Inspection on 03/11/05 for Franklins Lodge

This inspection was carried out on 3rd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 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 16/02/06

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 Doug Tunmore Unannounced 03 November 2005 10:30 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 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 Stationary 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 C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 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 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 only 19 Category(ies) of MD(E) Mental Disorder - over 65 (1) registration, with number MD Mental Disorder (18) of places Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 24 February 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 flatlets, which are shared by 2 or 3 service users. In addition to the flatlets 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 C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced. The main method of inspection used was called case tracking, which involved selecting two residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observations of care practice. This was a very positive inspection with the manager, staff and residents very open to the inspection and made it a very positive experience for the inspector. A partial tour of the home took place. What the service does well: What has improved since the last inspection? What they could do better: The home needs to address the issue of having risk assessments for those residents who self medicate to ensure their safety. The home must be proactive in training 50 of its staff to National Vocational Qualifications in care, level two. One bedroom seen had damp which needs attention and Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 6 wallpaper also need to be replaced. The bedding of one resident was stained and all residents bedding, including duvet covers, pillows and mattresses needs to be checked for suitability of purpose. 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 C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 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 standard(s) 2 Service users benefit from a comprehensive care assessment process that involves social workers and health care workers. EVIDENCE: Two residents’ files where looked at. The home carries out a care assessment with prospective residents either prior to admission or after admission, depending on circumstances. Care needs assessments had been carried out by social workers and other health care workers prior to admission. A letter was available on file confirming that the home can meet a residents needs and giving basic details of the home. Three residents stated that they had visited the home prior to admission and had either stayed for a night or an overnight stay. One resident stated that he ‘came and the staff showed me around and a week after I came to live here’. They also confirmed that they felt that their needs are met. A care worker commented that residents are encouraged to visit the home prior to admission and stay for tea and an overnight stay. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 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 standard(s) 7 Resident’s individual needs are promoted and documented appropriately. EVIDENCE: Each service user had an individual, detailed care plan. Both care plans seen had been reviewed on a regular basis and reflected the changing needs of the resident. Both care plans were also signed and dated by the residents. From the documentation and from discussion with residents, it was clear that they were fully aware of the plan, the changes and why it had changed and the goals towards which they were working. Residents risk assessments and reviews had also been signed by residents agreeing to the risk identified and/or the change in their care plan and how this might effect their daily living. Residents commented that they felt their rights were respected and their key workers or other staff gave support when required. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 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 standard(s) 12,13,15 & 16 Service users had busy and varied lifestyles with opportunities to engage in a range of leisure activities within the community. Social activities are available to residents and they are supported in visiting their family and friends. Work and further education programmes are available to residents. EVIDENCE: Family and friends are encouraged to visit at any reasonable time. Service users were supported to maintain contact through visits, telephone calls and letters. Residents confirmed that they get visits from friends and that they sometimes stay with friends or their families and inform the home if they stay out overnight. One resident confirmed that he visits his father weekly and helps him with his shopping. All residents spoken to confirmed that they had a key to the homes front door and their bedroom. Staff provided appropriate guidance and support to service users with regards to managing their finances and personal relationships, within and outside of the home. It was seen during the inspection that both residents and staff engage in social dialogue as equals. One resident commented that they play board games with care staff as a regular event in a relaxed and friendly atmosphere. One Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 11 resident is currently undertaking a college course and others are volunteers for the Shaw Trust, This entails various placements in a number of settings. Another resident said that she would be looking to undertake a beauticians course hopefully in 2006. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 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 standard(s) 20 The administration of medication was appropriately recorded. Risk assessments are not available for those residents who self medicate. EVIDENCE: Residents confirmed that care staff give them their medication when it is required. The pharmacist visited on 05/07/05 and the report showed that administration records were good and storage and stock control was good. The medication sheets showed that medication given on that morning had been signed for by care staff. The medication pack (blister pack) also showed that the medication had been given. Those residents who self medicate have signed an agreement to do so in line with the homes self-medication policy. However, a resident who self-medicates did not have a risk assessment, which would outline any possible risk in undertaking this task. One care worker confirmed that she had undertaken medication training, which is updated yearly. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 13 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 standard(s) 23 Staff are aware of how to respond to an adult protection allegation. EVIDENCE: There were appropriate policies and procedures in place regarding the protection of vulnerable adults. The homes training file showed that staff had received adult protection training on 08/11/04 and further training is planned for 21-22/11/05. Other courses such as managing challenging behaviour and sexual relationships have also been undertaken. One carer outlined what action she would take if she became aware of adult abuse, which was in line with the homes policies and procedures. Residents expressed the view that they felt safe in the home and that all care staff treated them very well. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 14 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 standard(s) 24 & 25 The home is reasonably well maintained. Bedding was found not to be suitable for its purpose. EVIDENCE: A resident showed the inspector around the home, taking in his bedroom, ensuite facilities and communal areas. The bedroom seen was large and had been personalised by the occupant. It was found that there was some damp along one wall and the wallpaper was peeling. The bed had been stripped and it was seen that the duvet was stained and torn with the pillow also stained. The home needs to check all bedding including mattresses to ensure that’s its suitable for its purpose. The homes maintenance plan was seen, which includes plans for the kitchen floor was to have new lino covering and a bedroom carpet was to be fitted. One bedroom is to be decorated due to damp. All residents have single room accommodation and they expressed satisfaction with their rooms. They also felt that staff respected their privacy on all occasions. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 & 35 Residents are protected by robust recruitment practices. Staff are trained to carryout their jobs. EVIDENCE: Recruitment practices were in place and two staff files contained all of the documentation required by law. However, it was found that interview notes of new care workers employed at the home had not been kept for possible future reference. The home has a copy of the General Social Care councils pack relating to the registration of care workers and the philosophy of the Care Council for all social care homes. A carer confirmed that she has the General Social Care Councils booklet. The homes training plan was seen and found to be up to date. The training record identified the manager and those care workers who had undertaken statutory training in 2004 and 2005. The manager has National Vocation Qualifications (NVQ) training in care level 2 and 3 and is currently undertaking the registered managers award in management and care. One worker has NVQ level 2, two workers have NVQ level 3 and three workers are working towards completing NVQ level 2. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 16 One carer stated that she had NVQ level 3 and had undertaken fire procedures, manual handling, adult protection training, infection control and health and safety. She was also able to demonstrate a clear understanding of her role and responsibilities. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 42 The current management structure ensures that the home is managed for and with the residents. Appropriate checks are carried out to ensure the safety of residents. EVIDENCE: The registered manager has thirteen years experienced in working in this home with people who have a mental health care needs. A deputy manager who is also experienced in working with this client group supports the manager. They have an open door approach to both residents and staff who require support and guidance. Residents confirmed that they can talk to the manager about their lives and she is always helpful and fair. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drill and emergency lighting checks are carried out. Staff also receive fire training as part of the homes initial training and as a regular training event. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 18 The homes induction training shows that ‘policies and procedures are read and signed by staff and that they inform practice’. Certificates were available showing that gas safety inspections have been carried out, electrical wiring checks, and portable electrical equipment checks. Window restrictors are fitted to all first floor windows, two of which were checked and found to be appropriately fitted. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 4 x Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Franklins Lodge Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 20 no 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 YA20 Regulation 13(2) Requirement The home must make arrangements for the safe keeping and safe handling of medication by ensuring that risk assessemnts are available for those residents who self medicate. The home must ensure that the care home is kept in a good state of repair externally and internally. The home must ensure that rooms occupied by residents has adequate bedding. Timescale for action 25/12/05 2. YA24 23(2) 15/02/06 3. YA25 16(c) 25/12/05 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. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 21 Refer to Standard YA32 YA 34 Good Practice Recommendations A minimum ratio of 50 trained staff members to NVQ level two excluding the registered manager should be available in the home by 2005. The home should keep all documentation including interview notes of all staff employed at this home for possible future reference. 4. Franklins Lodge C53-C04 S2363 FranklinsLodge V244525 031105 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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. 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