Inspection on 12/09/05 for Courtlands Lodge

This inspection was carried out on 12th September 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

Courtlands Lodge 01/06/07

Courtlands Lodge 05/05/06

Courtlands Lodge 02/06/05

Courtlands Lodge 13/01/05

Courtlands Lodge 12/07/04

Courtlands Lodge 19/02/04

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

CARE HOME ADULTS 18-65 Courtlands Lodge 25 Langley Road North Hykeham Lincoln LN6 9RX Lead Inspector Roger Harrison Unannounced 12 September 2005 09:30 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. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Courtlands Lodge Address 25 Langley Road North Hykeham Lincoln LN6 9RX 01522 693800 01522 687628 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) Dr Kalaria Life Care (UK) Ltd Mrs M Gale Care Home with nursing 29 Category(ies) of MD Mental Disorder Both 24 registration, with number MD(E) Mental Disorder-over 65 years Both 5 of places Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: A Condition of Registration is that the maximum number of service users in the home with Nursing needs does not exceed 24 (MD) and the maximum number of service users with Personal Care needs only, does not exceed 5 (of which 2 are under the category of MD and 3 are under the category of MD(E)). Date of last inspection 2 June 2005 Brief Description of the Service: Courtlands Lodge is situated in North Hykeham which is approximately three miles from the centre of Lincoln. The home is located on a bus route to Lincoln and North Hykeham has a range of shops and community facilities such as shops, a post office, a swimming pool, public houses and food outlets. The home is of single storey construction and accommodation comprises of eleven single and nine double rooms. The home is registered to provide accommodation for twenty nine residents with a Mental disorder, including three residents over sixty five years of age. The home has a philosopy of care which states its aim is to provide residents with a secure, relaxed and homely envioroment in which their care, well being, comfort and development are of prime importance. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a five and a half hour period. The current manager Maggie Gale was present during the inspection. The inspector toured the building and talked with residents, the Deputy manager and the care team using a method of inspection called “case tracking”. This involved selecting three residents in order to track their experience of the care they receive through the checking of their records at the home, discussion with them, care staff and observation of care practices in the home. What the service does well: What has improved since the last inspection? The requirements set during the last inspection have been fully considered by the homes owner and management team. The manager has provided evidence which confirms residents needs can be met prior to any admission. The home owner is further upgrading the communal bathing areas in order to make them less clinical. The home owner is also taking steps to listen to, and consult with the staff team more regularly. The home is actively seeking to recruit staff and issues regarding staff handover have been addressed. During the last inspection it was highlighted by the inspector that one residents needs could not be met. The home have taken action to work with the resident and other professionals to find an alternative placement. This move has been completed. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 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. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 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 Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 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) 2 The home has appropriate policies and procedures for the assessment and admission of residents to the home which are being followed. Assessments support the physical and social care needs of each individual. EVIDENCE: The home has a range of appropriate policies and procedures which include a Residents guide and statement of purpose. These documents are made available to new residents and their family carers prior to admission. Residents are encouraged to visit the home and records looked at confirm an assessment of need is carried out by the manager and senior care team before any move takes place. The home also provided written evidence confirming that new residents are informed in writing that needs can be met before admission, and the manager confirmed that trial periods are used in order to fully assess needs alongside those of residents already living at the home. The inspector observed staff promoting choice for residents to either spend time in their rooms, in the communal lounge or by going outside the home to take part in activities of their choosing. Staff were able demonstrate a good understanding of the needs and wishes of those they care for. During the last inspection it was highlighted by the inspector that the needs of one resident could not be met by the home. The manager has taken action to support a move for the resident which has helped to safeguard other residents and the staff team. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 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 and 9. Care plans contain sufficient information to ensure that the care needs of residents are met and are used in practice to actively support each individual. The staff enable residents to make choices about the way they wish to live. EVIDENCE: Each resident has an individual Key Worker who completes and develops a care plan together which documents existing and changing care needs. The inspector saw evidence of care plans which included risk assessments that were used to further support residents to make choices about how they wish to live along with recording responsibilities that each has in maintaining independence within the home and wider community. Care plans are reviewed by key workers every two months, or whenever changes occur. Residents are invited to review meetings as part of the process and residents told the inspector that “Its really fine here. The staff are good” and “The staff help me make decisions and check I am always okay”. One resident told the inspector how the risk assessment process had helped him to identify key risks in going Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 10 out alone and how this had helped him to make his own decisions, and take greater responsibility when travelling outside the home more safely. Care plans are detailed and demonstrate that the support given to residents by the care team is at the centre of the day to day process of care giving. The homes deputy manager has commenced a process to update information on care plans to make them easier to read so that they describe each residents own social and health care needs in date order to give greater clarity and consistency when reading or looking for specific information. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 11 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 and 17. Activities are used to promote independence and increase confidence. Residents are supported by the care team to develop and maintain personal relationships with residents that they live with and family members within the community. EVIDENCE: Residents told the inspector that they keep contact with family either through direct contact or with support from staff/community Social Workers. Residents told the Inspector that they are able to come and go as they wished. The inspector talked to a group of residents who were getting ready to attend an age appropriate day facility outside the home. Staff and residents also told the inspector about different social activities attended in the community and trips organised by the staff team which met the needs of residents. There is a card system used for residents to inform staff when they are leaving or returning to the building. This system upholds the right to be independent for residents Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 12 whilst offering monitoring and support appropriate for each resident. Rooms were personalised to a high level and the inspector talked to residents in their own rooms observing and listening to individuals talking about, and showing the inspector artwork, music, books, television and radio programmes. Care staff were seen to respect the right to privacy for individuals. There are nine shared rooms in the home which were seen to be appropriately divided to ensure privacy. All beds have individual call bell systems which residents use whenever help is needed from staff. Residents have keys to their own rooms which can be accessed by staff in