Inspection on 07/07/05 for Cosy Lodge

This inspection was carried out on 7th July 2005.

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

Cosy Lodge 24/09/08

Cosy Lodge 04/10/06

Cosy Lodge 03/01/06

Cosy Lodge 01/02/05

Cosy Lodge 27/04/04

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

CARE HOME ADULTS 18-65 Cosy Lodge Westwell Leacon Charing Ashford Kent TN27 0EH Lead Inspector Ann Block Unannounced 07 July 2005 16:05 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 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 Stationary 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. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cosy Lodge Address Westwell Leacon Charing Ashford Kent TN27 0EH 01233 713515 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Counicare Ltd CRH Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01 February 2005 Brief Description of the Service: Cosy Lodge is a detached chalet style property situated in a rural setting to the edge of Westwell Leacon on the outskirts of Ashford. Counticare are registered owners and have a number of other services in Kent. Cosy Lodge is registered to provide accommodation, personal care and support for up to six adults with leaning disabilities. Counticare vehicles are available to use. To the front of the property there is gated access leading to parking for up to four cars. Cosy Lodge is on two levels. On the ground floor there are two bedrooms, lounge, dining room, office, kitchen, laundry room and staff toilet/shower room. There are four further bedrooms on the first floor. There are secure gardens to the rear of the property. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission was represented by Ann Block, regulatory inspector, who was in the home from 4.05 to 7.50 pm. During that time the staff on duty, the manager and service users spoke with the inspector. A service user showed the inspector round the home, including his bedroom. Due to the nature of the service, evidence was also obtained from observation and records. At the commencement of the inspection, staff on duty were having a training session from the local diabetic nurse. Later in the evening four clients went out with two staff to a disco in Folkestone. The atmosphere was relaxed with clients and staff interacting fully and enjoying being at Cosy Lodge. Les Standley has been in a managerial role at the home for 2 years. He also oversees two other homes owner by Counticare. What the service does well: What has improved since the last inspection? The statement of purpose and service users guide have been updated and include those charges payable by the client, further detail is planned to ensure staff names and training is included. Staff costs, such as admission charges on outings, is now clearly stated as being paid through the amenity fund. Controlled drugs are now stored in a secure lockable container. External and internal medication is stored separately. A record sheet is available to list items held for safekeeping on behalf of a client. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4 & 5 Prospective clients follow a sound admission process to give a smooth as possible transition into the home. EVIDENCE: A statement of purpose and service users guide is available and contains the majority of detail as required. Following an inspection of a sister home, more detail of staff employed, with their qualifications and training, is to be included. The statement of purpose is available in printed format, the service users guide in print and widget. Rights and responsibilities, including services included in the fees, is detailed. Prospective service users make initial contact via the organisational placement officer who will decide which of the Counticare services has vacancies and would be most suitable. Records seen confirmed a sound assessment process with information obtained from relevant professionals and previous placements. The home specialises in providing care and support to younger adults with learning disabilities in a homely as possible environment. The current group are all male and include clients with autism. Staff have received training to meet the needs of the clients living at Cosy Lodge. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 9 Records detailed the process for a client moving into Cosy Lodge and included visits and meeting other service users in a planned manner. All clients start their stay on a trial basis to see whether they like the home and whether the home meets their needs. Each client has a contract between the home and themselves which they or a representative sign. The contracts give good detail of the services provided, are also in widget format, record who is responsible for what and include attachments as referred to in the document. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 & 10 Clients care and support needs, choices and preferences, are set out in a personalised and informative life plan. EVIDENCE: Each client has a life plan. Those seen as part of case tracking gave excellent detail of the client concerned being personalised, updated as necessary and informative. Information from a range of sources, such as care management, family, previous placements and health professionals, is used to set up the plan. Cultural differences are included and respected. Goals for a recently admitted client were to be set up following which records would be made of progress towards these goals. Daily record sheets are held which are sectioned to record areas of daily living. Separate records are made by the Counticare day service. Links between different records for each client were not explored on this occasion. Clients are encouraged to make decisions about their lives and to have those decisions respected. Clients meetings are held with minutes on display in the kitchen. A new grill section for the barbeque had been bought follow clients comment in a meeting. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 11 The majority of clients have their finances managed through Counticare with monies individually named held in a combined dedicated account. Records of monies held for safekeeping were well ordered. The manager said that records were audited as part of Regulation 26 visits. As with other Counticare services, due to the system for requesting monies for service users, a delay of two or three days can occur. Clients keep an amount for more immediate use in their wallets, the amount of which is recorded separately. Clients can take assessed risks with risk assessments carried out and available for staff to use. In speaking with staff, they had a good understanding of risks both presented to and by clients. Strategies for managing risks and behaviour which might challenge were recorded and carried out in practice. Staff had a good understanding of confidentiality issues. Clients’ records are held securely and those seen maintained client confidentiality. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16 & 17 Clients enjoy diverse lifestyles which includes opportunities for social, educational and recreational experiences. EVIDENCE: Opportunities that arise during the day, both at Cosy Lodge and external day care, to develop personal skills are encouraged. Mention was made of using Counticare day service in Folkestone but of ensuring other external opportunities were accessed. Four clients were going to a disco there during the evening and were excited about going. Clients had been on holiday to a converted barn in Somerset which they had enjoyed. Clients choices whether to join in an activity are fully respected. Staff rosters are altered to meet social and recreational needs as necessary. Staff costs incurred when escorting clients on outings is paid for by a recently created amenity fund. Guidelines for use of this fund were not examined. Many references were made to contact with family and including them in clients’ lives if appropriate, and to making home visits. Cultural experiences, Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 13 such as special meals, are shared as part of integrating family and background into clients’ lives whilst at Cosy Lodge. Visitors are welcomed to the home at all reasonable times. Personal relationships and close friendships are supported. Friendships have been made with other Counticare services, including Summerlands, which is in the same village. Staff respect service users rooms as private. Bathrooms and toilets are lockable. Staff carry out all catering on the premises. A four-week rotating menu is used as a basis for meal provision but will be altered according to demand. The fridge and freezer were well stocked and contained foods necessary for special diets. A client requested a yoghurt as a snack and was given a selection to choose from. Clients can have their lunch at the day centre in Folkestone, or take packed lunches when out on activities. If a client chooses to buy a meal out rather than take a packed lunch, the meal is payable by the client unless part of his care plan. Staff have an allowance for meals taken out with service users paid for out of petty cash. Local shops are used for general shopping. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 Clients benefit from health care and support being provided to meet their individual needs. EVIDENCE: Staff on duty had a very good understanding of the preferred routines of each client, as recorded in care plans seen. Clients have clothing and hairstyles which they like and have helped to choose. There is a small staff team giving consistency of staff working with the clients, this is particularly beneficial to those clients who find change difficult. The local diabetic nurse was giving training to staff on duty regarding new systems for blood sugar testing. Staff were responsive and interested. Records of attendance at appropriate health services were recorded in life plans. Specialist services are accessed as required including some practitioners contracted or employed by Counticare. Clients are registered with a local General Practitioner. Medication was not examined in detail other than to identify that internal and external medications are now separated and there is suitable storage for controlled drugs. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not inspected EVIDENCE: Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 & 30 Clients benefit from modern, well decorated and comfortable premises in which to live. The risks of cross infection will be reduced when suitable soap dispensers and hand drying facilities are provided. EVIDENCE: Cosy Lodge is a domestic style property which is well maintained and decorated in a homely style. The kitchen has recently been completely refurbished, as has one bathroom. The manager said the other bathroom was to be similarly refurbished. Other areas of the home have been redecorated giving a clean, modern and comfortable environment. A housekeeper oversees cleaning. There is ample communal space for clients to use with a separate lounge and dining room. The dining chairs are to be replaced with wooden chairs. Bedrooms are large and well personalised, for single occupancy and with plenty of storage space. None have washbasins, but there are two very large bathrooms on the first floor with separate shower cubicles and toilet. A client indicated he liked a bath best but thought the shower was also good. Staff have their own toilet and shower on the ground floor but do not have Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 17 separate sleep in rooms, using the lounge and the dining room when clients have gone to bed. There are large secure, attractive and very well maintained gardens to the rear of the property with super sized swing and trampoline for clients use. Seating and tables are provided on the patio with a brick barbeque for summer use. No specialist equipment is needed. A separate laundry room is sited to the rear of the house with washing machine, tumble drier and storage cupboards. Clients may assist with their washing. At the time of inspection there was no soap or safe hand drying facilities in either bathroom, the manager said these were on order. There is one phone line which serves the clients phone and the office. In addition there is a company mobile phone which can be used. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33 & 35 Clients are supported by a staff team who are interested and motivated to provide a good standard of care. EVIDENCE: A relatively small mixed gender team work at Cosy Lodge. One person is due to transfer to another Counticare home and another has just transferred from one. Staff spoken to were clear about their roles and responsibilities. Of those on duty one was a Senior Team Leader, one a Team Leader and the other an acting Team Leader. The acting Team Leader spoke of the skills, experience and qualifications necessary to be a Team leader, as she hadn’t completed her NVQ level 2 she would not be offered a full Team Leader post at present. Consideration is being given to creating a Deputy Manager post. Job descriptions for staff which reflect their roles have been seen at other Counticare services. Throughout the inspection, there was evidence of very good relationships between staff and clients, with much two-way interaction, appropriate communication – including signing, and unobtrusive monitoring of those at risk. The manager is aware of those staff with whom certain clients relate best with shifts planned in response. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 19 At the time of the inspection three staff were on duty, they advised that three were rostered on when the house was full but may be reduced when clients were on holiday. One client required one to one monitoring. Staff spoke of regular staff meetings being held. A recently transferred member of staff spoke of being interviewed for the post. The inspector was unable to confirm this in records as they remained at her previous service. She had undertaken a recorded induction over three days but was familiar with many of the polices and procedures having worked for Counticare for some years. She felt that the core of her induction was to get to know clients. Counticare have their own training coordinator. Staff spoke of a range of training they had undertaken including core and client specific training. The manager spoke of excellent ‘training’ given by an autistic woman which staff attending had found very enlightening. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,41 & 42 Clients benefit from a service which is safe and well managed. EVIDENCE: There is no registered manager, the registered manager of the adjacent home, Summerlands, also oversees Cosy Lodge. The manager has many years experience in working with adults with learning disabilities, including in a management role. He holds relevant qualifications in management and care. The manager felt he was able to implement policies and procedures which were relevant to Cosy Lodge. Policies were not inspected in sufficient detail to make a judgment as to their suitability. From previous inspection reports, the inspector is aware that service users benefit from an improved atmosphere, better management systems, greater recreational opportunities and enhanced environment over the last two years. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 21 Staff evidenced that they were aware of the management structure, the senior Team Leader taking general day-to-day responsibility but referring as necessary to the manager. Regulation 26 visits are made with a copy of the report sent to the Commission. Records are stored securely with those seen containing detail as required by regulation. The manager was aware that the personnel files of all staff must be in the home and available for inspection at all times, a memory lapse by another manager meant one file was not at Cosy Lodge. A new record sheet to receipt any valuables for safekeeping has been set up. Staff evidenced they had had training in safe practices and carried out learning in practice. The fire record showed that all staff had had a recent fire drill as confirmed by those staff on duty. Records of maintenance and servicing were not examined. Food was stored properly including date labels on opened foods. Fridge and freezer temperatures are checked daily. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 2 3 2 3 1 Standard No 11 12 13 14 15 16 17 3 2 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 2 2 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cosy Lodge Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 1 3 x H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 23 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. 1. Standard 1.1 Regulation 4 (1) (c) Requirement As planned, the statement of purpose must include detail of actual staff employed and training/qualifications held by those staff Systems and facilities must be put in place to reduce or remove the risks of cross infection. This will include that each hand basin has suitable soap dispensers and hand drying facilities as planned All records relating to staff must be available for inspection in the home at all times, this will include personnel and recruitment files. Timescale for action To be actioned by 15 August 2005 and thereafter To be actioned by 15 August 2005 and thereafter To be actioned by 15 August 2005 and thereafter 2. 30 (1) 13 (1) (3) 3. 41.1 17 (3) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 26.2 28.3 Good Practice Recommendations Consideration should be given to providing a separate phone line for use by clients which enables them to use a telephone in private. Consideration should be given to providing dedicated a staff sleep in area which is separate from clients communal H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 24 Cosy Lodge areas. Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT 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 Cosy Lodge H56-H06 S23375 Cosy Lodge V226777 070705 Stage 4.doc Version 1.40 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. 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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