Inspection on 27/02/07 for Concord Lodge

This inspection was carried out on 27th February 2007.

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 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

Concord Lodge 03/02/06

Concord Lodge 25/08/05

Concord Lodge 16/12/04

Concord Lodge 10/08/04

Concord Lodge 10/12/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Concord Lodge Kellaway Avenue Horfield Bristol BS7 8SU Lead Inspector Ashley Fawthrop Key Unannounced Inspection 27th February 2007 09:30 Concord Lodge DS0000037289.V330864.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 Concord Lodge DS0000037289.V330864.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. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Concord Lodge Address Kellaway Avenue Horfield Bristol BS7 8SU 0117 3532385/86/87 0117 353 2387 concord_lodge@bristol-city.gov.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) Bristol City Council Mr Glyn Short Care Home 6 Category(ies) of Learning disability (7) registration, with number of places Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate 7 persons aged under 65 years. A separate dedicated staff team must be available for a person when accommodated in the Safe Haven facility Residents will stay no longer than six months in the home unless agreed by CSCI 3rd February 2006 Date of last inspection Brief Description of the Service: Concord Lodge is registered to provide personal care and accommodation for up to six persons (male and female ) who are under 65 years of age and who have a learning difficulty. The staff team aim to provide a specialist facility for people with particularly complex needs. The service is in the process of being divided into three areas: Medium term assessment for individuals who challenge current service provision, working in a holistic way to reduce the impact of the challenging behaviour on each persons life, and support residents to develop their skills and move on towards a more independent setting. A safe haven Service is in the process of being developed for people who cannot be easily accommodated with others and would benefit from interim specialist support to reduce challenging behaviour. The staff at Concord Lodge will be working in partnership with the Bristol Intensive Response Team to provide this service and finally a respite service is also in the process of being developed to provide a short break to people with complex needs and sometimes challenge. The staff will be working in partnership with the Bristol Adult Placement Team and the Day Services Community Resource Team. At the 27 February 2007, the fees were levied at £62.35. Services offered that incurred extra cost are Hairdressing £5.00-£20.00, Chiropody £17.00 and Reflexology £25.00 a session. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted by one inspector in one day. Before the visit, accumulated information about the home was reviewed. This included looking at the number of reported accidents and incidents, the action plan submitted following the previous inspection, and reports from other agencies, i.e., the Fire Officer. This information was used to plan the inspection visit. I case tracked three people using the service. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. Where appropriate, issues relating to the cultural and diverse needs of residents and staff were considered. Pre inspection information was received before the visit was done and on the day of the inspection the staff were open and helpful throughout. The inspection included looking at records such as care plans and reviews of the care for people using the service and other related documents. I also read policies and procedures relating to the protection of vulnerable adults and health and safety. The views of the staff and people using the service were gathered either by face- to- face discussions or by surveys. What the service does well: Concord Lodge has developed it’s services into an assessment unit with one place for a person whose needs are very complex and requires one to one care. There are additional places for people to live with being assessed for more independent living and respite beds for people to use on a short-term basis. The manger and team deliver these services in line with the statement of purpose for the home. People wishing to use the service can decide if the home can meet their needs through written information and by visiting the home. The staff are trained and experienced to meet the needs of people and do assessments before people move in to the home to make sure they can manage their needs. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 6 There is evidence that the people are assessed correctly and to make sure that the person is not living at the home longer than the agreed time before moving on a discharge plan is commenced on admission. The care plans are individual and include the emotional and social needs of people, they have access to meaningful activities and their individuality is maintained through dress, activity and their environment. People are protected by the complaints procedure and policies and procedures relating to the protection of vulnerable adults. The home is managed to a good standard and people are protected by the Health and Safety policies and procedures. What has improved since the last inspection? 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. Concord Lodge DS0000037289.V330864.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 Concord Lodge DS0000037289.V330864.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, 2, 3, 4 and 5. Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The information provided to people wishing to use the service and their representatives provides is good and makes sure that people can see that the service can meet their needs before they move into Concord Lodge. The admission s process is good and makes sure that individual needs of people are identified and assessed before they move to the home. EVIDENCE: The statement of purpose has been includes the current service of medium term assessment and the two other services Concord Lodge to provides which are a safe haven and respite facility. The service user’s guide includes photographs and has been written in plain English this makes sure that people wishing to use the service find it easier to understand the content. