Inspection on 11/01/06 for Dorset Lodge

This inspection was carried out on 11th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Dorset Lodge 17/04/07

Dorset Lodge 20/09/05

Dorset Lodge 28/03/05

Dorset Lodge 16/12/04

Similar services:

Chesham House

Argyll House

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

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

CARE HOME ADULTS 18-65 Dorset Lodge 5-7 Dorset Gardens Rochford Essex SS4 3AH Lead Inspector Pauline Marshall Unannounced Inspection 11th January 2006 10.15 Dorset Lodge DS0000018109.V277027.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 Dorset Lodge DS0000018109.V277027.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. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Dorset Lodge Address 5-7 Dorset Gardens Rochford Essex SS4 3AH 01702 545907 01702 541517 Julie@dorsetlodge.fsnet.co.uk 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) Dorset Lodge Limited Company Mrs Julie Turner Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Dorset Lodge is a care home that provides care and accommodation to ten adults with mental health problems. The home is situated within walking distance of local shops and within a bus ride of Rochford and Southend town centre. Public transport is easily accessible. The home is decorated, maintained and furnished to a high standard, there is a comfortable lounge, a separate smoking lounge, a large kitchen/dining area and eight single bedrooms and one shared bedroom. Most of the bedrooms have en-suite facilities the remaining bedrooms have their own designated bathrooms. The property has a small garden to the rear and there is limited parking to the front. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection and lasted 6 hours and 10 minutes. The inspection process included a tour of the premises, inspection of a sample of policies and procedures, care and staff files. Discussions took place with the manager, three staff members, three current service users, one ex service user and two visiting professionals. 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. Dorset Lodge DS0000018109.V277027.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 Dorset Lodge DS0000018109.V277027.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, 3 The homes admission process ensures that prospective service users know that their aspirations and needs will be met. EVIDENCE: A full comprehensive pre-admission assessment is carried out in addition to the full forensic assessment provided by the Mental Health Service. The Care Programme Approach was evident in each of the care files sampled. The homes statement of purpose and service user guide set out clear and accessible information for the service users. All service users require specialist input from the mental health service; there are regular fortnightly visits from the team to check on the progress of the care plans. The Phoenix advocacy service based in Southend has been used in the past by the home however is not used at present by any of the service users. Staff have received training in moving & handling, fire awareness, health & safety, death & dying and first aid in addition to training in mental health issues. The manager does in-house training on a regular basis to update staff. Dorset Lodge DS0000018109.V277027.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): 9, 10 The home supports service users to take risks and ensures that information is handled appropriately and their confidences are safeguarded. EVIDENCE: Risk assessments are carried out by the mental health service and the home; they are recorded in the care plan and reviewed regularly. It was clear from discussions with the service users that they are involved in the whole of the care planning process including risk assessments and management plans. The home has a clear policy on unexplained absences. Staff sign the staff awareness form to confirm that they know about all of the policies and procedures. A copy of the confidentiality policy is written in the statement of purpose, service user guide, service user contracts and displayed on the kitchen wall. All records are stored in the office, which is kept locked when not in use. Dorset Lodge DS0000018109.V277027.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): 17 The home offers service users a healthy diet of their choosing. EVIDENCE: Meals are chosen by service users either at meetings or on an individual basis, mealtimes are flexible to suit service user needs and requirements. Service users are not encouraged to eat their meals alone in their rooms. The manager stated that the current service users care plans promoted the social aspect of mealtimes and that eating alone in their rooms might encourage seclusion as all the current service users are prone to depression. Service users spoken with said that the food was good and that they chose what they wanted to eat. Nutrition records are kept for each individual service user. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 10 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): 20, 21 Service users are protected by the homes policies and procedures in dealing with medication. The subject of ageing, death & dying sometimes presents a problem due to the age of current service users. EVIDENCE: Trained staff administers medication; the home uses the Boots blister pack system. The homes policies and procedures on dealing with medication are clear. An order sheet is used to confirm when medication is ordered and received or returned to the pharmacy. Storage of medication is in a locked metal cabinet in the laundry room. There are no controlled drugs in the home at present. Protocols for medication prescribed “as and when required” (PRN) have been developed as recommended in the last inspection. Service users wishes are discussed at the Care Programme Approach (CPA) meeting and recorded on the care plan where agreed. The manager stated that most of the service users were quite young and sometimes did not want to discuss the issue, and they have said, “ask mum”; this is recorded in the care plan. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 11 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): 23 The home protects the service users from abuse, neglect and self-harm. EVIDENCE: The home has a copy of the Essex County Council Protection of Vulnerable Adults Procedure in addition to their own policy and procedure. Staff are trained in house by use of BVS video training resources. The homes policies and procedures on physical and verbal aggression give clear instructions for staff to follow. Service users spoken with said they felt they were able to discuss any concerns with staff. The home has a clear complaints procedure with details are written in the statement of purpose and service user guide. The home does not handle any service users money or financial affairs. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 12 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, 30 The home provides a safe, clean and homely atmosphere and environment. EVIDENCE: All bedrooms in the home are comfortable and individualised with personal items and each room had either an en-suite or its own designated bathroom. The home has two lounges, one of which is for smokers to use; this room has been recently redecorated. The home is a short bus ride away from Rochford and Southend town centres; there are two parks nearby and a drop in centre within one mile and a church and local shops within walking distance. The kitchen was clean and tidy with well-stocked cupboards. Times for tea and coffee were displayed on the cupboard door. All store cupboards with locks on, were locked when checked. The large kitchen/dining room was nicely laid out in a homely fashion and overlooks a small paved garden with flower borders, which is accessed through the patio doors. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 13 The furniture and fittings are of good quality and there was sufficient light and heat at the time of the inspection. The home does not have a repairs and renewals plan, however the manager stated that decorations and repairs are carried out as and when they are needed. The laundry room is small and vented to the outside wall. Service users are encouraged to do their own laundry with staff assistance. The home has a good infection control policy and adequate hand washing facilities and was clean and hygienic on the day of the inspection. Dorset Lodge DS0000018109.V277027.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, 36 Staff are well trained and supervised to support the service users. The homes recruitment polices and practices are robust. EVIDENCE: Four staff have obtained NVQ’s in mental health, there are a further four staff members that do not wish to pursue an NVQ. Amongst the staff not wishing to pursue an NVQ, there was evidence of training in many aspects of mental health. Staff were seen to be approachable and service users appeared comfortable in their communications with them. Staff listened to the service users and appeared interested in what they had to say. The interaction between staff and other professionals visiting on the day of the inspection was good. The manager is responsible for recruitment; the files examined confirmed that the home has a robust recruitment procedure and practice. All checks under schedule 2 are made and each staff member is given a copy of the General Social Care Councils’ Code of Conduct. A copy of the code of conduct is kept in the homes office. Service users are not involved in staff selection. There was evidence of supervision taking place bi-monthly since the last inspection. All new staff receive induction training which is recorded in their Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 15 files. Individual training needs are identified and discussed at supervision and are recorded in the supervision notes. Appraisals are up to date. Staff meetings are infrequent and recorded when they do occur. Staff spoken with say they discuss issues at the time they occur and they feel that they have a good staff team that work together and morale is high. The manager provides supervision to all staff and has had training from the NHS some five years ago. Staff are given copies of grievance and disciplinary procedures and sign to confirm they have received them. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 16 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): 39, 40 The home has an effective quality assurance programme that ensures service users views are sought. The policies and procedures safeguard the rights and best interests of the service users. EVIDENCE: The home undertakes surveys on a regular basis where service users, carers, staff and other professional views are sought. Three service users were spoken with at the inspection and it was evident that their views were taken into account when plans are made within the home, as a group and individually. The manager stated that after the home has undertaken a survey for their quality assurance programme, any actions required would be taken. The home has not sent a report to the CSCI before but the manager said that she would in the future. All policies and procedures as required in appendix two are in place and they are monitored and reviewed, amended where necessary and signed and dated. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 17 Staff and service users have access to all policies via the manager. Staff are involved in the development of the homes policies through supervision, staff meetings and staff suggestions. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 18 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 4 3 4 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 4 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 3 X X 4 3 X X X Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? NO 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. 1. Refer to Standard Good Practice Recommendations Staff meetings should be carried out regularly and the outcomes recorded. Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Dorset Lodge DS0000018109.V277027.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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