Inspection on 17/04/07 for Dorset Lodge

This inspection was carried out on 17th April 2007.

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 11/01/06

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 Nicola Dowling Unannounced Inspection 17th April 2007 10:00 Dorset Lodge DS0000018109.V336731.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 Dorset Lodge DS0000018109.V336731.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. Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 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/company Name of registered manager 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.V336731.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11/01/06 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.V336731.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection site visit took place on one day over a six-hour period. The site visit consisted of a tour of the premises, speaking to staff and service users and reading of documents. Four health professional, one relative and six service user surveys were also received and contributed to the report. The inspector would like to thank the service users, manager and staff for their contribution on the day and their hospitality. What the service does well: What has improved since the last inspection? What they could do better: The promotion of healthy lifestyles is an area the home intends to get better at. Due to new smoking laws the home is going to seek the views of the service users on how smoking in the home is going to be managed. Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Dorset Lodge DS0000018109.V336731.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 Dorset Lodge DS0000018109.V336731.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, 3, 4, 5. Quality in this outcome area is good. Residents are involved in the assessment process and given the opportunity to decide if this home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The three residents spoken to confirmed that they were involved in the assessment process. And they had the opportunity to see and spend time at the home before they were admitted. This was also confirmed by the six resident surveys that were received by the Commission for Social Care Inspection. There was evidence that assessments involve a full team of specialist professionals for example, forensic services, locality mental health team professionals and psychiatrists. Some residents do have a limited choice and this is due to special restrictions placed on them by the Ministry of Justice. This is fully recorded and there is evidence that the Care Programme Approach documentation is used. Residents confirmed that they have signed a contract and know what the contract is about. Staff receive training in mental health, and the manager does in-house training on a regular basis. There was evidence that staff undertook mandatory training and staff confirmed that they had undertaken courses for example fire and health and safety awareness. Dorset Lodge DS0000018109.V336731.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, 9, 10. Quality in this outcome area is excellent. Service users are fully involved with their care plan. Their confidences are safeguarded and staff support service users to make their individual decisions. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One of the three service users that was spoken to said “I make my own choices”. Of the three residents spoken to all confirmed that they knew what was written into their care plan and knew what the restrictions were that had been placed on them. Long term goals are discussed and CPA documentation was in detail and signed by all professionals and the service user. A further risk profile is available for staff. There is open access for service users to view their documentation and documentation is held securely in the office. Staff are aware of confidentiality and the home has a statement on the sharing of information. Five of the six questionnaires returned by residents said that they “always” Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 10 make their own decisions about what to do each day, one said that they “usually” make their own decisions. Some residents cannot make all their own choices due to restrictions placed on them in their care plan. From professional surveys a psychiatrist confirmed that the manager helps residents to comply and be involved in care plans. There was documentary evidence that other health care professionals take an active part in ensuring that the care plan is complied with. On the day of inspection one resident had a routine visit from a professional worker to discuss his needs. Dorset Lodge DS0000018109.V336731.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, 17. Quality in this outcome area is excellent Routines in the home are flexible and service users enjoy a good lifestyle at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As a part of their care plan service users have scheduled activities and appointments. Service users confirmed that they participate in these activities, for example one resident said that they were “satisfied” with the computer sessions that they attend. Service users also said that they have “quite a lot of freedom and do what they want each day”. Service users do go out and take part in local community facilities for example going into Southend to buy their clothes, or going out to the cinema. The home also facilitates membership to a local gym. The home likes to know where service users are and ask that they tell staff when they leave the home. Many service users also have their own mobile phones to keep in touch with family friends and the home team. Service users spoken to were happy with this. Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 12 Where possible staff support service users to maintain family contact. On the day of inspection a service user was on home leave. Another service user confirmed regular leave to visit a family member. Service users have a lockable bedroom with a lockable space within the room and there is unrestricted access to the home and grounds. There is choice and flexibility with meal times. Two residents said that if they didn’t like what was on the menu staff will make something else for them and that the “food was good”. Fresh fruit was available for the service users to help themselves to and drinks are available throughout the day. Dorset Lodge DS0000018109.V336731.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, 20, 21. Quality in this outcome area is excellent. Psychiatric and physical health care is carefully monitored and proactive at this home. The subject of ageing, death and dying sometimes presents a problem due to the age of the current service users This judgement has been made using available evidence including a visit to this service. EVIDENCE: The administration and storage of medication is good in the home. Staff demonstrated how medicines are recorded and administered to the service users. Medication was checked and matched the record sheets used. One service users has frequently changing medication, this was properly recorded and evidenced in the care plan. Service users said staff “are good and listen and are kind”. Of the three service users spoken with all said that they were “happy” with the care the staff provide. Physical illness is well cared for example one service user has a weekly visit from a nurse consultant regarding their condition and visits from health professionals increase or decrease as the needs of the service users change. Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 14 All service users have regular Care Programme Approach meetings that are well documented. Health professionals regularly visit the home and there is good communication between them. This was commented on in a survey received from a health professional. Service users have different levels of monitoring for both their physical and psychiatric health. The home is proactive at seeking help for service users when required. Death and dying is a topic that is initially approached with the service users. However as many service users are young they did not want to talk about this subject preferring the manager to “ask mum”, this is recorded in the care plan. Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 15 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, 23. Quality in this outcome area is excellent. Service users have their views listened to and are protected from abuse by the homes policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are aware of the complaints procedure but generally felt that they would discuss their problem with the staff on duty or the manager. The complaints procedure is on the kitchen wall and in the service user guide as well as the policy file and residents have access to all of these areas. No complaints have been recorded this inspection year. There have not been any adult protection referals from this home. Policy and prodeures on this area were available and staff demonstrated knowledge on safeguarding adults. Service users manage their own money and said that they felt “safe and secure in the home”. The home do not use any form of restraint preferring to use de-escalation techniques. Advocates can be accessed and there was evidence that one service users had used them, however most residents have a solicitor due to their status under the Mental Health act 1983. Dorset Lodge DS0000018109.V336731.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, 30. Quality in this outcome area is excellent. Service users live in a clean, comfortable and well maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: This home is modern and homely in appearance. Furniture is in good condition and communal spaces are clean and tidy. The outside area to the back of the property is paved. There are benches and tables so that service users can enjoy the outside space. There is a designated smoking area in the home. The manager will look into the new legislation regarding smoking and seek the views of the service users on this subject. Service users bedrooms are personalised with some bedrooms having their own en-suites. Those that do not have their own en-suite share a bathroom and toilet with one other person. Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 17 The home has good access to the local community with a bus stop very nearby. All service users have travel passes enabling them to use public transport. The home is clean and hygienic. The laundry is sited away from food areas. Service users have access to the washing machine and tumble drier. The home encourages service users to take part in doing their own laundry as much as possible. Staff clean the home and one service user commented “staff clean the rooms and bedrooms everyday and keep them fresh and tidy”. Dorset Lodge DS0000018109.V336731.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, 34, 35. Quality in this outcome area is good. Service users are supported by trained staff that are skilled to care for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four staff recruitment files were checked. Three were complete, one was not with identification and photo missing. This is due to a transfer of files. This was discussed with the manager who will put in place the mising documents. Otherwise the home has a thorough recruitment process. Staff have regular training that is mainly in house. All staff spoken to had training in aspects of mental health. Medication training is via Boots the chemist. Fifty percent of the care staff have an NVQ. Staff keep work books that evidence their up-dated training. Staff spoken to were motivated and knowledgeable about their role and how they help the residents. There is evidence of staff apprasial and supervision. Staff have a daily handover and described communication between themselves as good. Staff meetings are held occasionally, however staff felt that when issues arise they are discussed and dealt with straight away. The staff team is regular and know Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 19 the service users well. A comment from a service users was that “staff are friendly to me and treat me with respect”. No agency staff are used ensuring consistency of care in the home. Dorset Lodge DS0000018109.V336731.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, 42. Quality in this outcome area is excellent. This is a well managed home that is run with the interest and safety of the residents in mind. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The proprietor is the manager and is a trained nurse in mental health (RNMH) with an NVQ4 in management. The manager also maintains good links with the local mental health trust and keeps up to date with current practice and law in mental health. The manager has good experience in mental health and has run this home successfully for a number of years. The home seeks the views of the service users and others to ensure that they are meeting their aims and objectives as stated in the statement of purpose. Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 21 Three service users that were spoken to said that their views were listened to when plans are made about the home. For example when the home arranges birthday celebrations. From the pre-inspection questionnaire the safety certificates were all up to date. A random sample was inspected at the home, for example fire equipment and portable appliance testing. These reflected the dates given in the preinspection questionnaire. The required policies and procedures were also submitted in the pre-inspection questionnaire. These are regularly monitored, reviewed and amended as necessary. Dorset Lodge DS0000018109.V336731.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 4 3 4 4 3 5 3 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 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 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 4 4 LIFESTYLES Standard No Score 11 x 12 3 13 4 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 3 4 x 4 x x 3 x Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 23 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. 1. Refer to Standard YA36 Good Practice Recommendations Staff meetings should be carried out regularly and the outcomes recorded. Dorset Lodge DS0000018109.V336731.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. Extracts may not be used or reproduced without the express permission of CSCI Dorset Lodge DS0000018109.V336731.R01.S.doc Version 5.2 Page 25 - 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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