Inspection on 05/05/06 for Courtlands Lodge

This inspection was carried out on 5th May 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

Courtlands Lodge 01/06/07

Courtlands Lodge 12/09/05

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 Lincs LN6 9RX Lead Inspector Roger Harrison Unannounced Inspection 5th May 2006 09:30 Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 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 Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 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. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Courtlands Lodge Address 25 Langley Road North Hykeham Lincoln Lincs LN6 9RX 01522 693800 01522 687628 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) Life Care (UK) Ltd Ms Melanie Ludkin Care Home 29 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (24), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (5) Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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)). 12th September 2005 Date of last inspection Brief Description of the Service: Courtland’s 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 five residents over sixty-five years of age. The home Manager is currently developing and updating information a brochure to support the promotion of the home to emphasise the philosophy of care, which states its aim is to provide residents with a secure, relaxed and homely environment in which their care, well being, comfort and development are of prime importance. Fees at the home on 05/05/2006 range from: £348.00 - £380.00pw. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information regarding Inspection records and information provided by the Manager available to the Inspector about Courtland’s Lodge, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying three residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived at Courtland’s Lodge. The inspection site visit was achieved by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 6 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 Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 7 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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has appropriate policies and procedures for the assessment and admission of residents to the home, which are being further developed. Assessments support the physical and social care needs of each individual. EVIDENCE: Information provided by the Manager prior to, and during the Inspection site visit confirms that the home has a range of appropriate policies and procedures, which include a Residents guide and statement of purpose. The Manager is updating and developing documentation about the home. The most recent monthly report from the home-owners confirms that there have been no new admissions for the last year. However, a group of six residents told the Inspector that these documents were made available to them prior to admission. Residents also said that they were encouraged to visit the home and records looked at confirm an assessment of need is carried out by the manager 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. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 8 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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans contain clear information to ensure that the care needs of residents are met and are used in practice to actively support each individual. Staff enable residents to make choices about the way they wish to live. EVIDENCE: Records available at the home confirm that each resident has an individual Key Worker who completes and develops a care plan together with residents, 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. One resident told the Inspector that, “I’ve got a key worker who I can talk to when I have any issues or need support with anything”. Care plans looked at confirmed that key workers review them every two months, or whenever changes occur. One resident said “I’m meeting my Social Worker next month to review my options for moving on”. 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. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 9 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: Information provided by the Manager since the last Inspection and reviewed by the Commission shows that resident’s family members are involved in risk assessment review meetings wherever possible. During the site visit to the home a group of three 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. Residents also told the inspector about different work and social activities attended in the community, which they said met their needs. There is a card system used for residents to inform staff when they are leaving or returning to the building. This system supports the right to be independent for residents 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 and in communal areas of the home. During these discussions care staff were seen to act sensitively to respect the right to Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 10 privacy for individuals. There are nine shared rooms in the home, which were seen to be appropriately divided to ensure privacy. All rooms 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 were able demonstrate a good understanding of the needs and wishes of those they care for. Menu plans provided by the Manager before the Inspection confirms that the home offers a varied and nutritious diet to meet the personal choices of residents at the home. The Manager told the Inspector that she regards meals as an important part of care provision. All residents told the Inspector that they are asked about likes and dislikes and are able to contribute to the menu choice. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 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 the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff in the right way to ensure health needs are met, and to understand wider needs in order to encourage choice for each individual. EVIDENCE: Care plans looked at during the site visit to the home provided information of all residents’ physical health care and medication needs and social needs, and that these are reviewed regularly. There was information on resident’s files, which confirmed good communication between the staff team and local medical practice/other professionals is maintained in order to provide support as appropriate as part of the review process. During this site visit the Inspector met with six residents who all said they were aware that they had a care plan. During the site visit the Manager confirmed that all residents require support with medication. The Manager showed the inspector the homes medicine storage and systems along with records used for giving out medicines in the correct way. These were all seen to be working in an organised way, with management and disposal practice in place to make sure residents are given the right medicines at the right time. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has measures in place for residents to raise concerns and express their views provides training and support for staff to make sure they are able to act in order to protect the residents from the risk of abuse or harm. EVIDENCE: During the site visit to the home five staff members told the Inspector that the Manager has an open door policy, which a group of three residents said helped them to raise any concerns direct with the Manager. The Manager confirmed that the Policy system for complaints and comments is being updated to make sure that residents know who to go to if they have concerns, The Manager also confirmed that staff are aware of the Policy for protecting adults in Lincolnshire and that staff received update training on 20/02/2006. This training remains ongoing to cover all staff. Four care team members told the Inspector how they would report any concerns they had to the Manager and that they understood the training they had received. The Manager confirmed that there had been no formal complaints made since the last inspection and key information provided by the Manager, shows that the care team are able to act to protect residents from abuse. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 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 the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a safe, clean and well-maintained environment for residents. EVIDENCE: During the site visit to the home the inspector found individual and communal areas to be clean and well maintained. Records provided by the Manager show that since the last Inspection the Manager has updated Fire safety records to comply with a Fire safety officer report. Since the last Inspection the Manager has also taken action to undertake a programme of full decoration at the home and three Residents told the Inspector that they liked the way the home had been recently painted. During the site visit work was also being undertaken to paint the fascia boards at the front of the home and it was clear from information provided and through this visit that restrictors have been fitted to all windows at the home and that some new windows had been installed as part of the ongoing maintenance programme. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 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 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 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager has safe recruitment procedures in place and provides appropriate levels of support to the care team, who are able to use training provided to support residents within the home and wider community. EVIDENCE: Information provided by the Manager before the site visit confirmed that staffing levels are currently being maintained well. Through a discussion with the manager and checking three staff files it was also confirmed that the organisation operates a structured recruitment policy with safety checks carried out to ensure that there is a balance skilled staff available for all residents. The Inspector met with a group of five staff members during the Inspection. The group individually described the right sort of action to take to protect residents from fire and from abuse. On the day of inspection there was a good mix of staff in place, who were working actively with residents providing physical and sensitive emotional support either in their own rooms or in the main activity areas. Other residents were being supported to attend outside activities. There is a structured programme of training in place for the year and the Manager provided details of key training that carers are encouraged to undertake so that the established team continue to maintain good levels of NVQ training for staff. Staff were able demonstrate a good understanding of the needs and wishes of those they care for. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 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 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager understands the needs of residents, who benefit from the consistency and support given by the manager and staff team. EVIDENCE: Since the last Inspection the deputy Manager was registered to undertake the role of Registered Manager on 16/02/2006, and is due to complete the registered Managers award in December 2006. The Manager has a “hands on approach”, which residents responded to throughout the site visit, and which five care team members said supported them in their duties. The manager told the inspector that she understands her responsibilities toward staff and residents, and since the last inspection has undertaken a quality audit questionnaire with residents. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 16 The Inspector looked at Resident’s and family comments and one family carer said, “The Manager is a star”. A family carer also commented that; “Courtland’s is a fabulous place for my Dad”. During the site visit the Inspector observed care team members being supported by the Manager to carry out the health and personal care needs of residents and a family carer visiting the home commented that; I’m really impressed with the care on offer here, I’m a trained nurse and feel that the Manager and staff are doing a great job”. Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 17 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 X 2 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 18 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. Refer to Standard Good Practice Recommendations Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Lincoln Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Courtlands Lodge DS0000002618.V286851.R01.S.doc Version 5.1 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!