/05

Cheddle Lodge 03/08/04

Cheddle Lodge 24/02/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 Cheddle Lodge 29 Ashfield Road Cheadle Stockport Cheshire SK8 1BB Lead Inspector Sylvia Brown Unannounced Inspection 17th January 2006 16:30 Cheddle Lodge DS0000008546.V274960.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 Cheddle Lodge DS0000008546.V274960.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. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cheddle Lodge Address 29 Ashfield Road Cheadle Stockport Cheshire SK8 1BB 0161-428 5189 0161 428 5189 cheddie@ukonline.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) Stockport East Cheshire & High Peak Cerebral Palsy Society Mr William Delaney Care Home 13 Category(ies) of Learning disability (13), Physical disability (13) registration, with number of places Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 13 LD and up to 13 PD. Date of last inspection 13th July 2005 Brief Description of the Service: Cheddle Lodge is owned by Stockport, East Cheshire and High Peak Cerebral Palsy Society. It is situated in a quiet residential area in Cheadle. Cheddle Lodge is registered to provided a specialist provision to 12 younger adults and one service user over the age of 65. Accommodation is provided on one level. Twelve single bedrooms are specifically designed for the long-term care of people with cerebral palsy. There is one additional bedroom, which is for the specific purpose of supporting service users on a respite care basis. The service users have the use of a lounge and dining area which are in the same area, enabling service users and staff to interact without hindrance. Families have formed an active group which meets regularly and is able to contribute to the development of the home. Family members are often on the premises and have become part of daily life at Cheddle Lodge. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Cheddle Lodge was unannounced, with a total of five hours on the premises. The previous inspection looked at number of standards, including the core standards which must be evaluated at least once a year. There were no requirements arising from that inspection with both recommendations made being met at this inspection. The current inspection reassessed a number of the core standards. Time was spent with the registered and deputy managers who were both on the premises throughout the inspection. The inspector was able to observe direct care practice as staff carried out evening routines. Time was spent talking to family and visitors and speaking to care staff, who are referred to by the home as enablers. Case tracking was undertaken for one person admitted since the previous inspection and two care files for longer term residents were seen. A sample of staff files were reviewed, as were some health and safety documents Comment cards were left at the home for both residents and their families. Four were returned by relatives prior to writing the report and, where appropriate, comments received have been incorporated. Requirements have been made where the home is below the required standards and recommendations have been made where there remains an opportunity to develop practice. Feedback regarding the outcome of the inspection was given to the registered manager at the conclusion of the inspection. What the service does well: The home continues to provide a consistently good standard of care support to the residents. Although the role of enablers is demanding and, at times, complex, the atmosphere within the home is relaxed and welcoming. Support is provided from a committed workforce, all of whom have formed positive relationships and friendships with the residents. Residents appeared, as far as possible, contented and happy. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: There are some concerns that the home can no longer meet the increasing needs of some service users and consideration should be given to whether a change in service can be made to meet the increasing needs. The home is now showing signs of wear and tear and the lounge and dining area should be refurbished in a timely manner. A recommendation has been made to ensure that faulty equipment within the kitchen is replaced prior to the upgrading to ensure that hygiene and safety standards are met at all times. A number of records need to include more details to ensure they reflect practice undertaken and practice to be followed by staff, particularly with fluid charts, the provision of individuals’ activities and night care routines. It was also evident that though staff stated they were formally supervised, records were not maintained sufficiently to demonstrate the frequency of supervision or the content. Training records also failed to demonstrate all staff had up to date training in place. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 7 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. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 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 Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Prospective residents are able to visit the home before making any decisions about their future, and those residents have their needs and aspirations recognised and planned for. EVIDENCE: Records demonstrated that the home continues to provide its statement of purpose and service user guide to all residents and relatives at the first point of contact. Due to the significant waiting time for placements, these documents are re-issued at the point of trial visits or admission. The registered manager informed the inspector that each resident has an individual introductory programme designed to meet their own desires and needs. Advice has been given regarding ways to specifically record the introductory process and any assessments or observations made. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 10 It is unclear if the resident or the relative receive confirmation from the home, as detailed within standard 3, regarding its suitability to meet the current needs of residents and what arrangements would be made should the resident require nursing support. At the time of the inspection, it was questioned whether tasks completed by care staff for some residents should actually be provided by a registered nurse. Some enablers are highly trained, however they should not be undertaking nursing tasks. The registered manager indicated his awareness of the increasing needs of some residents who have resided at the home for some considerable time. Action should be taken to ensure that the placements remain appropriate. One care file evaluated for the newest resident contained a contract of residency from the home and a Social Services contract. Assessments of need were detailed, as was the process of consultation with relatives. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 11 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, 7, 8 & 10 Residents are consulted about their needs and preferences and, as far as possible, supported to make their own decision. Information about residents is handled appropriately and in confidence. EVIDENCE: Essential lifestyle plans (ELP) are developed after consultation with the resident and/or their relative. The ELP extensively details the residents’ individual needs and personal aspirations and how they should be met. Continuous assessment processes are in place and recorded, as is consultation with relevant health care professionals. Changes in health care and personal requirements are recorded on a daily basis. Residents and their families have direct access to their individual day-to-day records, whilst more personal information is stored securely within the home. All comment cards received stated that relatives were made to feel welcome at the home and kept informed of important matters affecting their relative. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13 & 17 Residents receive support to develop and have the opportunity to take part in the life of the local community. Meals are varied and nutritious. EVIDENCE: A number of the residents continue to attend skills classes each day outside of the home, this enables them to develop their skills in many areas and socialise. In addition, the home arranges for residents to receive social stimulation, to take part in community life and visit local places of interest. Residents receive a daily nutritious diet both from the home and skills centre. Records of all meals received are individually recorded and intake is monitored. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 13 One relative’s comment card stated that their son ‘is happy’ at the home, whilst another stated ‘the quality of service is exceptional’ and ‘everyone is very well looked after’. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 & 21 Residents are supported by staff and health care professionals to maintain good health. EVIDENCE: Residents receive a consistent standard of support to maintain, as far as possible, good health. Two relatives spoken to at the time of the inspection stated they were able to continue providing care support at their visits and enjoyed being involved in the caring programme. Medication is managed and administered correctly. The balance between supporting residents’ health and completing duties which could possibly constitute nursing support is debateable and has been addressed within the report. In the main, residents’ families are actively involved with arrangements in place, enabling them to make decisions regarding the last wishes and feelings of the resident. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has an effective complaint procedure in place that is accessible to residents and their families. EVIDENCE: The home has a complaints procedure in place. Residents and relatives are informed of the complaints procedure and provided with written copies of the information to assist them in accessing the process should they have a complaint. Records are maintained of all complaints and of any action taken to investigate. Relatives spoken with at the inspection stated that when things are not as they desire, they speak with a senior on duty. Continuing, the visitors confirmed that issues are frequently resolved and that, overall, they have no major complaints regarding the conduct of the home. All comment cards stated that relatives were aware of and were able to access the home’s complaint procedure. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 & 28 The home is comfortable and safe for service users, however communal areas require upgrading. EVIDENCE: The home’s communal lounge and dining area has, for some considerable time, looked worn. Whilst it is appreciated that the demands on the environment are high, the area is now looking tired and shabby and not truly reflective of the caring ethos of the home or the Society. The registered manager agreed and was in the process of securing several decorating quotes. After agreement regarding timescales, a requirement was made concerning the upgrading of the communal facilities. One comment card stated ‘everywhere is spotlessly clean’ and at the time of the inspection the home was clean and tidy. Residents’ bedrooms continue to reflect their individuality and personality. They are all pleasant places, warm and inviting. They are equipped to meet the individuals needs of residents, providing them additional safety and support when and where required. Cheddle Lodge DS0000008546.V274960.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 & 36 Residents receive care from trained staff who are aware of their responsibility to meet the specialist needs of individuals. EVIDENCE: The home completes appropriate recruitment and selection procedures. Staff undertake induction training to the required standard and continue with their learning through NVQ training. Evaluation of the staff files identified that some staff have not completed or received updated essential training. The registered manager stated all training was up to date. It is essential that the home can demonstrate that staff are appropriately trained and that their future development and training needs are recognised., however training records were not. The home also failed to identify that staff received appropriate formal supervision. One staff member stated they had only attended one formal supervision since December 2004. Though other staff stated they received formal supervision, there was no recorded evidence that supervision was undertaken. Notwithstanding that, the registered manager frequently observes staff practice and provides guidance where required, as do senior staff as they complete caring duties on the rota. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 18 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): 38, 40 & 43 Cheddle Lodge is a well run and managed home, which is designed to ensure that all the needs of residents are met and the health and safety safeguarded. EVIDENCE: The leadership style of the registered manager is calming and professional whilst at the same time ensuring the complex needs of residents are met in a friendly and relaxed manner. On the whole, the staff team relate and work well together to provide a consistent standard of support to resident. Policies and procedures, along with recording systems, also ensure that staff have correct guidance, whilst at the same time demonstrating how care needs are met. Records demonstrate that the interests of residents are paramount and that the home’s routines are designed around the residents who live there. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 19 The society’s managing director visits the home on a monthly basis to undertake regulatory visits. At such time, he evaluates a sample of records, observes practice, inspects the building and talks with residents and staff. A report of each visit is completed and a copy is supplied to the CSCI. To further ensure standards are met and families are involved with the day to day developments of the home, the family committee meets frequently with the registered manager to discuss any issues and future plans. A copy of the minutes of the meeting is kindly supplied to the CSCI by the chair person of the meeting. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 20 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 2 4 3 5 3 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 3 26 3 27 X 28 3 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 3 X 3 X 3 X X 3 Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? NO 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 YA3 Regulation 12, 13, 14 Requirement Timescale for action 01/04/06 2 YA24 3 YA35 4 YA36 The registered person must ensure that the home does not operate outside of its registration categories. Nursing determinations should be completed for those residents who have increased health care needs and require complex support which may be more appropriate and/or required to be carried out by qualified staff. 23(2)(b) The registered person must ensure that redecoration and upgrading of the main lounge and dining room is undertaken. 18(1)(c)(i) The registered person must ensure that all levels of staff receive appropriate training for the work they are employed for. 18(2) The registered manager must ensure that all levels of staff receive appropriate supervision. 01/04/06 01/04/06 01/04/06 Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 22 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 Refer to Standard YA35 YA24 Good Practice Recommendations The registered person should ensure training records are completed accurately. The registered person should ensure that faulty equipment within the kitchen is replaced in a timely manner and prior to the upgrading of the kitchen. Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Cheddle Lodge DS0000008546.V274960.R01.S.doc Version 5.1 Page 24 - 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. 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