Inspection on 20/06/08 for Cherry Lodge

This inspection was carried out on 20th June 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cherry Lodge 13/07/07

Cherry Lodge 25/10/06

Cherry Lodge 16/05/06

Cherry Lodge 11/10/05

Cherry Lodge 21/07/05

Cherry Lodge 04/11/04

Cherry Lodge 13/05/04

Cherry Lodge 08/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 Cherry Lodge 14 Lynton Road New Malden Surrey KT3 5EE Lead Inspector Emma Dove Key Unannounced Inspection 20th and 25th June 2008 10:30 Cherry Lodge DS0000013379.V365595.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 Cherry Lodge DS0000013379.V365595.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. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cherry Lodge Address 14 Lynton Road New Malden Surrey KT3 5EE 020 8296 9188 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) Mr Younoos Jeetoo Mrs Kay Jeetoo Manager post vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 9 1st November 2007 Date of last inspection Brief Description of the Service: Cherry Lodge is a registered care home for up to nine adults with learning disabilities. Six people are currently living there. It is privately owned by a couple who own three other similar services in neighbouring towns. Cherry Lodge is located in New Malden and is a short, ten to twenty minute walk to local shops and bus or rail links. Information about the service is available in the Statement of Purpose and Service User Guide. Current fees are in the range of £590.94 to £855.08 per week. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means people who use this service experience adequate quality outcomes. This unannounced inspection took place over two hours on the 20th and five hours on the 25th June 2008. One regulation inspector visited, looked at records, spoke with people who use the service, staff and the registered person. An Annual Quality Assurance Assessment (AQAA) was sent to the service, although this has not been completed and returned. There is no registered manager at the home, arrangements have been made to provide management cover for the home. The continued absence of a permanent full time manager could have a detrimental effect on the services provided. The service is currently only provided to men. What the service does well: What has improved since the last inspection? Health action plans have been developed, therefore peoples healthcare needs are now fully documented. The complaints procedure is now available in pictorial format, making it more accessible to everyone who lives there. Improvements have been made to the environment with broken lighting repaired or replaced. Two male members of staff have started to work at Cherry Lodge. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has developed information to help people decide if it is the right place for them. This information is only available in a written format. Assessments are completed before admission. People are invited to visit to look around, meet people who live there and staff before they decide whether to move in. EVIDENCE: The Statement of Purpose includes information about the owner, manager, staff, the aims of the home, the admission process and details of how to make a complaint. A copy of the Service User Guide was seen in people’s bedrooms. These documents are only available in written format, it may be useful to have them in pictorial format for any prospective new people to the service. People told us that they are ‘glad they moved in’, ‘I’m happy here’ and ‘it’s the best place I’ve lived’. Six people said that they were involved in making the decision to move in and had enough information to help them decide. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 9 We saw assessments in case files. The acting manager said before anyone new moved in, a detailed assessment would be completed by someone from the company in addition to a social work assessment. Cherry Lodge DS0000013379.V365595.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 and 9 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service involves people in planning their care. Care plans could be more person centred. Staff understand the importance of people being supported to take control of their lives. People are encouraged and supported to make their own decisions and choices. Risk assessments are in place. EVIDENCE: Care plans show peoples assessed needs and how to meet them. There is still a lot of information in case files, making it difficult to find the most up to date details. Staff have separated information into two files, with old information in one folder. Action plans have been developed and include personal goals, although the ones we saw had not been reviewed since 2006 and it was not clear if the goal had been achieved or was still relevant. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 11 However, we saw a Person Centred Plan had been developed with one person in 2006, it had not been reviewed. More work could still be done to make the care planning process more person centred. People said they meet regularly with their key workers. However we only saw records for key work sessions up to March 2008. People told us that they feel their needs are met at Cherry Lodge. We saw people involved in making decisions about the activities they participate in, their meals, their clothing and how they keep their rooms. We saw risk assessments have been developed with a balance between people living fulfilling lives and safety. We saw reviews of risk assessments to have taken place annually with the exception of 2007. Cherry Lodge DS0000013379.V365595.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 and 17 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People are involved in meaningful daytime activities of their choice. The service has a commitment to enabling people to maintain and develop their skills, including social, emotional, communication and independent living skills. People who use the service have the opportunity to develop important relationships and are supported to keep in contact with family members and friends. People are involved in the domestic routines of the home. The menu is varied with choices available. EVIDENCE: We saw people involved in community activities, going out shopping, going to a local cafe, visit family or friends and attending day centres or clubs. Five people told us they ‘always’ do what they want during the day, evening and weekend. One person said they ‘usually’ do what they want. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 13 Staff said they are arranging a barbeque and trip to the coast in the next few weeks. One person said they enjoy barbeques. One person said they ‘like going out for a drive’. Another person told us ‘I see my girlfriend regularly’. One person told us the service supports people to live the life they choose. We saw that people are supported to maintain important relationships. One person told us that there has been no progress with getting Internet access and that having a Skybox would provide more choice of television programmes. Staff said most people go to their rooms after their evening meal and watch their televisions. Staff told us that people who use the service are involved in the domestic tasks, with a rota for kitchen duties including laying the table, cooking and washing up. People told us the rota of tasks is ‘fair’. One person said they ‘enjoy doing the cooking’. We saw a varied menu, which takes into account people’s food preferences and caters for any medical or religious dietary needs. We saw people offered a choice. People told us that some staff are very good cooks and they like the food provided. Cherry Lodge DS0000013379.V365595.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 and 20 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service need only minimal personal support, when given, this is appropriate for the individual. People have access to community healthcare facilities. Medication is well managed. EVIDENCE: Staff told us that people who use the service are very independent and manage their own personal care. People confirmed that they care for themselves and that staff are available to offer support if required. We have previously commented about the lack of male staff employed at the home. Staff told us that two male members of staff are now employed. People who use the service were not worried that most staff were female and felt that any member of staff would be able to offer appropriate support. It is good practice for the people who live there to have male staff and saw good interactions between people and the acting manager. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 15 We saw case files contain details of peoples health needs. Health action plans have been developed which include information about actions staff may need to take to support individuals. We saw details of health appointments and any actions for staff. People told us that staff are available to attend health appointments if required. Staff said they have up to date information about peoples health needs. One person said people’s healthcare needs are ‘always’ met and that staff seek appropriate medical advice. Appropriate medication policies and procedures are in place. We saw staff follow procedures when administering medication. We saw medication stored appropriately. Records of medications received and administered are up to date and correct. We suggest where medication is sent out to people day centre, that this be noted on the Medication Administration Record Sheet so the balance is correct. Any old unused medication should be returned to the pharmacy. Cherry Lodge DS0000013379.V365595.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 and 23 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and accessible to people who use the service and their representatives. Policies for safeguarding are in place and give instructions for staff. EVIDENCE: People who use the service told us they would speak to the manager or staff if they had any worries, concerns or complaints. One person said that they have raised issues in the past which have been addressed. Records of complaints include the complaint and any actions taken to address the issue. No complaints have been received at the home or by us since the last inspection in July 2007. Improvements were made to the way peoples finances were handled following our last inspection. We saw staff supporting people to manage their money, discussing budgeting and safety with individuals. Records of finances were up to date and correct. Staff said they have training in safeguarding and are aware of their responsibilities if an allegation is made. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 17 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, 25, 27 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. Bedrooms are single and have been personalised by the individual. Sufficient bathrooms and toilets are available. The home is well lit, clean and tidy and smells fresh. EVIDENCE: Accommodation is provided over three floors. On the ground floor there is a large lounge/dining area which has been made homely with photographs of the people who live there around the room. The kitchen is clean and well equipped. There is a large, well maintained garden to the rear which people say they enjoy. There are also two bedrooms and a shower room. A bathroom and separate toilet are on the first floor with a staff sleep-in room and five bedrooms. One bedroom is on the top floor. We saw bedrooms have been personalised with individual’s belongings, pictures and photographs. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 18 People made positive comments about their bedrooms. We saw the curtain rails down in one bedroom, this had been replaced on our second visit. People said that things generally get repaired when needed. One person told us they wanted their bedroom redecorated and we saw the hallways need repainting. We saw all areas to be clean and well maintained. Six people told us the home is ‘always’ clean and fresh. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 19 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 and 36 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People have confidence in the people who care for them. There are enough staff to meet the needs of the people currently living there. EVIDENCE: Six people said the staff ‘always’ treat them well and staff ‘always listen and act on what they say. One person said ‘I like the staff’. One person said ‘the staff are fun’. We saw some good positive interactions between staff and people who use the service. We also feel that having a male acting manager and two male staff has improved the service provided to the men living at Cherry Lodge. The staff rota shows that two people are on duty during the day with one person on call, asleep at the home at night. These staff levels were seen to be adequate to meet the needs of the people currently living there. People who use the service said there are enough staff for them to do what they want to do. We saw staff discuss future activities and events with people, ensuring sufficient staff are available. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 20 We noted that the staff rota has gone back to staff finishing at 8pm in the evening. Staff said there was a trial period when they finished at 9.30pm but they found as everyone goes to their rooms after their evening meal, staff were not really needing to stay after 8pm. This is not considered good practice and may prevent people from leading full active lives in the evening. Staff said that if people want to go out and need staff support after 8pm, the rota would be changed and the member of staff who sleeps in is at the home should people return later than 8pm. People who use the service confirmed that they sometimes go out and return late and the staff rota does not interfere with their social lives. The rota does not include time for a staff handover, although we saw staff come in early and leave late to ensure they have the information they need to meet people’s needs. We saw improvements in the staff recruitment process with files containing the required checks, or confirmation that the checks were completed, noting that the information is at the company’s head office with one exception. One staff file had only one reference and no confirmation that a Criminal Records Bureau check had been completed. These checks must be completed and the information is at the home to ensure that the people who use the service are protected from harm. Staff confirmed that they had completed an application form, attended an interview and had the appropriate checks before they started work. Staff said they have access to appropriate and good training to help them do their job. We saw records from four staff meetings held between July 2007 and May 2008, with a five month gap noted. The acting manager said that staff have not been receiving regular supervision and that he is due to see people. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 21 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 and 42 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. There is no registered manager. The annual quality assurance assessment (AQAA) has not been returned. Quality assurance systems are in place but actions do not seem to be taken to improve services when suggestions are made. Health and safety records are generally up to date with the appropriate checks taking place. EVIDENCE: The company has employed an acting manager to cover the service short term after the previous manager left in December 2007. The home has been without a registered manager for over one year. The AQAA was not returned within the given timescales. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 22 The acting manager said there are Quality Assurance systems in place and that people who use the service had been given questionnaires in February 2008. We saw the responses to the surveys which indicated some people would like some changes to the service provided, to their rooms and to have a front door key. There was no indication as to when the changes would be made, whether people would get their bedrooms redecorated or if the person got a new front door key. One person confirmed that they had not received a new front door key. We have found in previous inspections that people who use the service are asked their opinion on things and suggestions are not followed through. This does not involve the people who use the service and does not make them and their comments feel valued. We saw one record for a monthly visit carried out by a representative from the company in June 2008, with no other records available. The company must arrange for a representative to visit the home, speak with the people who use the service and check on records, then write a report made available to the manager with actions taken. This is to comply with the Care Homes Regulations. No progress has been made with this in the last year. We would also like a copy of the report to be sent to the CSCI. Appropriate systems are in place to monitor health and safety. Records showed the gas safety, portable electrical appliances and the fire alarm were tested at the appropriate intervals. The fire alarm has been tested weekly in May and June 2008, although it was only tested twice in April 2008. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 23 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 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 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 2 X 2 X X 3 X Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA36 Regulation 18 (2) Requirement All staff must receive regular supervision to ensure they are fully supported to carry out their role. To make sure there is effective monitoring of the home, monthly visits must take place and a report be kept at the home with a copy to the CSCI. Timescale for action 15/08/08 2. YA39 26 01/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA12 Good Practice Recommendations Internet access should be provided at the home to allow for better access to information and communication networks. To ensure there is sufficient support for individuals, staff must be on duty until a reasonable time in the evening and handover time must be included as part of the rota. DS0000013379.V365595.R01.S.doc Version 5.2 Page 25 2. YA22 Cherry Lodge 3. YA39 To make sure people at the home are properly consulted, any quality assurance questionnaires must be user friendly and any action taken as a result of such feedback made clear. Cherry Lodge DS0000013379.V365595.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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