Inspection on 16/02/06 for Franklins Lodge

This inspection was carried out on 16th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Franklins Lodge 08/12/09

Franklins Lodge 03/11/05

Franklins Lodge 24/02/05

Franklins Lodge 10/12/04

Franklins Lodge 27/01/04

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

CARE HOME ADULTS 18-65 Franklins Lodge 120 High Street Boston Lincs PE21 8TH Lead Inspector Jill Clifton Unannounced Inspection 16th February 2006 09:15 Franklins Lodge DS0000002363.V283775.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 Franklins Lodge DS0000002363.V283775.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. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Franklins Lodge Address 120 High Street Boston Lincs PE21 8TH 01205 311925 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) Arc Healthcare Limited Miss Andrea Yates Care Home 19 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (18), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Franklins Lodge is a care home providing personal care and accommodation for 19 service users between the ages of 18 and 65 years of age who have a mental health condition. It is owned by Arc Healthcare Limited who are a subsidiary company of the national organisation, Care UK. The home is situated close to the town centre in Boston. Service users have easy access to the town centre shops, pubs, library and other services. Accommodation at the home comprises of self-contained flat, which are shared by 2 or 3 service users. In addition to the flats there is a communal dining room and two lounges. A main kitchen is used by staff to prepare meals and there is also a communal laundry room. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is an unannounced inspection, which took place over four and half hours. Service users in this report are referred to as ‘residents’ as this is their chosen preference. A resident accompanied the inspector in a tour of the building, two resident care records were checked along with other documentation. Two members of staff and five residents were spoken to in order to gain comments and opinions. Feedback was given to the manager about the inspection findings. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to review the cleaning hours within the home because due to sickness there has not been a dedicated cleaner in the home since the end of November. Attention is required to the damp and redecoration within some of the flats, this has been held up by the need to repair the roof first. A radiator to an upper floor flat needs attention, as it cannot be regulated at present. It would be beneficial to review the storage facilities and stored items within the home. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 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. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 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 Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 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): 1,4 and 5 Residents are given information and a chance to stay in the home, which helps them to make an informed choice of whether the home is suitable and can meet their needs. EVIDENCE: Residents prior to admission are sent a copy of the home’s Statement of Purpose, Service Users Guide and welcome pack. Residents are offered a trial in the home, which involves at least an overnight stay; a service user was able to confirm this. There was evidence in service users care plans that a statement of terms and conditions had been given to each individual; a resident was able to show the inspector that he had been given a reviewed and up to date statement. As part of the pre assessment screening, the resident is asked about their personal aspirations; one resident had commented that ‘I see this as a stepping stone to more independent living’ and this is recorded in the care plan. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 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 and 9 Residents are fully consulted on the care that is to be received and are part of any decision-making regarding their daily life. EVIDENCE: Care plans are comprehensive and well maintained and include daily and clinical records; they also include the residents prospective, which they have written themselves. A resident commented that he knew about his care plan and had a weekly meeting with his key worker and any changes are fully discussed. The plans show full consultation has taken place and there are regular reviews of all identified needs to ensure that any changes are reflected and the appropriate care given; reviews are also undertaken by the individual resident social workers. There are individual risk assessments in place to reflect all activities of daily living, these have been agreed and signed by the resident, manager and key worker and where appropriate the Consultant and care manager or Community Psychiatric Nurse; there is evidence of these being reviewed on a monthly basis. Self-medication risk assessments are reviewed every 5 days. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 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): 17 Residents are able to choose their menu options, and have the opportunity to gain or maintain independent food preparation skills. EVIDENCE: During the morning of the inspection residents were noted to be taking part in a weekly menu planning meeting to decide the main meals through out the week. Suggestions are made from each of the residents who chose to attend the meeting. Residents make their own breakfast within the kitchen in each group of flats. To aid independence kitchens are supplied with a cooker, microwave, fridge and kettle. Milk is supplied to each kitchen daily. Staff (all of whom have an up to date basic food hygiene certificate) prepare a meal for all residents in the main kitchen on a Tuesday, Wednesday, Friday and Sunday at 12.30pm. Residents cook or prepare their own teatime meal. Each kitchen has a stock of basic provisions; residents are able to come to the main kitchen to get other items as required such as frozen foods. If assistance from staff is required then this is identified through assessment and care planning and supervision is given. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 11 Residents spoke to are all complimentary about the meals provided and the amount, ‘the meals are wonderful and there’s always plenty’. Often residents do not want their meal at lunchtime and so the meal is saved for them. A resident said that she ‘often shares a Chinese takeaway with another resident’. Key workers encourage residents to consider healthy options in their menu planning. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 12 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 and 20 Residents have access to the support that they need which promotes choice and independence. Residents have independent access to health workers who can assist and support with individual needs. Robust risk assessment for self-medication helps to keep residents safe whilst taking medication. EVIDENCE: All of the residents were independent in attending to their personal care needs. Bedrooms had ensuite facilities and bedrooms had door locks to provide privacy. Residents had a key to the front and back door of the home and could come and go as they wished provided staff were aware of a return time. The majority of residents had a mobile phone to contact the home if a problem occurred whilst they were away from the home. Support was given by an allocated key worker who met with the resident on a weekly basis. Residents accessed the supportive General Practitioner practice, which was across the road from the home, where there was a choice of 5 doctors to choose from. The majority of residents were independent in arranging and organising their own health care appointments, although their key worker is Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 13 always available to provide support when attending out patient appointments and provide access advice. Residents were able to contact their care coordinator or CPN through regular CPA reviews, optician, dentist and chiropodist as required, but again staff are on hand to support them through this process. A resident was able to verify this independent access. Self-medication risk assessments are comprehensive and reviewed every 5 days. The documentation shows that there has been consultation and agreement with the resident, manager, key worker, GP or consultant and social worker or Community Psychiatric Nurse. Staff undertook blood glucose monitoring for any diabetic residents who needed assistance, and this invasive procedure was only carried out by staff who had received training and following consultation and agreement from the Practice Nurse. The review records of a service user were noted to have the comment ‘BM not bad’ but this does not adequately indicate blood sugar status from which a medical decision could be made by a health professional. Medications were kept in service users bedrooms within a lockable facility. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Residents feel that they are listened to and that their opinions are valued. EVIDENCE: The home’s complaint procedure is displayed in each resident’s bedroom, and those residents spoken to were aware of the procedure. Residents commented that they were very happy with the running of the home and the support received, no one had any negative comments or concerns about their care. Residents commented: ‘I feel able to talk to my key worker about anything that is worrying me’; ‘the manager is a very good listener’. Weekly meetings between key worker and individual residents were held. Residents opinions were reflected in all aspects of the home and where gathered on a formal basis through a 6 monthly survey. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 15 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, 25 and 30 Residents live in a clean, homely environment which promotes privacy and independence; shortfalls in attention to damp problems in the residents bedrooms my be a potential health risk. EVIDENCE: The property is a grade 2 listed building and is need of ongoing decoration and maintenance for which the manager is requested to submit to the Commission the programme for 2006. Residents requested that there be a non-smoking lounge within the home, which has been provided. There is a lounge where smoking is permitted and a dining room, which is the ‘hub’ of the home, residents like to meet and chat in this area throughout the day. A mattress was noted to be stored in the lounge, alternative suitable storage should be found. There is a tree noted to be growing from the guttering which if left may affect drainage. There is a large gap between the floor and the bottom of the front door, which affects the temperature in the home. There is bedroom furniture stored on the ground and middle floor corridors, which is an unnecessary fire risk. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 16 Bedrooms are personalised and give residents privacy and two residents showed the inspector around their rooms. One resident was unable to regulate the temperature of his radiator; this was brought to the attention of the manager. Several bedrooms, which have been identified to the manager, have a damp problem, which is very evident and requires attention and then redecoration. A resident indicated that he would like to decorate his own bedroom once the damp problem had been addressed. Residents have their own towels and soaps within their flats, which avoids communal use thus helping to prevent cross infection within the home. Residents are responsible for attending to their own laundry for which there is a communal laundry room, which had contract washers and dryers in place. The fridge which is used to store milk, was placed in the laundry room, this should be reviewed to provide a more suitable storage area. Residents are responsible for the cleaning of their rooms; staff assistance is available where required. Although the home is clean there had not been a dedicated cleaner on duty since the end of November and this situation should be reviewed, as care staff where undertaking these tasks at present. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 17 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): 33 and36 Resident’s benefit from being cared for by a well supported and supervised staff group. EVIDENCE: The staffing group is stable. The manager is supernumerary to 2 care staff who cover the am, afternoon and evening shift. There is one waking staff member on duty and one sleeping staff member on the premises. Due to illness there had been no dedicated cleaner for the home, care staff are having to undertake these duties at present; the manager should review this situation. Staffing levels are increased as required for example if residents need support in attending appointments or reviews. Staff receive formal supervision on a 3 monthly basis, this was confirmed by a care staff member and there is supporting documentation. Staff spoken with said that the manager of the home was approachable and supportive and that there are plenty of training opportunities. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 18 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 Residents views are reflected in the way in which the home is run. EVIDENCE: Residents meetings are held on a basis and there is documentation to evidence this. A quality survey is completed by residents on a 6 monthly basis, the previous one showed that 83 of residents thought the overall support and care received was good, the remaining percentage was due to some of the questions being not applicable. Residents were able to express preference as to their choice of key worker and meetings were held on a weekly basis. A suggestion box was available on the first floor together with a notice board of all current activities and information including the current inspection report. Care plans demonstrate that residents are fully consulted about the all aspects of their care and have a large input into the daily running of the home. A resident showed how he was able to make choices in his daily routines, which assisted him to lead an independent lifestyle with support and the security of a safe environment. Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 19 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 3 2 x 3 x 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 x ENVIRONMENT Standard No Score 24 2 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 3 34 x 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x x x 3 x x x x Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 20 yes 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 14/03/06 1. YA24 23(2) (b) 2 3. YA24 YA24 23 (2) (b) 23 (2) (l) The home must ensure that the care home is kept in a good state of repair externally and internally. This is outstanding since 15/02/06. The manager must therefore send to the Commission the maintenance and redecoration plan for 2006 within one month, which must include the arrangements for dealing with the damp in several bedrooms and subsequent redecoration of same. Attend to the gap in the front door Remove mattress from lounge and remove bedroom furniture from corridors 14/04/06 14/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 21 1. 2. 3. YA20 YA30 YA33 Give precise information when referring to a blood sugar level rather that making a judgement Relocate the small fridge that is presently stored in the laundry room. Review the cleaning staff arrangements for the home Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Franklins Lodge DS0000002363.V283775.R01.S.doc Version 5.1 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!