Inspection on 01/05/07 for Garden Lodge

This inspection was carried out on 1st May 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Garden Lodge 10/01/06

Garden Lodge 11/08/05

Garden Lodge 23/11/04

Garden Lodge 06/08/04

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

CARE HOME ADULTS 18-65 Garden Lodge Maureen Terrace Seaham Durham SR7 7SN Lead Inspector Ms Kathy Bell Unannounced Inspection 1st May 2007 10:30 Garden Lodge DS0000007472.V335571.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 Garden Lodge DS0000007472.V335571.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. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Garden Lodge Address Maureen Terrace Seaham Durham SR7 7SN 0191 5131185 0191 5130388 No e-mail 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) European Services for People with Autism Limited Ms June Naylor Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: Garden Lodge is a care home providing personal care and accommodation (but not nursing care) for eight people between the ages of 18 and 65 years with autism spectrum disorders. It is managed by the organisation now known as European Services for People with Autism Limited, (ESPA), which was established in 1987 and runs a range of services for younger adults with autism. The home was purpose-built and has eight single bedrooms, two living rooms, a dining room and its own garden. The premises are decorated and furnished to a good standard and in a domestic style throughout. Adaptations have been made to meet the needs of a resident with some disabilities. The weekly charges for this home range from £596.40 to £1905.92 a week. This information was provided to CSCI in February 2007. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during one day in May 2007. It was the one inspection planned for this year and the home had not been told when the inspection would be. During this visit, the Inspector looked around the building and at records. She talked to staff and to some residents, although many residents have communication problems related to their autism and find it difficult to comment directly on their care. However the Inspector shared a meal time with residents and was able to see some of the daily life in the home. Staff had helped residents who wanted to, to fill in survey forms and six relatives filled in surveys and made many useful comments about the home. What the service does well: What has improved since the last inspection? The people who run Garden Lodge continue to think carefully about how they can best help their residents have control over their lives and have their privacy and dignity respected. Staff have recently had training in how to find out and record exactly how much physical contact each resident is comfortable with. All the staff have had training in diversity, to increase their understanding that residents may have different needs and choices because of their culture, religion or sexual orientation. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 6 The home has now achieved the target of having more than half the staff qualified with the National Vocational Qualification in care at level 2. This is the recognised qualification for care staff. The lack of other improvements is not a bad sign: it reflects the high standards already in place in this home. 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. The summary of this inspection report can be made available in other formats on request. Garden Lodge DS0000007472.V335571.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 Garden Lodge DS0000007472.V335571.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): Standard 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. ESPA finds out full information about residents before they are admitted, to make sure that the home will be able to meet their needs. EVIDENCE: The records of the two residents who have most recently been admitted to the home show that ESPA had carried out a full assessment of their needs. They had used a lot of information from parents and also from other ESPA services, which these residents had been using. This was used to produce a first care plan which provided staff with the information they needed from the start to provide satisfactory care. Records of a residents visit to the home show that staff also use this short stay as a chance to get more information about each resident. Garden Lodge DS0000007472.V335571.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): Standards 6, 7 & 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents each have a plan which describes how staff should care for them. This makes sure that staff are aware of each persons needs and preferences and respond in a consistent way. The home encourages residents to make decisions about their daily lives as much as possible but where restrictions are necessary for their safety, these are recorded and justified. Residents are not able to have a great deal of independence but the home assesses the risks of activities they enjoy or would benefit from. It provides staffing which enables the activities to take place safely. EVIDENCE: Residents each have a plan which describes the care they need. These are very detailed and include all the information staff need to make sure they respond to needs in a way suitable for each person. The plans include guidelines on how to respond to any challenging behaviour, which parents have signed their consent to. They also include assessments and guidance from specialists such as the speech and language therapist. The care plans Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 10 include information about residents cultural choices, for example, that one likes to celebrate Burns Night. Care plans are reviewed every six months and updated when something has changed. The manager described how one resident, who is able to do this, has been very involved in agreeing what is in her care plan. On the survey forms, residents said that they could make choices about what they wanted to do. The parents of one resident described how he is helped to choose his clothes, what he likes to eat (he goes shopping with staff) and the activities he takes part in. Staff described how one resident now seemed much more comfortable about saying what she wanted. Residents bedrooms showed that they were making individual choices about what they wanted their rooms to look like. The home records consultation with residents about important issues, such as having a birthday party. When new staff are being interviewed for jobs in the home, they visit the home and staff record whether residents seem to like them or not. Some people would find it difficult to make a completely open choice so staff use their knowledge of individual residents to offer, for example, the choice of two options for how to spend an evening. Staff use pictures to help residents express their choices. Comprehensive risk assessments are recorded, which describe the benefits a resident may gain from an activity and the safeguards which must be in place. These explain, for example, how many staff are needed for an activity. Where a resident can only go in the kitchen if they are supervised, the reasons for this were written down and seem justifiable. Garden Lodge DS0000007472.V335571.