Inspection on 08/11/06 for Corben Lodge

This inspection was carried out on 8th November 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 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

Corben Lodge 07/06/07

Corben Lodge 10/05/06

Corben Lodge 06/03/06

Corben Lodge 27/07/05

Corben Lodge 05/01/05

Corben Lodge 01/06/04

Corben Lodge 01/12/03

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

CARE HOME ADULTS 18-65 Corben Lodge Moorings Way Milton Portsmouth Hampshire PO4 8QW Lead Inspector Jan Everitt Key Unannounced Inspection 8th November 2006 10:00 Corben Lodge DS0000044248.V311957.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 Corben Lodge DS0000044248.V311957.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. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Corben Lodge Address Moorings Way Milton Portsmouth Hampshire PO4 8QW 023 9273 1941 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) www.portsmouthcc.gov.uk Portsmouth City Council Mr Michael Paul Collinge Care Home 19 Category(ies) of Physical disability (19) registration, with number of places Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate up to 19 male and female service users in the PD category between 18 and 65 yeas of age. 9th August 2006 Date of last inspection Brief Description of the Service: Corben Lodge is a local authority home situated in a residential area on the eastern side of Portsmouth. The home, built over twenty years ago, is a purpose built single storey building that provides care for up to nineteen service users between the ages of 18 & 65 years. The home was originally built to provide rehabilitation to physically disabled young people to enable them to achieve greater independence and to move on into specialist housing provision in the community. The home has evolved to now provide a mix of long stay residential care and respite short stay accommodation. There is no active rehabilitation programmes in progress. At the time of this inspection there was a high proportion of permanent residents, one of whom spoken to, had lived at Corben Lodge for over 18 years. The remaining accommodation was offered to people living in the local community who receive short stay, respite care, weekend programmed care, and one person was staying in the purpose built rehabilitation flat at the home. In addition there are some care packages available for people living in the community who may need use of Corben Lodge facilities, for example assisted bathing, in order to sustain them living independently. Fees range between £713 - £1.024 Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Corben Lodge, which was unannounced, took place on the 8th November 2006 and was the second key inspection for the inspection year 2006/07. One inspector attended the inspection over one day. The registered manager and deputy manager assisted the inspector throughout the visit. The staff and senior practitioner on duty at the time were also available. The judgements made in this report are the result of regular monitoring of the service and its performance since the first key inspection of May 06, at which time the service was considered to be not meeting the required standards. Following this, a CSCI management meeting took place, to identify the shortfalls in the standards of the home and to plan how the regular monitoring of the service would take place to ensure service users’ were protected appropriately, A further random inspection took place in August 08, at which time the requirements made from the previous report were monitored as to the stage of compliance. This second key inspection was to reassess and make fresh judgements about all key standards and any other standards assessed as not having been met. Information has been gathered from correspondence with the City Council and action plans submitted by them of how the service would be complying with standards and stated timescales within which these would be met. The inspector toured the building and spoke with most of the residents and a number of staff. The inspector viewed a sample of care records, recruitment files, training records and spent time observing practices and speaking with residents. The atmosphere in the home was relaxed and the staff were observed to work well with clients whose activities of daily living routines they were familiar with. The staff were observed to interact well with the residents they worked with. The ethos and overall care delivered in the home was judged to be good. What the service does well: Corben Lodge provides a pleasant homely environment for a young disabled group of clients. The provision of the respite care service has proved to be valuable to carers caring for younger disabled people in their own homes to give an opportunity for regular respite from the caring role. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 6 The facilities at the home are good and there are plans to further improve the environment. Specialised equipment has been installed to facilitate residents to promote their independence. The building is purpose built and is therefore designed to be spacious and light and wide corridors that allows for easy mobility in a wheelchair. A number of the staff team are well established and have worked at the home for a number of years and are therefore very familiar with the client group and of meeting the resident’s needs. The residents are well served by the local primary health team who will visit the home when requested. The home has regular service users meetings at which time residents are given the opportunity to voice their issues, opinions and suggestions. What has improved since the last inspection? The Statement of Purpose and service user guide have been reviewed to reflect the philosophy of the service and state the right of the service user to be included and consulted in the formation of their care plans. The home has developed a new care planning system that is now operational for all service users. The service users are involved in the formation of their care plans and sign the plans as agreement and evidence of their involvement. Care plans identify all aspects of the service user’s life, and their personal goals and aspirations are recorded. All areas of the home have now been risk assessed. A self-medication policy has been introduced and all service users have been assessed as to their ability to manage their own medication. This is documented in care plans and their choice of if they wish to self-medicate or not is also recorded and confirmed by a signature from the service user. All staff have attended adult protection training. The registered manager has taken responsibility to formulate a process for quality assurance and the auditing of the service. A quality questionnaire was distributed to service users, and significant others, which has been returned and analysed by the manager. Further auditing of systems, records and practices of the home must continue to be developed. The upkeep and maintenance of the building has improved and a great deal of work has been undertaken to carry out repairs and improve the fabric and appearance of the building. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 7 All areas of the home that are designated for communal space for the residents are now fit for purpose and available should residents choose to use these areas. The infection control procedures at the home have been reviewed to reflect the appropriate management of soiled pads stored in bedrooms. The manager has procured a new contract for the disposal of waste, which is more conducive to operational aspects of the home. The home now has the DOH publication on guidance on infection control in care homes. Staff have received appropriate mandatory training and further specialist training is to be undertaken. 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 Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 9 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 Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 10 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users’ guide sets out clear and accessible information which is client focused and would inform service users details about the home and would allow them to make informed choices about living in the home. Prospective service users would have their needs and aspirations assessed prior to admission to the home. EVIDENCE: The reviewed service users’ guide was viewed by the inspector that now states service users have a right to be included in the development and review of their care plans. The home has admitted only one service user, for respite care, since the last inspection, and there was evidence in their care plans of their signature to evidence their involvement and agreement with the plan. This will be tested further as the home admits more clients. The inspector did observe that when viewing a sample of other care plans, service users, who were able, had signed their plans, to evidence that they also had been involved in the development of their plans. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 11 The manager discussed with the inspector the future plans for the unit and that one area is being designated for rehabilitation and the necessary resources, along with staff training, will be provided to achieve this. It was discussed with the manager that The Statement of Purpose and service users’ guide will therefore need to be reviewed to reflect the operational changes to the unit when they are fully functional. The service has developed a comprehensive preadmission assessment tool and this has been tested out on the one respite care admission the home has had since the last inspection in May 06. The manager received a referral from social services and went to assess the client in their own home before they were admitted. The inspector viewed the pre admission assessment document and considered it to be completed well and quoted the client’s expectations of their stay at the unit. This process will also be further tested when other service users are admitted to the unit. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 12 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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home develops and agrees with service users an individual plan that reflects clients’ changing needs, aspirations and goals. Service uses are able to make decisions about their lives. Service users are enabled to take risks within the context of the service user’s plan and the environmental risk assessment and how risks are managed. EVIDENCE: A sample of care plans was tracked. One being the one admission into the home since the last inspection and who was resident for only one week. The other two care plans tracked were for two service users who had been at the home for some time and both had active discharge plans in place. It was clear that the senior care staff have worked hard in transposing all the care plans over to the new care records system and all service users Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 13 assessments and care planning records are now in the new format and the new care planning system fully operational. The inspector observed that assessments and care plans have been written with the involvement of service users and if they are able, have signed them as evidence of their agreement with what has been written. The care plans detail how service users wish to have their needs met and these are written in the first person and are quotes made by service users at the time of their consultation in the planning of care and has given them more ownership of the care plans. One service users spoken with reported ‘I know what is in my care plan I have seen it and signed it’. He confirmed that he had been fully involved with writing them. All care plan folders are now set out in the same order and contain good key information about the service user. There are numerous assessments and appropriate risk assessments and from these care plans are written to document the management of whatever level of risk has been identified and how needs can be met. The previous report of May 06 identified that there was a lack of documentation for discharge planning and that people from other disciplines or professions involved in service users’ care did not document in the records any actions or treatment they had planned for the service user. This has now improved and the discharge plans viewed for two of the