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 9 Three case files were studied and all had assessment information that had been done before moving into the home. There was evidence that people and their families have the opportunity to visit the home prior to moving in and this is part of the assessment. This is good practice as staff can see what the needs of people are before they move in and have good information to start a care plan immediately. There were assessments made by the Social Workers but the manager said that they always make sure they do their own assessment as well. On all the care plans seen there were contracts recording the services offered by the home and there cost. As well as any services that might be cost extra. These were written in plain English and included pictures and symbols so that they were easier to understand. People using the service said they had been happy to come to Concord Lodge they had come to look around before moving, in the staff were friendly and they did not feel rushed. Concord Lodge DS0000037289.V330864.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 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The care planning in place is good. There is evidence that care plans include information given by people using the service and their representatives. This makes sure that peoples changing needs and goals are included in the plan. People continue to be well supported by the staff team of Concord Lodge who enable them to take risks so that they reach their own highest level of independence and achievement. EVIDENCE: Three care plans were read. These had been signed either by the person it related to or their representative if they were unable to sign. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 11 The care plans were of a good standard and contained the detailed information required by staff to support each person’s needs some of which were very difficult to manage. People said that they did the same thing they do at home and staff listened to them and supported them. During the inspection the inspector heard about several residents who had made very good progress in developing skills in activities of daily living whilst living at Concord Lodge. On reading the care plans I could see the progress made by people while living at the home enabling them to move towards living in the community with support. People were allowed to take risks and these were seen in the assessments that were in place for these people and I saw that they are regularly reviewed and kept up to date. Families of people using the service said that the quality of care is good and that they were aware that the home was used for assessment and that people would move on, they hoped that the care would be as good as at Concord lodge. Concord Lodge DS0000037289.V330864.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 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People are seen as individuals, they have the opportunity to be involved in meaningful activities either provided by the home or a continued personal interest. There individuality is maintained sexual expression is recognised and appropriately risk assessed. The dietary needs of people are seen as important both culturally and where required medically. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 13 EVIDENCE: People that use the service have the opportunity to be involved in activities with people of their own age group. A number attend various day centres and others are employed in the local area. All the people have the opportunity to go out either on a one to one with staff or in small groups. Activities in the community include going to pubs and restaurant, shopping, cinema and bowling. There are also activities available in the home and include games and puzzles, music and reflexology. People are given the opportunity to develop appropriate relationships and expressing sexuality is part of the care planning process and where expressed this is assessed for risk to make sure both parties are safe and have consented to the relationship. Individual activities are recorded and staff work hard to make sure that people continue with their interests and pass times. Where a risk had been seen these are assessed to make them as safe as possible while not over protecting the person making the activity meaningless. Though there are meal times these are flexible because many of the people are out at some part of the day. Staff prepare the meals and these reflect the wishes of the people eating at that time. Special diets are catered for including cultural choices (Halal) or vegetarian foods. Other diets provided are for medical reasons and may include wheat free or dairy free diets. Concord Lodge DS0000037289.V330864.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 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People to receive personal care in an individual way and staff are provided with information on how to do this. The social and enotional needs are seen as important , this is reflected in the individual daily living expreieces of people. The medication administration system has improved since the last inspection, the security of all of the medication held on the premises is safe. EVIDENCE: On reading the care plans I saw that as well as physical tasks, social and emotional needs were seen as important. Personal profiles are written and include the person’s interests as well as what makes them anxious and how the people express themselves. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 15 This is good practice as it gives staff information on what makes the person an individual. It gives them an insight into what makes them an individual and though some expressions of behaviour are unusual to them it is normal to the person. I looked at the procedures for storing, giving and recording of medications. There is a policy available for staff to read that includes guidelines for people who keep their own medications. The manager said that staff observe people taking their medicines then sign the medication chart to record that this has been done. I also noted that a requirement of the last inspection was to have a suitable secure medication cabinet in place for controlled medication or medication to be treated as controlled. This had been done and there are lockable facilities within the cabinets these meet the recommendations for the storage of controlled substances. Concord Lodge DS0000037289.V330864.