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): Standards 12, 13, 15, 16 & 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents take part in a range of leisure activities and use local community resources. This gives them opportunities to develop new skills and enjoy their lives. Residents are supported to keep in contact with their families and ESPA provides social activities. The home acknowledges residents rights and tries as far as possible to enable them to exercise these rights. The diet in the home is varied and the cook aims to provide meals which are healthy and enjoyable. EVIDENCE: Residents take part in many different leisure activities, such as swimming, riding and walking. They can attend ESPAs Day Centre which provides a range of craft activities such as pottery, a cafe, computer room and relaxation Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 12 room. One resident goes to ESPAs College to continue her education. Residents who enjoy outdoor activities go to ESPAs farm or the conservation group where they can take part in looking after outdoor spaces. The home has its own vehicle for residents who need it, but some residents can go out on local buses with staff. The home uses local facilities such as pubs and shops. One relative said, they get the residents out and about as much as possible which is good. Residents are able to spend time at home with their families or go out with them. Parents said that staff were very good at keeping them informed and they received letters and cards from their children (helped by staff). ESPA runs some regular social activities which enables residents to meet people from other homes. Care plans show that staff do consider carefully whether residents have the understanding to form relationships but not be at risk of abuse. There is a choice of main meals and residents are encouraged to help themselves. The menu is varied and the cook has described how they are trying promote healthy eating. The home receives advice from a dietician on the menus provided. Garden Lodge DS0000007472.V335571.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): Standards 18,19 & 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff provide care in a way which promotes residents independence. Detailed care plans make sure they know each residents needs and preferences. The home make sure that health needs are identified and met. There is an established system to make sure that medication is handled and given to residents properly. EVIDENCE: Each resident has a detailed care plan which explains the care they need and how they prefer the care to be given. Staff showed they knew about each persons individual needs and personalities. Throughout the care plans the emphasis is on supporting residents to look after themselves. One relative commented that behavioural problems have been handled sensitively by all staff. ESPA has supporting policies and procedures which guide staff in protecting residents dignity. Recently staff have had extra training to help them consider carefully each residents wishes about how staff care for them. Records show that staff review a full assessment of medical needs each year for each person. They make sure that regular checkups for teeth etc are carried out (providing residents agree to this). There is a clear system showing when the home makes referrals to specialists such as the psychiatrist Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 14 and the action taken or advice given. This make sure that staff are clear about what has been advised and also enables the home to demonstrate that it has asked advice when necessary. There is a detailed procedure covering how medication must be looked after and given to residents. A sample of records showed this had been followed. When a resident has been prescribed medication to be given in an emergency, the home has the required records which explain clearly how it has to be given and who has received training to do this. As well as training within the home, staff have attended external training in medication. Garden Lodge DS0000007472.V335571.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): Standards 22 & 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 a satisfactory complaints procedure which means that staff know how to respond to complaints and any relative who wants to complain knows how to do this. The home has done all it can to help residents understand how they can complain. The home takes all reasonable steps to protect residents from abuse, by providing training, procedures and oversight by senior staff. EVIDENCE: The home has a satisfactory complaints procedure and this has been produced in a form which could be easier for some residents in ESPAs services to understand. Staff have recorded when they have tried to explain this to residents. A full text version is also given to parents. Parents confirmed in the questionnaire that they had been given information on how to complain and one explained that they had been reminded about it several times. Most relatives who commented felt that any concerns they had raised had been dealt with properly. If I have had any concerns I have told staff and the person in charge, and it does get dealt with. Staff receive regular refresher training on preventing abuse and the organisation has satisfactory policies and procedures to protect residents. The manager has had training on safeguarding adults so that she can give refresher training to her staff. She has also had training on the new law about capacity which means that people working in social care must think carefully about each persons rights to make their own decisions. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 16 ESPAs procedures require staff to include detailed guidelines in care plans on how staff can respond to any challenging behaviour, including the use of restraint. Relatives are asked to look at these guidelines to check that they feel they are reasonable. This is a valuable safeguard for residents who might not be able to speak up for themselves. Senior staff check the records of any incidents involving restraint to make sure that residents are kept safe from harm. Full records are kept of money handled for residents and these are checked by ESPAs finance department. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 17 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): Standards 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable and safe place to live and is decorated and furnished in a domestic style. Each bedroom is different and reflects the interests and preferences of each resident. On the day of inspection the home appeared clean and well maintained. EVIDENCE: The building is decorated and furnished in a domestic style and appears bright and welcoming. There is a programme of replacement of carpets etc to make sure that standards are maintained. Bedrooms are decorated according to the preferences of each resident. The manager has described how they had found out the colour preferred by a Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 18 resident who was due to move in and repainted her room to suit her. One resident confirmed that she had chosen the pictures in her room. A bathroom and toilet were adapted to meet the needs of a resident who moved in last year. The home appeared clean and free from odours. Staff are now only allowed to smoke outside-two relatives had found that smoke from the staff room did affect other areas of the building. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 19 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): Standards 32, 33, 34 & 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are enough staff on duty to meet residents needs and help them enjoy an active lifestyle. Staff seemed to have the personal qualities, skills and training needed for this home. Comprehensive training is provided, including good support for new staff. This make sure that staff have the knowledge and skills to provide the specialised care needed in this home. Proper checks are carried out on new staff to make sure that only suitable people begin working in the home. EVIDENCE: The rotas showed that there are never less than three staff on duty in the home, and usually between four and six staff are available in the daytime. The times when only three staff are on duty are mainly at weekends, when fewer residents are in the home. These high staffing levels allow staff to provide an active lifestyle for residents and to meet individual needs. At night, there is one person awake on duty and one sleeping in. On each shift, one person is clearly identified as the person in charge. Shifts are arranged so that there is always a mix of more and less experienced staff and male and female staff on duty. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 20 Relatives generally appreciate the staff in the home. One said that , Garden Lodge staff are the most dedicated and conscientious people Ive ever met. No one could give so much love as these people do. Over half of the staff now have the recommended qualification for care staff, the National Vocational Qualification in care at level 2. The rest of the staff are registered to start working towards this qualification. ESPA has an established system for recruitment, which includes all required checks. No new staff have been employed recently (though some have transferred from other ESPA homes) but records previously seen have shown that Criminal Records Bureau/POVA checks had been carried out and three references obtained. There is a comprehensive training system for new staff and existing staff. This includes key areas such as food hygiene and also subjects specific to the type of home, such as restraint and autism. One of ESPAs staff has had training which means she is qualified to provide other staff with training on restraint to the standard expected by the British Institute for Learning Disabilities, which is recommended for care home staff. All of the care staff, apart from the manager, have had training in diversity.This aims to make sure that they understand the need to respect everyones different needs and choices. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 21 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): Standards 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well, although the manager has still to achieve one of the qualifications recommended for care home managers. Staff make sure that the home is a safe place to live and work. ESPA has good systems to check how successful the home is in meeting the needs of residents. EVIDENCE: The manager has been in charge of this home for a few years and has kept the home running well. She has already achieved one of the qualifications recommended for care home managers, the NVQ 4 in management and hopes to achieve the other, the NVQ 4 in care by this June. Completing this qualification was delayed by her unavoidable absence from work. She has continued to update her knowledge of changes in laws etc. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 22 Staff felt that the home was running well, with good communication. They said that the manager and her deputy were approachable. Good attention is paid to making sure that the health and safety of residents and staff are protected. Regular safety checks, fire drills and maintenance are carried out. ESPA has a number of systems to make sure that the home provides a good service. There is an annual development plan which is linked to individual goals for each resident. Each year residents and their relatives complete a survey so that ESPA knows what they think of the service. A senior member of the staff of ESPA visits the home once a month to check how it is running. The company has continued to develop its services and improve how it provides care. When asked in the survey how they thought the care home could improve, one relative commented that they could not think of anything but I am sure if anything comes up Garden Lodge will have anticipated it first. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 4 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 2 X 4 X X 3 X Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA37 Good Practice Recommendations The manager should achieve NVQ 4 in care. Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Garden Lodge DS0000007472.V335571.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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