Inspection on 13/02/07 for Fir Tree Lodge

This inspection was carried out on 13th February 2007.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

Heather House Nursing Home

REACH Upton Court Road

The Cotswold Home

Fairways

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

CARE HOME ADULTS 18-65 Fir Tree Lodge Heather Drive Tadley Basingstoke Hampshire RG26 4QR Lead Inspector Peter J McNeillie Unannounced Inspection 13th February 2007 09:00 Fir Tree Lodge DS0000067693.V324158.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 Fir Tree Lodge DS0000067693.V324158.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. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fir Tree Lodge Address Heather Drive Tadley Basingstoke Hampshire RG26 4QR 01189 815147 01189 815171 khebdon@seeability.org 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) SeeAbility Karen Hebdon Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Nil Date of last inspection N/A Brief Description of the Service: Fir Tree Lodge is a registered purpose built care home, which provides accommodation and support for up to six persons in the categories learning disability, physical disability and sensory impairment. The home which is owned and managed by a registered charity SeeAbility is sited on a small campus that includes a registered nursing home and a day centre which is equipped with a number of facilities including a hydrotherapy pool, sensory room, gym, I.T. and craft rooms all of which can be accessed by the residents. The campus is located in the North Hampshire town of Tadley close to local amenities, local transport and within easy travelling distance of the towns of Newbury, Reading and Basingstoke. All residents are accommodated in single rooms all of which have with ensuite toilet and bathing facilities. All rooms are also fitted out with specialist equipment including beds; baths and permanent fixed overhead hoists. Weekly charges are £1934 per week. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report was written after taking into consideration a number of sources of information /evidence including a site visit to the premises, information provided during the registration process, examining residents /staff records, personal observations, talks with staff and management, responses to a C.S.C.I. pre inspection survey, results from an in house quality survey and responses by the manager to a pre inspection questionnaire. This key unannounced visit was the first inspection for the year 2006/07 and the first since the home was registered on 12/05/05. The inspection took place on 13/02/07 between the hours of 09.00 am and 01.30pm. During the inspection the inspector who was assisted by a senior support worker had the opportunity to discuss living and working in the home with a number of staff both individually and in groups but was unable to communicate with residents due to their profound communication difficulties. The results and findings contained in this report which looked at all of the key standards for care homes for younger adults will determine the frequency and type of future inspections. Current fees are £1934.00 per week. What the service does well: What has improved since the last inspection? What they could do better: Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 6 • Pre admission assessments need to be available. • Care plans need to demonstrate residents or their representatives were involved and consulted when they were being produced. • Satisfaction surveys need to be expanded to include residents. • Residents and staff files need to be tidied up to make them more user friendly. 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. Fir Tree Lodge DS0000067693.V324158.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 Fir Tree Lodge DS0000067693.V324158.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 adequate. This judgement has been made using available evidence including a visit to this service. Whilst there was some evidence of consultation and a formal assessment process had taken place this could not be confirmed from the records viewed? The home could not demonstrate it has a system of assessing and identifying residents needs which ensures residents safety and assessed needs can be met. EVIDENCE: The inspector was informed that no resident is admitted into the home without assessments of need and risk being carried out by an external care manager and a senior member of the homes care staff. This could not be confirmed when viewing the three residents files selected at random none of which contained any pre admission assessments of need but did include assessments of risk. Confirmation of compliance with the standards was made more difficult by the confused and uncoordinated manner in which the resident’s files were maintained. Fir Tree Lodge DS0000067693.V324158.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 adequate. This judgement has been made using available evidence including a visit to this service. Plans seen would indicate there is a clear and consistent planning system but this could not be confirmed due to the absence of assessment documentation. EVIDENCE: Detailed written day-to-day living care plans and risk assessments were available for all residents. Plans and other important information was available in individual A5 sized user friendly support files which all bore evidence of day to day use by all care staff in ensuring each resident receives the appropriate care and support they need. In these files or residents files kept in the administration office the inspector did not see any evidence to confirm residents or their representatives had been consulted or has any input into the plan when it was produced. Due to the extreme difficulty in communicating with residents the inspector was unable to ascertain their views, but from their general demeanour the Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 10 inspector formed the opinion that they were happy/content to live in the home and were satisfied with the services they were receiving. Fir Tree Lodge DS0000067693.V324158.