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. Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The system for dealing with complaints and the arrangements for protecting people from harm are good. People are protected by the policies and procedures for the protection of vulnerable adults. EVIDENCE: Bristol City Council complaints procedure continues to be in place. This procedure has been translated into a pictorial format for the benefit of residents, which was seen around the home and in people’s bedrooms. There have been no complaints referred to the Commission (CSCI) since the last inspection. Since the last inspection the “whistle blowing” procedures have been updated and since the last inspection all staff have done Protection of Vulnerable Adults training. The staff training records confirmed this. Concord Lodge DS0000037289.V330864.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, 26 and 30. Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. Concorde Lodge now provides a comfortable, homely, and safe standard of accommodation. EVIDENCE: A tour of the communal areas and bedrooms was done with the manager Concord Lodge is a comfortable homely place to live and the manager, team manager and staff team continue worked hard to this environment. Each person has their own individual space allowing them privacy and a place to go away from other people if they wish. This is good practice because at times the behaviour of some people can be disturbing to others. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 18 The home was clean and smelt fresh through out. The manager explained that all physical / environmental adaptations and equipment are provided where possible as identified in an individuals needs assessment/ care plan. The staff team have access to an established office in the centre of the home and the manager’s office is now in an annex in the grounds of Concord Lodge where the Bristol intensive response team and also located. The safe haven is a separate unit within the home and is only occupied by one person at a time whose needs a high level of care. This area continues to be well maintained and clean. Concord Lodge DS0000037289.V330864.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 and 35 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People benefit from an effective well-managed staff team. The have the skills through training and experience to deliver good quality care. EVIDENCE: Staff continue to be aware of their roles and responsibilities and on the day of the visit staff morale was good. The manager said that this is due to the staff team being more consistent and working well together All staff does an induction on employment, this has been updated recently to include including information on the complex needs of the people who are referred to the home. This is good practice as it gives staff a good knowledge of the needs of the person some of which are very complex. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 20 There continues to be that the staff team is well managed by the manager with support from the team manager. Staff meetings are held regularly and the records are made available to all staff. Regular supervision continues to take place in the home. There had been a recommendation made at the last inspection to hold regular staff team days the manager agreeing that he thought it was a good idea but these continue to be difficult to do because of the amount of cover needed to maintain a safe environment while all the staff are way. Continued progress has been made with NVQ training and specialist training. The staff development plan has recently been reviewed by the manager and plans for a rolling programme of training put into place. ` Concord Lodge DS0000037289.V330864.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 Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. People who use the service, their representatives and staff benefit from the development plan in place for the home, which ensures that residents’ best interests are protected. The management of health and safety records is good and since the last inspection developments to protect people from harm have been made. Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 22 EVIDENCE: Since the last inspection the registered manager and team manager have developed a new service named “Safe Haven” this bed is used as an emergency care and a respite facility in partnership with the Bristol Response Team. People who had been living at Concord Lodge long term continue to be supported by the staff team in consultation with themselves and their representatives to move onto more suitable long-term accommodation and there is evidence that this is an on going plan. Medium term placements are being offered to new residents. The respite facility is now complete and is working well. I looked at a sample of records, which are maintained for the protection, and safety of people who use the service and staff all periodic tests and training were up to date and accurate Since the last inspection the fire risk assessment in place has been updated to include the up to date as physical environment throughout Concord Lodge. Concord Lodge DS0000037289.V330864.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 3 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 3 25 3 26 3 27 X 28 X 29 X 30 3 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 Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 24 NO 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. Refer to Standard YA33 Good Practice Recommendations Manager and staff team should review changes to services provided within six months and affect on staff team and staffing levels Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. Extracts may not be used or reproduced without the express permission of CSCI Concord Lodge DS0000037289.V330864.R01.S.doc Version 5.2 Page 26 - 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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