an emergency. Some residents have their own mobile phones and there is a telephone in the communal area for residents use. If private calls are needed the managers office is made available for those who wish to use it. Staff told the inspector that it is important to encourage contact with family and were able to encourage residents to maintain and develop relationships as they wished. Meals within the home are regarded as an important part of care provision. All residents are asked about likes and dislikes and are able to contribute to the menu choice. The weekly menu is planned with input from residents and provides nutritious food with alternatives available for those that want them. This was confirmed by residents through individual and a group discussion. The inspector observed residents enjoying a wholesome lunch which is served using two different sessions. This system is used by the staff team in order to give greater time for residents to enjoy their meals with appropriate support and was set up through full discussions with residents about their needs and how they would like them to be met. Food at the home is prepared and cooked in the kitchen to a high standard. Two residents told the inspector “The food here is brilliant” and a group of residents described the meals they received as good quality with plenty of choice. During the last inspection the inspector highlighted a need to offer residents a variety of options for breakfast and that this should be written onto the menu plan. Residents told the inspector that they can have whatever they want for breakfast and the Manager confirmed during this inspection that cooked breakfasts are available to all residents if they request it. Other alternatives are also available at breakfast upon request. The manager did agree that more written information needed to be included on the menu plan for residents to see so that the option for alternatives is made explicit, this is particularly important for new residents. The manager is taking action to add more detailed information to the menu plan regarding breakfast choices. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 13 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) 20. Residents are protected by the homes policies and procedures for storing and administering medication. EVIDENCE: The home has policies and procedures in place for storing and administering medication to residents. Residents are supported to enable self medication wherever this is possible, however at the time of inspection there were no self medicating residents at the home, therefore the manager takes responsibility for all medication. The inspector saw that locked storage facilities for medication are used as appropriate. Medication records were seen to be up to date and are kept locked with medicines in the medicines office. The senior staff care team were seen to understand the medication needs of residents and the inspector observed appropriate preparation and distribution of medication to residents during the course of this inspection. Residents told the inspector that they felt their health care needs are being met and that they felt protected by the systems in place at the home. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 14 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 The home seeks residents views about the care provided and systems are in place for dealing with complaints and adult protection. Staff are aware of the action they need to take in the event of any complaint or concern relating to abuse. EVIDENCE: The home has a complaints policy and procedure for residents which is used as guidance for staff. Residents and the staff team are aware of the process to use regarding complaints and during this inspection the home manager was seen to be dealing with a complaint from a member of staff in a supportive and appropriate way by following the policies of the organisation. Residents told the inspector that they were supported by staff and one resident said “If I have any problems I talk to the manager and get the support I need”. During the inspection the inspector observed the manager talking sensitively with a resident about a specific concern. Ideas to resolve the problem were shared and the manager described the action she would take to improve things for the resident whilst maintaining confidentiality. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 15 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) These outcomes were not looked at. EVIDENCE: Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 16 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 and 35. The manager, deputy manager and care team attend training to give them the skills needed to carry out and develop their roles within the home. EVIDENCE: During the last inspection concerns were raised about the handover of information regarding residents at the time staff commence work. The manager confirmed that more discussion does take place and time is used at the start of each shift to ensure information is shared. Residents told the inspector that the staff are very supportive and helpful and that they felt there was always someone available when needed. The home continues to actively try to recruit new staff. While this is ongoing temporary or bank nursing staff are being used to ensure sufficient staffing is maintained. The home manager said that communication had improved and staff told the inspector that they felt positive about the day to day support they receive. Staff roles and responsibility was seen to be delegated consistently throughout the inspection by the manager and deputy manager. Senior care team members had specific roles, for example administering medication, which were being undertaken in the right way whilst giving support to other care team members. Training for all staff is supported by the home owner and manager and the home are working toward identifying and supporting staff to achieve National vocational qualifications to the required levels by December 2005. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 17 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 and 43. The home has a competent manager and deputy manager who understand the needs of residents. Residents benefit from the consistency and support given to staff by the management team. EVIDENCE: Action taken by the manager since the last inspection demonstrates that residents needs are regarded as paramount. Care plans, reviews and the key worker system in place confirmed what residents told the inspector about the high level of support each receives. The current manager is leaving her post soon to take up another role in the care profession. It was confirmed during inspection that the deputy manager will be taking over the position temporarily and has commenced an application to become the manager of the home. The home is run in an appropriate way by the current manager. The deputy manager intends to continue with current systems in order to maintain consistency for residents which was seen as important, and has met with the proprieter of the home in order to discuss positive plans for developing the service. The staff team were seen to work well together and told the inspector Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 18 that they felt supported by the manager and deputy manager to their job. The manager told the inspector that morale had improved since the last inspection and that the work being undertaken to improve the building had helped staff to feel things were developing in the home. During the inspection the inspector talked to the homes proprieter about the benefits of ongoing communication between the owner and staff. During this period of management change the proprieter informed the inspector that there will be increased contact with the management team and staff in order to increase consultation, understand any concerns and take action to address any issues which the team has. Team meetings are in place and the manager confirmed these are held monthly to enable carers to share ideas or concerns. Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 19 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x 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 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Courtlands Lodge Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 3 C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 20 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 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 Good Practice Recommendations Courtlands Lodge C53 C04 S2618 Courtlands Lodge V248541 120905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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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