Inspection on 06/12/06 for Cumberland Lodge

This inspection was carried out on 6th December 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 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cumberland Lodge 17/07/07

Cumberland Lodge 10/02/06

Cumberland Lodge 17/10/05

Cumberland Lodge 03/03/05

Cumberland Lodge 28/09/04

Cumberland Lodge 04/03/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 Cumberland Lodge 22 Cumberland Avenue Southend On Sea Essex SS2 4LF Lead Inspector Michelle Love Unannounced Inspection 6th December 2006 08:00 Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cumberland Lodge Address 22 Cumberland Avenue Southend On Sea Essex SS2 4LF 01702 602361 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) Mr David Houghton Mrs Judith Anne Hatley Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One resident over the age of 65 Personal care to be provided to 12 service users with a Mental Disorder, excluding Learning Disability or Dementia (MD). 10th February 2006 Date of last inspection Brief Description of the Service: Cumberland Lodge provides 24 hour residential care for up to twelve people with mental health issues. The home is situated within a residential area close to Southend Town Centre, with Westcliff and Leigh on Sea a short distance away. There are good bus and train links to the area. The home currently has ten single and one shared bedroom, which are located on the ground and first floor, as well as a detached annexe to the rear of the property. The home has a large well maintained garden to the rear of the property and sufficient off street parking facilities. Residents within the home access the local community independently or with staff support. The Pre Inspection Questionnaire issued to the registered provider was completed and returned to the Commission for Social Care Inspection by the due date. The range of weekly fees charged range from £385.00 to £1500.00 per week. In addition to the fees, there are additional costs for residents pertaining to hairdressing, chiropody, toiletries, magazines, newspapers, personal toiletries etc. Upon request, prospective residents and/or their representatives can have access to a copy of the latest inspection report. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced `key` site visit whereby all key standards were inspected. The visit was undertaken by Michelle Love, Regulation Inspector and commenced at 10.00 a.m. and finished at 15.15 hours. At this visit a range of records relating to individual residents (care plan documentation) and support staff, were examined (staff recruitment records, induction records, staff supervision records and training plan). Additionally an inspection of the premises was undertaken and other records relating to the homes medication systems, staff rosters, arrangements for food/menu’s and health and safety issues were examined. No visitors were observed at the care home on the day of the site visit. Following the inspectors visit, several surveys were forwarded to residents’ relatives/representatives and professionals, to seek their views as to the care and support provided to residents at Cumberland Lodge. It was disappointing to note that to date no comments have been received at the Commission. The site visit was conducted with assistance from the registered manager. What the service does well: What has improved since the last inspection? The one double bedroom within the home has been altered and now all residents residing at Cumberland Lodge have a single bedroom space. The kitchen area has been relocated and is to be refitted to a high specification. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 6 Lounge areas within the annexe and the main house have been redecorated and comments from residents were complimentary and positive. 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. The summary of this inspection report can be made available in other formats on request. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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. 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. Prospective residents are assessed prior to admission to the home and have the opportunity to visit on a trial basis. New residents/residents representatives have sufficient information so as to make an informed choice about living at Cumberland Lodge. EVIDENCE: From inspection of the pre inspection questionnaire and from discussion with the registered manager, no new residents have been admitted to Cumberland Lodge since August 2004. The homes pre admission assessment format was seen to be comprehensive. It is evident that in addition to the homes own assessment, other information is sought from professionals i.e. Care Managers, Consultant Consultants, Community Psychiatric Nurse etc. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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. 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. The homes care planning systems reflect individual residents needs and depict how care is to be provided for residents by support staff. Individual residents are empowered and supported by staff to make independent decisions about their lives. EVIDENCE: On inspection of two individual care plans, these identified resident’s needs, how these were to be met/supported by staff and included risk assessments. One resident since the last inspection, has requested that only they have sole access to their care file/records. The registered manager advised that the resident does not always like/agree what is recorded by support staff and will often dispute the information and `target` the author. As a result the registered manager has made a decision to allow the resident to keep their care file, however unbeknown to the resident there is a duplicate care plan Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 10 available for support staff. The Commission does not condone the deception but recognises that in the best interest of the individual resident, information must be made available for support staff. The registered manager was advised that the restriction imposed must be recorded within the duplicate care file and significant others i.e. professionals/resident representative made aware. Both care plans were observed to have been reviewed and updated to reflect changes. Daily care notes continue to be written regularly and contained detailed information about the residents. No formal reviews by residents placing authorities have been undertaken for some considerable time. Residents continue to be involved in daily living and living an independent life style. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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. 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. Opportunities are available for all residents to participate in both internal and external activities. Residents receive a varied and appealing diet which meets their requirements and choice. EVIDENCE: Care plans continue to evidence that some residents access and participate within `formal` activities i.e. adult education and local `drop in centre`. The majority of residents residing at Cumberland Lodge continue to organise their own daily activities. Where required, residents are supported by staff to access the local town centre for personal shopping trips and other interests within the community. The Commission have over recent months received several Regulation 37 Notifications detailing occasions whereby residents have returned to the home environment under the influence of alcohol. Evidence indicates that issues have been dealt with appropriately by the registered manager and support staff. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 12 Family and friends are made to feel very welcome. Residents wishes pertaining as to whether or not they wish to meet with their member of family/friend are respected by support staff. During the site visit, residents were observed to relax and spend time in their own room, listening to music, sleeping, watching television, conversing with others living at the home and with support staff. Residents spoken with advised that they continue to enjoy living at Cumberland Lodge and expressed support given by staff. Menus were submitted with the homes pre inspection questionnaire. The registered manager advised that residents are given the opportunity to contribute ideas/be part of the decision making processes, pertaining to menu planning and shopping. The menus are devised on a weekly basis and offer residents a flexible and varied diet. Alternative to the menu are readily available. Individual residents spoken with were very complimentary regarding meals provided. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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. 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. The home ensures that the healthcare needs of individual residents are met by a range of healthcare professionals. Systems for the safe storage, recording and administration of medication were deemed satisfactory and appropriate. EVIDENCE: Residents access and receive support from a variety of healthcare professionals and services within the local community (Consultant Psychiatry, District Nurse Services, Community Psychiatric Nurse, GP etc). The homes medication storage facilities were deemed appropriate. A list of staff names, signatures and initials depicting those staff deemed competent to administer medication was up to date and readily available. No omissions of signatures/initials were observed on medication administration records. PRN (as and when required medication) protocols were devised for all residents. The pre inspection questionnaire completed by the registered manager details ten staff are responsible for administering medication. On examination of training records, the majority of staff had received up to date medication training. Records indicate that three staff require refresher training. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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. 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 a clear and robust complaints procedure and adult protection policy and procedure. EVIDENCE: Since the last inspection (February 2006) the home has received no complaints. However the Commission received one complaint/concern from Southend General Hospital relating to the healthcare needs of one resident. On inspection of the aforementioned residents care plan/daily care records and healthcare records, there was clear evidence to indicate that the registered manager/support staff had taken appropriate action to address the issues and within a reasonable timeframe. It was concerning to note that despite attempts by the Commission to speak with Southend General Hospital, contact was not made and no further communication relating to the above was disclosed. The complaints procedure was displayed in the lobby/reception area. The registered manager was advised that this needs to be amended to reflect that the Commission for Social Care Inspection no longer has any statutory responsibility to investigate complaints. Any complaints brought to the Commissions attention will be referred back to the registered provider to deal with. In some instances the complaint may be referred to the local authority if they are contractually involved. Any information from the complaint relating to regulations and standards not being met could induce a site visit from inspectors to check compliance. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 15 Residents residing at Cumberland Lodge continue to have a good relationship with support staff. The home has a key worker system in place and residents can liaise with their `link person` and raise any issues. No protection of vulnerable adults issues have been raised since the last inspection. The registered manager advised that all staff have attained protection of vulnerable adults training and that in addition to this the home has acquired a training DVD from Southend Borough Council. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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. 