service users, documented a chronological record of what had been planned, who had to action it and the outcome or result of that persons/professionals intervention. There were clear goals documented as part of the planning and these goals were addressed and recorded well. The manager discussed how complex discharges can be and reported that they involve so many people, departments and varying budgets that it was a time consuming process to ‘make it happen’. The inspector observed that of the eleven service users at the home at the time of the inspection there were four or five clients who wished to move to more independent living and most had some form of discharge planning in progress. The manager reported that although most service user’s wish is to move to more independent living and a planning process can begin, that sometimes when clients are faced with the reality of moving from the home it becomes more complex. One client, who had been on the housing waiting list for some time had recently been offered an appropriate flat but having been living in the home for so long, was very reluctant to make the final decision to be more independent. This highlighted the need for a more active rehabilitation programme to be in place for specific service users, to enable them to gain confidence, reach their full potential and be accurately assessed by the multidisciplinary professionals as to whether their goals and aspirations are realistic. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 14 The senior staff reported that most staff have embraced the changes in the care planning system. All levels of staff are in the process of receiving training from the senior practitioner to guide them through the paperwork to ensure they understand the process, and how care plans should be used as working documents on a day-to-day basis. Staff spoken to were enthusiastic about the new system and were aware of how the information is collated in the care plans to inform their practices. The care planning system and associated records can now be easily audit trailed and the manager will undertake this as part of his quality assurance programme. The regulation 26 reports from the representative of the local authority from October 2006 identified that care plans have been documented thoroughly. The environment has been risk assessed but there were workman working on the conservatory area at the time of the inspection and this area had been closed off to service users for their own safety. This area was clearly marked as ‘ out of bounds’. The tree identified as a hazard at the last inspection and causing the patio slabs to lift has now been felled (not to the roots) and the patio slabs have been replaced. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 15 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): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does well to support the residents in a range of activities of their choice and to further their education and to maintain links with their families, friends and the local community. Service user’s rights are respected. The home provides a varied and wholesome diet for service users to choose from. EVIDENCE: The home can demonstrate that a range of activities takes place each day. The inspector observed the programme advertised on the notice board. The support worker, who has taken a particular interest in the activities and has taken the lead to organise and plan these, maintains a record of the activities undertaken each day and who has participated. She reported that she Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 16 consults with the service users daily as to what activity they would like to take place that day. There are some future events advertised on the board and these are special nights i.e. 60’s 70’s music night, a trip to the local theatre, trips out, which she reports, is very popular with the service users. The support worker also reported that any suggestions for activities or particular preferences are discussed and recorded at resident’s meetings. It was documented that a service user suggested that a listening book club be created. He has now taken the lead for organising the group to sit and listen and discuss chosen books. The inspector observed the poster on the notice board advertising this. Service users the inspector spoke with reported that there is a good activities programme available. One service user confirmed this although she did not join in all the activities, she preferred to go to her room quietly or just sit and observe. Another service user reported that ‘scrabble was his preference but most service users enjoy bingo, but I do get a game of scrabble sometimes’. The manager reported that the home economics classes supplied by Portsmouth City Council and held once a week, have proved to be popular and service users are supported to plan, shop and cook a meal on the day the person attends. The manager reported that the home has a mini bus but it is difficult to obtain staff that are willing and able to drive it. One new support worker transferred from another local authority home spoke to the inspector and reported that she can now drive the bus which will enable some of the service users to get out of the home and have more contact with the community. One service user expressed a wish to the inspector that she wished she could go out more; another reported that she wished there were more staff on duty to enable her to go out more often as she has to be assisted. invited to festive celebrations, which are normally well attended. The previous key inspection identified from comments received from relatives that they felt they were always made welcome at the home. The manager and staff reported that families are involved in the home and are The father of a service user attended the home during the inspection. He had travelled down from north Hampshire for a review meeting, which had been cancelled by the care manager at the last minute. This had not pleased him as no explanation had been offered, but took the opportunity of taking his son out for a trip. Service users have unrestricted access to all parts of the home and were observed to be moving about the home freely. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 17 Service users are supported to form meaningful relationships and there is a policy in place to guide the home on how and what support is given. The inspector observed that good relationships existed between staff and service users and staff were obviously familiar with service user’s preferences and needs. The atmosphere in the main lounge area was relaxed and friendly and service users were interacting with each other. The inspector observed that staff were heard to be giving choices to service users about their daily activities. The manager discussed the dilemma of one service user who attends a day centre three times a week and has been reassessed as not meeting the criteria any longer. This has upset the client and the manager reported that the home would be supporting the service user to appeal or look for alternative day care. This was documented in the care plans. The inspector was informed that the service users discuss menus with the cook at resident’s meetings, the cooks are aware of the residents likes and dislikes and any special dietary requirements. Service users do buy any special foods they particularly like. The menu for the day is displayed on the resident notice board in the main dining room. The inspector spoke to the agency chef who confirmed what the evening main meal was for that day and that none of the service users were choosing the alternative meal. It was observed that fresh fruit was available in a bowl in the lounge area for residents to help themselves. The inspector spoke to a number of service users who reported that the food was good. The manager reported that the menus and food are always discussed at the resident’s meetings. The manager has distributed a quality questionnaire to all service users and the results indicated a 100 positive reply about the size of meals, variety and choice of food. The manager reported that he wishes to continue to develop the menus with greater input from the clients. It was a service user’s birthday on the day of the inspection and a large chocolate cake had been provided for afternoon tea to celebrate the occasion and was enjoyed by everyone, including visitors. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 18 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): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in a way they prefer. The service users health, emotional and psychological needs are met. Service users are encouraged and supported to maintain and manage their own medication within a risk management framework underpinned by the polices and procedures of the home. The home complies with the stated policies and procedures for the management of service users medication. EVIDENCE: A personal care policy is in place. A service user spoken with confirmed that she receives care only from female carers, as is her preference, which is documented on her records. The inspector spoke with a number of service users who were having their breakfast. They confirmed that they get up what time they wish and that those spoken to confirmed that they like to be up quite early. The inspector observed that service users wishes were being respected as to their choice of Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 19 what they wished to eat and drink at breakfast time. The staff were observed to be familiar with service users care and there existed good relationships between them. One service user was spoken with at lunchtime that confirmed that he had chosen to stay in bed all morning and was able to get up himself whenever he wished, but was encouraged by the staff to get up for lunch. The inspector was informed that two of the service users were on holiday that week. They had chosen to go the same week to Netley Waterside, where they both enjoy an annual break. The service users have access to members of the primary care team who visit the home on request. The occupational therapist visits the home weekly to assess moving and handling and any mobility problems. The care plans demonstrate good moving and handling risk assessments and how service users mobilise and what equipment is used, and what support is required from carers, to move and handle those service users who are less able. The report of May 06 documented that psychological and emotional needs of service users was not being met. The care plans new demonstrate that all service users’ emotional and psychological needs are assessed and care plans are in place to address this. It was observed that in one care plan a service user had been referred to a psychologist as he was finding it difficult to comes to terms with loosing his independence, and along with that, his home. The inspector viewed plans that demonstrated that other service users had been referred to counsellors to support them through emotional crises. Although these professionals did not document in the notes any outcomes, the home can demonstrate that service users emotional and psychological needs are now being assessed and action taken to support the person. The previous two report findings have identified that a self-medication policy and procedure must be formulated. This has now been undertaken. The inspector viewed the policy and procedure. The inspector viewed the care plans for a recent respite care person who is no longer resident at the home. The plans demonstrated an excellent self-medication risk assessment and the service user signed the assessment as evidence that she wished to selfmedicate whilst she was in the home. There was also evidence in all service users’ care plans of a risk assessment for service users to manage their own medication. Care plans documented that service users have been consulted as to whether they wish to manage their own medication with support, but no one at the present time wishes to do so. This was discussed with the manager who reported that this will be reviewed and service users will be encouraged to be more involved with their medication. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 20 The manager reported that the service user who is nearing their discharge would physically not be able to manage their own medication and part of the discharge planning is to ensure that this will be administered by an appropriate person. The inspector observed the breakfast medication round. The deputy manager and a support worker were administering the medication from the trolley to service users during the breakfast period. Procedures were observed to being followed and were safe. The medication charts were documented appropriately. The inspector identified that service users on some PRN medications and had not needed them for months, were still being recorded on the MAR sheets. It will be recommended that the GP discontinue any medication from the prescribing record that has not been needed for some considerable time. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 21 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 Quality in this outcome area is good. This judgement has been made using available evidence including viewing documentation and records. The home has a complaints procedure that service users and some relatives are aware of, they feel that their complaints will be listened to and responded to within an appropriate timescale The home has policies and procedures to protect service users from abuse. All staff employed in the home have now received training in adult protection. EVIDENCE: The random inspection of August 06 identified that the complaints policy and procedure were documented in the Statement of Purpose. The inspector also observed that leaflets are on display in the reception area to allow service users and visitors information about how they can complain if they wish to do so. The results of the quality audit undertaken by the manager in the form of a questionnaire to relatives and service users identified that two thirds of the replies received confirmed that they were aware of the complaints procedure and would know how to make a complaint. Service users spoken with also confirmed that they would speak to the senior support worker or the manager if they wished to complain. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 22 The logbook identified two complaints having been received. The records demonstrated that the manager had investigated both complaints and copies of the letters of reply were also evidenced within the stated timescales. The training files can now demonstrate that all levels of staff have received adult protection training. Staff spoken with demonstrated awareness of what they would do if they witnessed abuse or if there were any allegations of abuse to service users. There have been no allegations or abuse/concerns reported in the home. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 23 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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including visiting the home and touring the building. Service users live in a homely, comfortable environment that is in the process of undergoing maintenance and improvements to be made safe and the garden areas more aesthetically pleasing for service users. The home is clean and hygienic. EVIDENCE: The two previous reports identified a number of maintenance and repair issues that were in need of being undertaken. Following the last report Portsmouth City Council submitted an action plan to the CSCI stating timescales and plans to comply with the requirements around the environment. The inspector toured the building. The home was clean and hygienic. The local authority has undertaken an extensive maintenance programme for the repair and improvement of the building. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 24 The cladding all around the building has now been repaired and repainted. The conservatory that joins two part of the home was under repair and refurbishment, at the time of this inspection. The offending tree with roots lifting the paving slabs on the patio area has now been felled but not completely removed. New paving slabs have replaced the old ones. The inspector commented to the manager that the tree roots were still intact. He said he would monitor further movement of the slabs. The patio areas have not been completely cleared of weeds and there has been some attempt to cut back some of the shrubs in the garden area. The inspector considered it difficult to assess the garden area as everything was dying back and looked quite sad. More effective monitoring of the surrounding gardens and patio areas must be undertaken next year for the safety of the service users using the patio areas and also for aesthetic reasons for service users to use in the finer weather. The manager discussed the forthcoming plans for the building and redecoration of one area. Six rooms in this area are to have replacement windows and wider doors fitted so that service users in wheelchairs can access the patio and garden areas if they wish. The manager also discussed the plans for another area of the home to be designated as a rehabilitation area for four service users to support them to be more independent with their living skills. The City Council is endeavouring to improve the fabric of the building and to also identify the purpose of the service. The random inspection in August 06 continued to identify that waste bins holding soiled pads were not being emptied at appropriate intervals and were observed to be overflowing. This has now been addressed and the home has a new contract for waste disposal. New bins have been supplied and these are emptied and retained in a large waste bin with a lid outside of the home. There is a policy to guide this procedure. The inspector observed that bins were being used appropriately and were not too full. The inspector observed that a new bedpan/urinal sterilising machine has been installed in the sluice room and is more hygienic and appropriate for the disposal of bodily fluids and the cleaning of the receptacles. The inspector viewed the infection control policy for the home and the home has information and guidelines from the DOH on infection control care homes. Staff training records demonstrated that staff have received training on infection control. