Inspection on 20/06/05 for Court Lodge

This inspection was carried out on 20th June 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Court Lodge 22/08/07

Court Lodge 13/10/06

Court Lodge 03/11/05

Court Lodge 17/02/05

Court Lodge 27/04/04

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Insight - Eastchurch

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

CARE HOME ADULTS 18-65 Court Lodge Church Road Mersham Ashford Kent TN25 6NS Lead Inspector Sue Gaskell Unannounced 20 June 05 09:00 and 23 June 05 10.00 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. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Court Lodge Address Church Road, Mersham, Ashford, Kent, TN25 6NS 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) 01233 503117 Counticare Limited Ms Anna Page Registered Care Home 6 Category(ies) of Adults with a Learning Disability registration, with number of places Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17.02.05 Brief Description of the Service: Court Lodge provides residential care to up to 6 adults with a lerning disability. The home is owned by Counticare Ltd, a provider of approximately 14 services throughout the East Kent area. The Home is situated in the village of Mersham, some 15 minutes drive from the town of Ashford where there is a variety of amenities such as shops, swimming pool, a cinema, churches, pubs, clubs and colleges . The home has access to a minibus and other vehicles owned by the company. Residents also make use of the day centre owned by the company. Court Lodge is a detached chalet bungalow which comprises individual bedrooms for each resident, a lounge, kitchen, dining room, laundry room and office. There is a large enclosed rear garden with seating and a barbecue area, and there is a large parking area to the front of the property. Staffing comprises the registered manager and support staff. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over approximately 4 hours on 2 separate days as on the first visit the manager and residents had an appointment elsewhere. The Inspector toured the building and inspected a number of records, policies and procedures. 3 of the 6 residents were spoken to, in addition to the manager and another member of staff. What the service does well: What has improved since the last inspection? What they could do better: There are still outstanding issues from previous inspection reports which the company has failed to address. Although the Statement of Purpose and Service User Guides have been amended, they still do not show the fees charged by the home. Some residents’ contracts have been revised, but there is still insufficient clarity on what is provided by the company and what residents have to pay for, eg residents have to pay for any outings/activities carried out at weekends, but this is not specified in their contracts. The company must provide the CSCI with copies of letters to the residents’ care managers informing and/or reminding them that this is the case and asking the care managers for confirmation that they have approved this arrangement. The company must also provide CSCI with copies of the responses from the care managers. There is still no hand wash basin in the kitchen and the folding bed used by sleeping in staff in the office is worn and inadequate for regular use. There is a strong smell of urine in one bedroom and the carpet and mattress are heavily soiled. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 6 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. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 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 Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 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, 5 Only limited progress has been made to ensure that the homes’ Statement of Purpose and Service User Guides provide prospective residents with the true costs of the services provided. Prospective residents’ health care, emotional and social needs are assessed prior to their admission to the home. Residents’ contracts do not provide prospective residents with the true costs of the services provided. EVIDENCE: There are still outstanding issues from previous inspection reports that the company has failed to address. Although the Statement of Purpose and Service User Guides have been amended, they still do not show the fees charged by the home. Some residents’ contracts have been revised, but there is still insufficient clarity on what is provided by the company and what residents have to pay for, eg the manager confirmed that residents have to pay for any outings/activities carried out at weekends. Whilst residents’ contracts state that some activities must be paid for they do not specify that this is at weekends. The care plans included written pre-admission assessments, carried out in conjunction with the placing agencies. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 9 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) 6,7,9 The health care and social needs of residents are well met and they are consulted and encouraged to contribute to any decisions that affect their lives. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. EVIDENCE: The individual care plans are reviewed regularly and include details on short and long term goals and how the home will assist residents in achieving their goals. Residents have key workers who monitor their individual needs and activities. Residents are assisted in understanding the contents of their care plans and encouraged to sign them where possible. Risk assessments are prepared and include specific guidelines. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 10 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) 12,13,15,16,17 Links with the community are good and residents have the opportunity to participate in a range of activities appropriate to their age and peer group. Meals in the home are good, offering a healthy, nutritious diet with choice and variety. EVIDENCE: Residents said that they are consulted over what activities they would like to do, either on company premises or within the community. This includes therapeutic work activities within the company, eg office work, for which residents receive a small remuneration of £2.50 per hour. Activities are generally carried out with the assistance of staff but residents are encouraged to be independent whenever appropriate. The menus and contents of the store cupboard were seen to be varied and appropriate for a balanced diet. 1 resident said that residents are encouraged to make suggestions about the menu and to assist with food preparation whenever possible. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 11 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) 18,19,20 Staff have a good knowledge and understanding of residents’ physical, emotional and support needs and provide this according to residents’ wishes and preferences. The medication administration and storage systems are sound and appropriate to residents’ needs and wishes. EVIDENCE: There were specific guidelines in some residents’ care plans and the manager said that staff are advised to put these into practice in a practical and sensitive manner. The residents were clearly comfortable with staff and able to talk about serious issues. There was also appropriate banter between staff and residents. The medication is stored safely and the administration of medication was clearly and appropriately recorded. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 12 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) 22,23 There is a sound complaints system and the home makes every effort to protect residents from abuse or harm. EVIDENCE: Two residents and all staff were aware of the home’s complaints procedure, and two residents said that they would feel comfortable in mentioning anything that they were not happy with. One resident said that she felt “safe” in the home. Staff have been provided with training to enable them to recognise different forms of adult abuse and the correct way of responding. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 13 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) 24,30 Whilst the general standard regarding the environment is adequate, there are specific areas requiring attention which could affect hygiene. EVIDENCE: Whilst the home is generally clean and well maintained, one residents’ room smelt strongly of urine. The carpet and mattress in that room were heavily stained. Other rooms were of an acceptable standard. There is still no hand basin provided in the home’s kitchen even though residents, and visiting service users from other homes within the company, use the kitchen for food preparation. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 14 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) 35 The deployment, training and supervision of staff at the time of the inspection was sufficient to ensure good quality care. EVIDENCE: Although only the manager was on the premises at the time of the first inspection due to staff sickness, this was sufficient for the care of the residents present in the home at the time, and there were staff within close proximity in the event of an emergency. Staff files included reference to induction training, training in core subjects, and on-going training in NVQ’s which is funded by the company. Staff receive regular supervision and staff morale appears to have improved. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 15 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) 39,42 The home regularly reviews aspects of its performance, which includes seeking the views of residents, their relatives and staff. While generally of an adequate standard, there are some health and safety issues which require attention. EVIDENCE: Various policies and procedures have been reviewed by the manager since the last inspection. Two residents said that they are asked about how they feel about different aspects of the day to day management of the home and that their suggestions are listened to and acted upon. Various health and safety checks were recorded, such as fire alarm testing, and risk assessments had been prepared. Apart from the health and safety issues referred to in Standard 30, the folding bed in the office, used by staff who are required to sleep in, was worn and inadequate for regular use. Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 16 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 x x 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Court Lodge Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 17 yes 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. 2. Standard YA1 YA5 Regulation 5 5 Requirement The Service User Guide must state the fees charged and the costs of additional extras. Contracts must specifically reflect the services offered and the Service User Guide and Contracts must show the fees. specified in their contracts. The company must provide the CSCI with copies of letters to the residents’ care managers informing and/or reminding them that the fees paid do not include activities a weekends and asking the care managers for confirmation that they have approved this arrangement. The company must also provide CSCI with copies of the responses from the care managers. i A handwash basin must be installed in the kitchen. Replace soiled carpet and soiled mattress in room 6 Provide adequate furniture for sleeping in staff. Timescale for action 31.07.05 31.07.05 3. 4. 5. YA30 YA30 YA42 13 13 HSWA 1974 31.07.05 31.07.05 31.07.05 Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 18 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 Good Practice Recommendations Court Lodge H56-H05 S23374 Court Lodge V231831 200605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU 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. 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