Inspection on 24/02/09 for Colney Lodge

This inspection was carried out on 24th February 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

Colney Lodge 14/04/08

Colney Lodge 30/05/07

Colney Lodge 18/07/06

Colney Lodge 14/02/06

Colney Lodge 28/12/05

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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: Colney Lodge 323 High Street London Colney Herts AL2 1ED     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: Jeffrey Orange     Date: 2 4 0 2 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 27 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 27 Information about the care home Name of care home: Address: Colney Lodge 323 High Street London Colney Herts AL2 1ED 07766066307 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : colneylodge323@yahoo.co.uk Colney Lodge Limited care home 2 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 2 Situated in the centre of London Colney, Colney Lodge is an end-of-terrace property that has been converted and adapted to enable it to provide a home to two younger adults who have a mental health disorder. There are in fact three bedrooms located on the first floor, with two reception rooms and a conservatory on the ground floor. There is an enclosed back garden and the front area is open plan. Beyond the back fence, there is car parking available. There is a shopping complex about a mile from the home and the wide range of facilities offered by the city of St Albans are located relatively close by. Copies of the homes Service User Guide and Statement of Purpose, together with a copy of the last inspection report by the Commission for Social Care Inspection (CSCI) are available in the home for current or prospective service users. Weekly charges are from £750- £780. The individual service user pays for personal toiletries, newspapers and dental or chiropody charges if they apply. These charges were confirmed on 24/02/2009 Care Homes for Adults (18-65 years) Page 4 of 27 Care Homes for Adults (18-65 years) Page 5 of 27 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: We last inspected this service on the 14th April 2008. This unannounced inspection was carried out by one inspector, where the report refers to we it recognises that it written on behalf of the Commission for Social Care Inspection(CSCI). This inspection took place over the course of one morning, during which time we met both of the people who live in Colney Lodge. We were able to talk to them about their experience and discuss any comments they may have made in the service user surveys that they had completed and returned to us prior to the inspection. We had very useful discussions with the proprietor and also inspected some key records for the service, including those for care planning, staff recruitment and medication administration. As well as from people who live in the home we also received completed surveys from members of staff and health and social care Care Homes for Adults (18-65 years) Page 6 of 27 professionals associated with the home. This report also draws on information provided by the service in their annual quality assurance assessment or AQAA. The AQAA is a self-assessment document that assesses how well care outcomes are being achieved in Colney Lodge and also contains some useful statistical information, for example about staff training and complaints. What the care home does well: What has improved since the last inspection? What they could do better: 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 8 of 27 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 9 of 27 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. People who use this service can be confident that the pre-admission process is robust and thorough and should ensure that only those people whose needs can be satisfactorily met are admitted. Evidence: When we asked someone who has recently moved into Colney Lodge about the process of assessment and pre-admission visits they told us that they felt this had gone very well and that they were pleased with the outcome. Because there had been issues in the past with people living in the home not getting on with one another, we asked someone who has lived in Colney Lodge for some time about how the admission of the new person had been handled and they told us that they felt it had been done well and they too were happy with the outcome. When we looked at the pre-admission assessment process we found that it was very thorough and detailed and that the care plans drawn up in that process included all the Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: information that staff would need to be able to identify and meet the persons needs appropriately. When we asked health care professionals about the assessment process, they told us On the initial assessment the manager is very careful in his judgement as to whether the service will suit and meet individual needs. When we asked each person living in Colney Lodge if they had enough information about the home before they moved in to help them decide if it was the right place for them, they all confirmed that they did. Care Homes for Adults (18-65 years) Page 11 of 27 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. People living in Colney Lodge can be confident that they will be involved in the planning and detail of the care and support they need and that they will be encouraged and empowered to build their independence and confidence by making decisions and choices in their lives. Evidence: When we looked at care plans for people who live in Colney Lodge, we found that they are active documents with good evidence of a review process fully involving the person concerned with all the health and social care professionals involved in supporting them. When we talked to people who live in Colney Lodge they told us that they felt reasonably empowered in the day to day decisions about their care. They also told us that they either always or usually felt that care workers listen to and act on what they say. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: When we asked health and social care professionals involved with the home, they told us that one of the things the home does well is; Empowerment, creating opportunities for individuals to increase independence,improve their social skills and avoid stigma. Care Homes for Adults (18-65 years) Page 13 of 27 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. People living in Colney Lodge can be confident that they will have opportunities for personal development and that they will be encouraged and supported to take part in activities within the home and the community in line with their needs and expectations. Evidence: When we asked people who live in Colney lodge if they could do what they want to in the morning, evening and at weekends, they both answered yes in each case. Care plans and supporting documentation was seen to show that people living in Colney Lodge access the community as they want to, and that they have contact with family and friends regularly if that is their wish. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: When we talked to people living in the home they were quite positive about the way the home is organised and run and felt that they were treated well by care staff and in particular they were very positive about the support they receive from the proprietor. One health and social care professional said that the willingness of the home to adapt to the specific needs of people living there, for example by helping them meet a commitment to a vegetarian lifestyle was very positive. In their AQAA the proprietor informed us that they have encouraged one person living in the home to purchase a laptop computer and indicated that they will be providing help and support as required to help them get the best from it. The proprietor also informed us in the AQAA that people living in Colney Lodge are able to do their own shopping for clothes and other items and that they access the doctors and pharmacy to collect their own prescriptions. All of this helps build, maintain and develop interests and social skills within the community. Care Homes for Adults (18-65 years) Page 15 of 27 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. People living in Colney Lodge can be assured that where they receive support with their medication this is done safely and effectively in a way that safeguards their health and well-being. They can also be confident that they will have appropriate access to the routine and specialist health care services that they need in order to maintain and improve their health and well-being. Evidence: When we asked health and social care professionals about the way the service meets the health needs of people living there, they told us that the service always seeks advice and acts upon it in order to manage and improve the health care of people living in Colney Lodge. They also told us that in their opinion the home always meets the care needs of people living there and specifically in terms of medication that the home always liaises with professionals in the community mental health teams before making any decisions about self-medication. When we spoke to one person in the home, they told us that they self-medicate and that staff simply monitor this in an appropriate way to make sure medication needed Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: for their health and well-being is being taken as directed. When we looked at care plans, we saw they included details of reviews and assessments made by various health and social care professionals and also included details of appointments made with health care services to address any specific health care needs that may have arisen. When we looked in detail at the records kept by the home in respect of the administration of medication, we found that there had been a significant improvement since the last inspection. All balances were correct and there were no gaps found. This suggests that the home have now put in place a system that protects and monitors the medication administered on behalf of people living in Colney Lodge in a way that is effective and protects their health and well-being. Care Homes for Adults (18-65 years) Page 17 of 27 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. People living in Colney Lodge can be confident that their views will be listened to and acted upon and that they are protected by the training provided to those who care for them that ensures that the services safeguarding policies and procedures will be put into practice where appropriate and necessary. Evidence: When we looked at staff files we found that safeguarding training is provided both by Colney Lodge and also in many cases through other employment in local mental health services within the NHS. This should ensure that all staff working in the home have a good understanding of safeguarding and what to do if any abuse is seen or suspected. When we asked care staff, they told us that they know what to do if a service user, relative, advocate or friend has concerns about the home. Each person who lives in the home has ready and frequent access to individuals and services outside of the home, this provides them with ample opportunity to raise any concerns that they may have independently. When we asked the people living in Colney Lodge they told us that they knew who to speak to if they were not happy about something and also that they knew how to make a complaint if they wanted to. They also told us that the people that care for Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: them either always or usually listened to them and acted on what they said. Care Homes for Adults (18-65 years) Page 19 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Colney Lodge provides a homely, comfortable and safe environment for those people who live or work there. Evidence: When we looked around the service we saw that some new carpets had been provided and some redecoration undertaken since the last inspection. We saw that the home is comfortable, clean and homely in character and when we asked people who live in Colney Lodge about the home, they told us that it was always fresh and clean. When we asked health and social care professionals associated with the home about the environment, they told us; The service provides a safe environment for individuals to reside in and Environment is non-institutional and homely. Currently none of the people who live in Colney Lodge require any adaptations or specialist equipment and the service meets their environmental needs well. Care Homes for Adults (18-65 years) Page 20 of 27 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. People living in Colney Lodge can be confident that the care and support they receive is provided by staff who have the necessary skills and experience to do so effectively and safely and who have been employed following a rigorous recruitment process in order to protect them from the employment of unsuitable people to care for them. Evidence: When we spoke to people who live in the home they told us that care staff either always or usually treated them well and usually or always listened to what they said and acted upon it. When we looked at the recruitment file for a recently recruited member of staff we found that the standard of records had improved since the last inspection and on this occasion the necessary documents were in place and the required checks had been carried out in order to protect those people living in the home from the employment of unsuitable people to care for them. When we asked care staff they each confirmed that a criminal records bureau check had been carried out before they were employed by the home and that they had provided references as to their suitability for the post they were applying for. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: People who work in the home told us that they were well-supported by the proprietor and when we saw supervision records, we found that regular supervision is recorded in most cases. Training records that we saw provide evidence that basic training and updates are provided by the home and that this is augmented in most cases by additional training provided through local mental health and NHS services where staff are also employed. This means that care staff have a wide range of experience and expertise that enables them to support and care for the people who live in Colney Lodge in a professional and effective way. Care Homes for Adults (18-65 years) Page 22 of 27 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. Colney Lodge is a well managed service that achieves good care outcomes for the people who live there. Evidence: The standard of records that we found during this inspection had significantly improved and now provide adequate safeguards for the rights, best interest and well-being of people who live in the home. Care staff and people who live in the home were all positive about the proprietor and the support and encouragement that he provides, formally and informally. The scale of this service means that some of the quality assurance is quite informal and this is borne out in the homes AQAA which is adequate but short on detail. The evidence we have seen and what we have been told by many people involved with this service, including those who live or work there or who are responsible for people Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: who live in the home and who have regular routine contact with the proprietor supports the assessment that it is a well managed service that achieves good care outcomes for the people who live there. There is however, still no registered manager, although we were told by the proprietor that they are still attempting to recruit one. It is important for all registered care services to have a manager who has been registered as fit by the CSCI and as discussed with the proprietor there is no reason why they could not apply to be registered themselves if they chose to do so. The rating of this outcome area as good reflects the improvement we have found in key areas since the last inspection and also recognises that good care outcomes have consistently been achieved over several years. It must not however be seen as a reason or excuse for the service to continue without a registered manager indefinitely. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 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. 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