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. Furnishings and décor within the premises remain to a high standard and residents live in a homely comfortable environment which suits their needs and lifestyles. Since the last inspection there have been some changes to the premises. EVIDENCE: At the last inspection the home had 10 single bedrooms and 1 double bedroom. The registered provider has altered the double bedroom and now all residents have a single bedroom space. Four of the bedrooms have en-suite facilities. The kitchen is in the process of being relocated and refitted. Both the annexe and main lounge have been redecorated. Resident’s bedrooms continue to be personalised and individualised. The home provides ample communal space, both within the main house and the annexe (lounges x2, conservatory and large lobby/reception area). The inspector was advised that it is likely that the smoking room will be reintroduced within the Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 17 home in due course. A new office space has been designated on the first floor of the main house. No health and safety issues were highlighted at this inspection. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels at the home are appropriate for the needs and numbers of current residents. Robust recruitment procedures are in force and all newly appointed staff receive an induction. All staff receive formal supervision. EVIDENCE: Fours week’s duty rosters were provided with the pre inspection questionnaire. Staffing levels of 3x staff (07.30 a.m. to 14.30 p.m.), 3x staff (14.15 p.m. to 21.15 p.m.) and 1x waking night (21.00 to 07.45 a.m.) continue to be appropriate. The rosters continue to evidence some staff working long days i.e. 07.30 a.m. to 21.15 p.m. (Total 13.45 hours). The rosters for week commencing 20.11.06 detailed that one senior member of support staff worked 4x consecutive long days without an off duty day (Total of 54.20 hours). The registered manager must review this as staff working long days could suffer with tiredness which may hamper their ability to work effectively/deliver support and care to residents. The staff rosters must include a key to decipher codes used i.e. E, L, N, R, * etc. Since the last inspection no staff have left the homes employment. One new member of staff has been appointed. On inspection of their staff recruitment Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 19 file, it was positive to note that all records as required by regulation had been sought. A copy of the employee’s job description was not available on the day of the site visit. A record of induction was readily available. Discussion took place with the registered manager regarding Skills for Care Induction Standards for new employees in the future. Details can be located on the Skills for Care Website - http:/www.topssengland.net/view.asp?id=751 Supervision for support staff is undertaken by both the registered manager and senior support worker/deputy manager. On inspection of three random recruitment files for staff, there was evidence to indicate that supervision is being conducted in line with regulatory requirements and standards. With regards to NVQ, 2x staff have NVQ Level 2&3. The senior support worker/deputy manager is completing NVQ Level 4 and 1x member of support staff is completing NVQ Level 3. The training matrix provided with the pre inspection questionnaire highlights that since the last inspection the registered manager has successfully completed a course to be the homes manual handling trainer, 1x staff member has undertaken manual handling training, 6x support staff have commenced infection control training, 3x staff have undertaken medication administration training and 1x member of staff has completed training relating to risk assessments and COSHH (Control of Substances Hazardous to Health). The registered manager is aware of some shortfalls relating to refresher/updated mandatory training for some staff and the need to provide specialist training i.e. mental disorder, challenging behaviour, alcohol/drug addictions, falls and pressure area care. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. 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 registered manager is competent and experienced. The home is well managed and run in the best interests of the residents. EVIDENCE: The registered manager has been at Cumberland Lodge for the past 7 years. The registered manager is due to complete the Registered Managers Award by April 2007. Both support staff and residents were complimentary regarding the management of the home. The manager advised that quality assurance questionnaires have not been completed for 2006, however as detailed within the last inspection report, a residents questionnaire had been devised and completed. No questionnaire is available for support staff/professionals to complete. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 21 Although the registered provider visits the care home daily and has a good all round knowledge of issues arising, Regulation 26 visits/reports have not been completed. Following discussions with both the registered provider and manager, it has been agreed that visits/reports will be conducted bi monthly. A random sample of records as required by regulation were inspected pertaining to fire drills, fire alarm testing, emergency lighting, fire equipment, employers liability certificate and the homes gas safety certificate. All records were deemed satisfactory. A copy of the homes electrical certificate was not available on the day of the site visit, this must be forwarded to the Commission within 7 days of receiving this report. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 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 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 2 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 3 34 3 35 2 36 3 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 3 X 2 X X 3 X Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 YA23 YA35 Regulation 13(6) 18(1)(c) Requirement Ensure that all staff have training relating to challenging behaviour. Ensure that specialist training relating to residents specific needs are provided to all staff. Reports under this regulation are devised and completed bi monthly. Previous timescale of 10.8.06 not met. Timescale for action 01/06/07 01/06/07 3. YA39 26 01/02/07 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. 3. Refer to Standard YA22 YA32 YA32 Good Practice Recommendations The complaints procedure needs to be amended to reflect that the Commission no longer investigates complaints. Devise a key on the staff roster for codes used. Staff should not work too many consecutive long days on duty. Cumberland Lodge DS0000015430.V320515.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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