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 25 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, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service and viewing records. The service users are supported and needs met by sufficient and competent staff. Service users are protected by the home’s recruitment policies and practices that are now in place. The staff are not regularly supervised at the current time. Staff received mandatory training but need to be provided with more service specific training appertaining to the client group in residence EVIDENCE: At the time of this visit staffing rotas were viewed. The manager reported that that morning there were eleven service users in residence. There was the unit manager and deputy manager on duty with a senior carer and four other support workers. It was reported that two of the carers were in the process of their induction programme. Both had moved from another local authority home but were undertaking the induction at Corben Lodge and consequently were not counted in the numbers for that day. The rotas demonstrated sufficient staff on duty to meet the current needs of service users. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 26 The inspector viewed a sample of four recruitment files. Although the recruitment of staff is coordinated by the human resource (HR) department, copies of all the information that is stated on Schedule 2 of the Care Home Regulations were evidenced as being kept in the home. The home is now meeting the regulations and liaises with the HR dept. for the manager to ensure that the recruitment of the staff has been robust. Agency staff do attend the home on occasions. The manager reports that the vetting of agency staff is part of the terms and conditions of a contract that exists between the city council and the approved provider. Staff training needs are identified through a yearly appraisal and supervision, which takes place at least six times a year. The manager reported that the supervisions and appraisal programme has fallen behind and he will be addressing this imminently. The manager has a training matrix from which he can identify who has undertaken training and when mandatory training is due. In view of the future plans for the unit and the specialist training that staff will receive to provide effective rehabilitation, the inspector concluded that this will be in place before the unit is operational. Staff spoken with at the time of the inspection reported that they receive training and that they are very satisfied with their training and consider it to be appropriate. The deputy manager has been allocated to go on a health and safety course to ensure he is familiar with the management of hazardous substances. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 27 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): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including viewing documentation and records. The home is managed by a person who is qualified and experienced to run the home and who is now taking responsibility and accountability to ensure the home is run in the best interests of the service users. The manager has developed an appropriate survey questionnaire for obtaining service user’s, relatives, advocates and other professionals involved in the service user’s care, opinions and levels of satisfaction with the service. Service users health, safety and welfare is promoted and protected by policies for monitoring equipment, systems and staff training. EVIDENCE: The registered manager is now demonstrating that he is aware of his role as registered manager and he has an accountability and responsibility to ensure Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 28 that all of the National Minimum Standards are monitored and maintained. He is undertaking regular audits of the systems and documentation in the home. As part of the manager’s quality assurance system he has distributed a satisfaction questionnaire to service users, relatives and other visiting professionals to gain their views and level of satisfaction with the service. The results have been analysed and the inspector viewed the results and was given a copy of the analyses. The outcome of this survey demonstrated positive results. The report documented eleven action points that had been identified by the comments made by the recipients to improve the service for the clients. The manager had drawn up an action plan of how these issues would be addressed A plan for improvement, submitted by the local authority to the CSCI following the random inspection of August 06, stated that the manager would in future monitor all systems and care documents and sign appropriately within the care plan. This was demonstrated in some of the care documentation viewed at this inspection. The MAR charts are checked at each shift handover and signed by senior staff that they have been completed correctly. The inspector observed signatures to confirm this was happening. The reports from the Regulation 26 visits by a representative of the local authority have been consistently received by the CSCI. The home could demonstrate at this visit that all staff have attended the mandatory health and safety training to include moving and handling, fire, infection control, first aid, and all staff have obtained their basic food handling and hygiene certificates. A number of staff, including the chefs, have attended a refresher course in this. The mixer valves on the sink hot water taps in the kitchen areas have now been corrected and the taps are emitting hot water that is of a temperature within safe parameters, should service users use them. Regulation 37 incident reporting to the CSCI are being submitted appropriately. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 29 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 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 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 Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 30 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 YA20 Good Practice Recommendations It is recommended that the service users’ medication MAR charts be reviewed and all PRN medication that has not been needed for a considerable time be removed off of the prescription chart. Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 32 Corben Lodge DS0000044248.V311957.R01.S.doc Version 5.2 Page 33 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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