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. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. EVIDENCE: A full programme of activities and social opportunities both in house and community based were available. Examples of activities on offer included swimming, hydro bath, story time, cooking, craft, I.T. sensory life skills, music/dance, gym and karaoke. Whilst a number of activities are available on campus, the home is outward makes full use of community facilities such as swimming pools, shops, library etc. Currently the use of a local social club is being investigated and will probably take place subject to risk assessments. The inspector was informed an activities coordinator had recently been appointed and is due to commence work when all statutory checks had been completed. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 12 Residents are supported to maintain family contact and establish friendships. None of the students is able to use a telephone without the assistance of staff however contact is still maintained by telephone email, the sending of birthday cards to family and friends. All of the residents are registered to vote. Only four of the residents are able to take advantage of the extensive and varied menu that was available. These four residents are able to exercise choice regarding the food they eat, whether they eat and where and when they eat. The remaining two residents are on special diets, which are administered by trained staff. Fir Tree Lodge DS0000067693.V324158.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. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. EVIDENCE: Guidelines seen and staff/management comments indicated choice was being exercised by residents in respect of all aspects of their lives and providers of personal services, bedtimes, clothes, food, gender of carer, GP, dentist optician and key worker being quoted as examples. During the inspection the inspector observed staff inter acting with residents. It was clear that staff held residents in high esteem and treated them with respect dignity, and affection. In the inspectors view, looking after the residents was more than a job to the staff who are to be commended for the manner in which they went about what was clearly a most difficult and demanding task Records seen indicated that any special medical or health or social care needs would be provided following consultation with the appropriate professional, these might include learning disability, sensory specialists, doctors, district nurses and care managers. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 14 In support of external health care professionals the home /residents receive the services of an occupational therapist for up to seven and a half hours per week. All residents are registered with the same local medical practice where approximately ten plus doctors are available. Medication administration records are clear and show that medicines are given when required by trained staff and disposed of it line with the homes medication policy. Medication is stored safely and securely in individual locked facilities. No residents are able to administer their own medication following a risk assessment. Fir Tree Lodge DS0000067693.V324158.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 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 clear policies and procedures in place which ensures residents are able to complain and are protected from abuse . EVIDENCE: A whistle blowing and Adult Protection Policy and Procedure have been implemented to work in tandem with the procedure produced by Hampshire County Council. All management staff spoken to demonstrated they were aware of the procedure to follow should they witness or suspect the abuse of a resident. The complaints procedure, which was also included in the service users guide included information on how to contact The Commission for Social Care Inspection (C.S.C.I), was seen, as was record of complaints, which indicated no complaints had been received. Due to the problems of communication the inspector was not able to ascertain whether residents felt comfortable in discussing any concerns they had with the homes manager but staff did state they felt comfortable in discussing issues with management on behalf of any resident. Fir Tree Lodge DS0000067693.V324158.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 excellent. This judgement has been made using available evidence including a visit to this service. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. EVIDENCE: A tour of the home indicated it was safe, well-maintained and met residents individual and collective needs. A great deal and of time, resources and expertise had clearly gone into the design, building, furnishing, equipping and decorating the new spacious purpose build building. Throughout the building there are examples of best practice, large corridors, double doors to bedrooms allowing the free movement of wheelchairs, personal fitted overhead hoists in bedrooms which were also equipped with special beds, baths and non slip flooring. All communal rooms were fully decorated, large windows ensured light airy rooms that were equipped with furniture designed to meet resident’s needs. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 17 Not only have the needs of the residents been taken into account, so have the needs of the staff enabling then to deliver a good service in a pleasant safe environment. During a tour of the building, which was tidy, clean and free from any adverse odours, no obvious hazards to health and safety were seen and fire safety arrangements were all being observed. An infection control policy and procedure is in place. All staff have access to aprons, gloves and antiseptic soap. Fir Tree Lodge DS0000067693.V324158.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 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. EVIDENCE: The rota indicated the planned deployment of staff would be a manager, 3 support staff and a housekeeper/cook per shift. At he time of the inspection this deployment of staff from observations met residents needs. Staff were observed to carry out their duties in a calm unhurried manner taking time to talk with and assist individual residents. It was confirmed that staffing levels are closely monitored to reflect the assessed needs of residents and would be increased if required. The inspector viewed three staff files, which included evidence that staff are employed in accordance with a robust recruitment and selection procedure designed to protect residents. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 19 This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, satisfactory Criminal Record Bureau, Protection of Vulnerable Adults and reference checks followed by the satisfactory completion of an in house induction training and probationary period of employment. Files seen also included a copy of a job description and contract together with evidence of all training undertaken. In common with residents files previously commented on in this report, apart from one, staff files viewed were untidy, fragmented and generally difficult to use. Comprehensive staff training records covering all aspects of care were available, including, care and administration of medication, manual handling, basic first aid, health and safety, risk assessment, P.O.V.A. visual impairment, basic food hygiene and fire. Following their appointment all staff take part in a “skills for care “ induction programme followed by further training in N.V.Q. (care) to at least level 2. At the time of the inspection 28.6 of staff had been trained to at least level 2 with a further 14.2 (2) commencing training. Further sources of N.V.Q. training are currently being investigated. Progress will be evaluated at a future visit to the home. Fir Tree Lodge DS0000067693.V324158.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 management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought through their representatives. EVIDENCE: The service is well managed by the manager who is qualified to N.V.Q. level three and is currently undertaking study to N.V.Q. level four registered managers award. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 21 Staff who were fully aware of their responsibilities towards residents confirmed management have an open door policy, and encourages them to share any concerns or ideas they have to better the service. The inspector viewed responses to a satisfaction questionnaires completed by resident’s relatives, which indicated an 83.33 , were totally satisfied with the home and the services it provided. An action plan has been drawn up to address those areas indicated by the survey that may need attention. The positive results obtained by the internal exercise were mirrored in a survey undertaken by C.S.C.I. as part of their pre inspection preparation. The inspector was informed work in progress includes expanding the current scope of the survey to include residents and how best to overcome the problem of communication. Progress will be reviewed at a future visit to the home. A sample of records relating to money held by the manager on behalf of residents was checked. Receipts were available and the cash balances reconciled with the records seen. A health and safety policy and procedure was in place. During the visit no obvious hazards to health and safety were seen. Protective clothing, gloves, control of substances hazardous to health (COSHH) assessments, risk assessments, equipment servicing and accident records were available as were records to confirm all staff have receive training in the techniques of moving and handling first aid health and safety and the procedures to follow in the event of fire, including evacuation. The home has a laundry procedure and a washing machine, which is capable of disinfecting soiled items. All of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered. Fir Tree Lodge DS0000067693.V324158.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 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 x 32 x 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Fir Tree Lodge DS0000067693.V324158.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. 1 Standard YA2 Regulation 41(1) Requirement Timescale for action 27/03/07 2 YA6 15(1) The registered person is required to ensure that when pre admission assessments are carried out on potential residents a record is available to confirm the assessment has taken place and the resident or their representative was consulted. The registered person is required 27/03/07 to ensure that when residents care plans are produced residents or their representatives are consulted and the records reflect this. 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 YA2 YA6 YA32 YA34 Good Practice Recommendations That the manner in which records are maintained is reviewed as a matter of urgency and that any future method ensures the records are user friendly and available. Further guidance can be obtained from schedules 2,3 and DS0000067693.V324158.R01.S.doc Version 5.2 Page 24 Fir Tree Lodge 4 of The Care Home Regulations 2001. Fir Tree Lodge DS0000067693.V324158.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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