CARE HOME ADULTS 18-65
Drake Lodge Care Home Drake Lodge 42 Meredith Road Peverell Plymouth Devon PL2 3QJ Lead Inspector
Brendan Hannon Announced Inspection 10th November 2005 09:35 Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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 Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Drake Lodge Care Home Address 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) Drake Lodge 42 Meredith Road Peverell Plymouth Devon PL2 3QJ 01752 773848 Mr Adewale Michael Ileladewa Mrs Christianah Bosede Ileladewa Mrs Christianah Bosede Ileladewa Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service must only accommodate service users between the ages of 25 and 65 Two named service users over the age of 65 Date of last inspection 11/11/04 Brief Description of the Service: Drake Lodge care home was purchased by Mr and Mrs Ileladewa on 12/08/05. The home is a semi detached large Victorian Villa in the middle of a residential street, on the edge of the Peverell area of central Plymouth. A full range of amenities and facilities are within walking distance and Central Park is just across the road from the home. The service can accommodate up to five service users over two floors. The home is entered on the ground at the front. There is one bedroom with ensuite bath and toilet on this level as well as the communal lounge, dining room and kitchen. On the first floor level is one double room with ensuite shower and toilet, two double bedrooms and one single bedroom. The main bathroom with toilet is also on the first floor. There are no shared rooms and due to the age of the building all the ceilings are reasonably high giving an additional feeling of space in the home. There is a large area of patio garden to the rear of the building. The service offered by the home is registered for men and women with mental health issues between the ages of 25 and 65 years of age. Because of the layout of the home this service would have difficulty supporting residents with significant mobility difficulties. The present group of residents has a mixed range of ages and abilities. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced. Preparation for the inspection included analysis of communication with the home over the past three months and the pre inspection questionnaire. Comment cards completed by relatives and residents were also received before the inspection. An inspection plan was developed from this information. The inspector was in the home for 5.5 hours from 9.35am to 3.00pm. The inspector looked into the care of the four residents, and spoke with three of the four residents. The home provides an individualised service for the residents all of whom are presently over the age of 50. The whole of the building was inspected. The registered providers were spoken to at length during the inspection. Care planning files, care delivery records, medication records, general records, and health and safety records, were inspected. What the service does well:
The home owners have recruited a new staff team since taking over the home. The management and staff aim to provide a homely and comfortable place for the residents to live. The service provides good information about the home to prospective residents and their representatives enabling an informed choice to be made as to whether to use the service. The service states clearly the needs that it can meet. All the residents enjoy enough individualised leisure and valued life activity. The service supports relationships between the residents and their families and friends. Residents care is well organised and carefully planned. Residents’ personal care needs are met by support from an effective staff team. The home maintains strong links with general and specialist health services. The residents benefit from a homely, comfortable, clean and well maintained building. The new owners have already invested in decoration, carpets and the patio garden area. Resident’s needs are well met by enough competent and adequately trained staff. The new owners have an open system of management and have clearly defined objectives for the service. They have already shown considerable skills in completely redeveloping the paperwork system for the home in the first three months of ownership. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 6 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. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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 Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 The home provides adequate information about the service and support to allow a new resident, and their representatives, to make an informed decision to use the service. EVIDENCE: Both the service users guide and the homes statement of purpose were available. These documents met the requirements of the Care Homes Regulations and also accurately reflect the service delivered by the home. The information in these documents would enable potential new residents and their supporters to understand the service provided by the home. Residents and the service providers were observed and spoken to throughout the inspection. Through this observation, and through records there was good evidence to show that residents’ needs are being met. The home will use the new care plan format as the format for assessing new potential residents before they enter the home. This pre admission assessment will be carried out for all potential residents. An existing resident said that he was very happy at the home because he was allowed to make his own choices about how to lead his life. The registered providers at Drake Lodge are clear about what the service provided is and what needs it can meet. Therefore new residents needs are likely to be met by the home. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9,10 The delivery of resident’s care is good and is supported by good planning of care. EVIDENCE: Resident’s care plans were sampled. All residents care planning is comprehensive and thorough. All the residents’ care plans and individual risk assessments have been re developed by the new owners. There is thorough assessment of needs, and care planning, including behaviour management guidance, to plan the delivery of support in response to the residents’ needs. Though risk assessment was comprehensive some restrictions of personal freedom or choice had not been documented. These included for example the need for specific residents to only leave the building with a supporter, and the need for preferred activities to be limited due to the level of risk. Care planning is being appropriately reviewed. Information is managed carefully in the home. The administration area and the storage within it, is used effectively to maintain the confidentiality of all information. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 10 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): 12,13,14,16,17 Residents have appropriate activities to ensure a good quality of life. Residents receive enough, varied, good food. EVIDENCE: The providers described at length the activities that were enjoyed by the residents. This information was supported by care planning and by residents’ daily diaries. These diaries contained clear daily entries for each resident covering all the positive and negative elements of their day. All the residents have individualised activities depending on their interests and abilities. Some of the activities provided within the home include arts and crafts, listening to music, watching films, reading newspapers and tabletop games. External activities include drop in centre, use of the local park and shops, and trips within the Plymouth area. The management and staff at the home are actively supporting residents relationships. The food provided record, food stocks and the sampled lunchtime meal showed that residents are supplied with enough, good quality food. Plans for meals are reviewed with the residents every four weeks. The residents receive enough appropriate food that they like. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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): 18,19,20 Residents’ health is maintained by meeting the residents’ personal care needs, health care needs, and through the satisfactory administration of their medication. EVIDENCE: All of the residents present in the home at the time of the inspection were seen. There was no observable evidence of any personal care issue not being met. Weight records are being maintained for all the residents. A record of all contacts and appointments with health services, and a daily diary for each resident, are kept. All the residents are in regular contact with health services either for regular treatment or assessment. Basic dental, optician and chiropody services are made available to the residents. Records showed that residents’ health and personal care needs are being supported. One of the residents manages their own medication and a risk assessment supporting the safety of this arrangement is in place. The home uses a monitored dosage system of medication administration. The homes medication record was good. The management and record of controlled drugs administration was also good. The medication storage was clean and ordered. The residents can be assured that they are receiving their prescribed medication appropriately.
Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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): 22,23 The welfare of the residents is protected through, the proper management of concerns and complaints and thorough adult protection procedures. EVIDENCE: There is a complaints procedure in both the Service Users Guide and displayed prominently in the front hallway of the home. There have been no complaints made to the new owners. The home has all the appropriate anti abuse policies and procedures in place and this information forms part of the structured induction completed by all new staff. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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): 24,26,27,28,30 The residents benefit from a homely, comfortable, clean and well maintained building. EVIDENCE: The home provides appropriate accommodation and facilities to meet the needs of the service users. The accommodation is adequately maintained. To the rear of the building is an enclosed and safe patio garden area of a reasonable size. The new owners have completely refurbished this area to make it more pleasant and useable. The new owners have repainted the rear of the building. The bedrooms are of a good size and due to the age of the building they have high ceilings, giving more feeling of space. There is a reasonable level of personalisation in each resident’s room depending on their tastes. Furnishings and fittings in bedrooms were of adequate quality. The new owners have replaced two bedroom carpets. The quality of the living environment and the standard of decoration and fixtures in the communal areas is high. The new owners have redecorated these areas. The home was clean and odour free. All the bathroom and toilet doors are fitted with locks that can be overridden from the outside to ensure the residents safety. All the bedroom doors are fitted with individual locks. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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): 32,33,34,35 Resident’s needs are met by enough competent, qualified, properly vetted and trained staff. EVIDENCE: The providers stated that there is always an adequate number of staff on duty to meet the needs of the residents. Because of the small size of the home, the level of need of the residents, and the extensive care work done by the providers, only a very small staff team is necessary. Of the two staff employed one has gained an NVQ2 qualification. A training programme is being developed by the new owners to ensure that residents’ needs are fully met by skilled staff. However the staff and providers should have received up to date refresher training in all the basic training areas. This should be accomplished. The registered providers stated, and there was documentation to prove, that both the staff had Criminal Records Bureau (CRB) checks underway. Protection Of Vulnerable Adults register checks had been obtained before the new staff members came into contact with the residents. Because of the small size of the home and therefore the impracticality of supervising staff that have not yet received a CRB clearance, the new owners were advised to obtain in future, a CRB clearance for new staff before they begin work with the residents. Personnel records were available in the home to verify the recruitment procedure carried out for each member of staff. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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): 37,40,41,42 The management of the home is effective, ensuring that residents’ needs are met. EVIDENCE: Mrs Ileladewa holds the registered manager role. She has obtained an NVQ 4 in care and is a qualified mental health nurse. She is currently pursuing the Registered Managers Award. The providers ensure that there is an open positive and welcoming atmosphere within the home. The interaction between the residents and providers throughout the inspection showed that the needs of the residents are paramount to the management. All the residents have their own individual named bank accounts and any personal money kept safe by the management is kept individually. Records are generally well maintained in the home. The following section covers Health and Safety. Comprehensive safety checks have been carried out during the last year, as noted in the pre inspection questionnaire, including gas appliances and domestic electrical equipment. However an electrical wiring certificate covering the wiring in the building should be obtained. Also a Legionella risk assessment should be put in place.
Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 16 Fire protection system records were not clear and the management was advised to reorganise these records. The registered providers stated that window-opening restrictors have been fitted to all windows above the ground floor. None of the hot water taps available to residents have been adapted to reduce the water temperature to approximately 43 degrees centigrade at the point of use. Risk assessment should be in place for each hot tap to document that this situation is safe. Most of the radiators in the home have been covered. Each of the remaining uncovered radiators should be risk assessed and this assessment should be documented. Good management of health and safety protects the welfare of the residents. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X 3 3 3 N/A 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Drake Lodge Care Home Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 2 X DS0000064535.V251470.R01.S.doc Version 5.0 Page 18 N/A 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 2 3 Refer to Standard YA9 YA35 YA42 Good Practice Recommendations Individual risk assessments should include all the restrictions of choice or personal freedom agreed to be in the resident’s best interests. All basic training should be in place for all staff. An electrical wiring certificate covering the wiring in the building should be obtained. A Legionella risk assessment should be in place. An individual risk assessment should be in place for all un adapted hot water outlets and for the remaining uncovered radiators available to residents. Drake Lodge Care Home DS0000064535.V251470.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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