Inspection on 03/05/05 for Hastings Lodge

This inspection was carried out on 3rd May 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Hastings Lodge 14/07/08

Hastings Lodge 03/08/06

Hastings Lodge 23/01/06

Hastings Lodge 25/10/04

Hastings Lodge 21/07/04

Hastings Lodge 27/01/04

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Hastings Lodge 20-22 Althorp Road St James Northampton NN5 5EF Lead Inspector Sheila Smith Unannounced 3rd May 2005 10.00 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. Hastings Lodge Version 1.10 Page 3 SERVICE INFORMATION Name of service Hastings Lodge Address 20-22 Althorp Road St James Northampton Northants NN5 5EF 01604 750329 01604 750329 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) Mr John Hastings Elliot Mrs Marie Llandinaff-Elliot Care Home 14 Category(ies) of LD(E) Learning Disability - Over 65 Years (2) registration, with number LD Learning Disability (14) of places Hastings Lodge Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate 11 services users at 20-22 Althorp Road, St James, Nothampton, NN5 5EF 2. To accommodate 3 service users at 6 Althorp Road, St James, Northampton Date of last inspection 25th October 2004 Brief Description of the Service: The home provides a service for 14 service users with learning disabilities and is situated within a residential area of Northampton. The home is divided into three properties situated in the same street.Two of the properties are ajacent and have been tastefully converted into one property, which is home to 11 residents. 3 further residents, who have been assessed as requiring minimum support live in a smaller property further down the street. The properties blend in well with the surrounding houses in the area, and shops, and other facilities are close by. 12 service users are accommodated in single rooms with one double bedroom and the lounges, dining room and kitchen are freely accessible to all the residents .. Hastings Lodge Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a weekday evening beginning at 5.30pm and lasted for 3.5 hours. All of the residents living in the main house were present, and one of the residents from the cluster home was also visiting. The Registered Manager Mrs Marie Marguerite Landinaff- Elliot was present for some of the inspection. The inspection consisted of individual discussions with the residents, discussion with the Registered Manager and member of staff, a tour of the home, and observation of records, including two of the resident’s personal files. A pre-inspection questionnaire from the Registered Manager, and feedback forms from 6 residents and 4 relatives, had been received since the last inspection and also formed part of this inspection. What the service does well: What has improved since the last inspection? The Registered Manager has re-organised the staff rotas so that the number of hours worked by staff, at the main house and in the cluster home is clearly stated. The Registered Managers hours have been included on the rota. Staff spoken to felt that there were enough staff on duty, with out of hours support from the Registered Manager who lives close by. Staff demonstrated that they were familiar with the Home’s organisational structure and had received individual contracts. They demonstrated, through Hastings Lodge Version 1.10 Page 6 discussions, their awareness and understanding of the different roles and responsibilities within the staff team, and felt supported and encouraged to undertake National Vocational Qualification training. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hastings Lodge Version 1.10 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 Hastings Lodge Version 1.10 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) 3 Staff had a clear understanding of the current residents needs and were able to meet them. EVIDENCE: The current residents have lived together for a number of years and the original documentation of the assessment of their needs on admission no longer forms part of the personal file. Reviews by care manager and the daycentre were seen. The inspector observed staff to be competent and knowledgeable about the individual needs of service users and noted that they were skilled at managing their differing needs, communicating appropriately. The day- to -day records reflected careful monitoring of the service users needs. The Registered Manager discussed a new system she is to introduce shortly, which consists of a pen picture of each resident identifying individual needs. Hastings Lodge Version 1.10 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) 6,7,8,9 Systems are not in place that allow residents to be involved in decisions about their own lives, or informed about restrictions that had been imposed, or about the running of the home. There is the potential for residents to feel frustrated at being denied opportunities to make everyday choices and major life decisions. EVIDENCE: Comprehensive care plans were in place, but had not been reviewed on a regular basis with the residents so that they had not had the opportunity to contribute to their care. (A recommendation has been made) Staff spoken with demonstrated their knowledge and understanding of the service users needs and their familiarity with the care plans. One resident informed the Inspector that residents were not allowed to assist in the kitchen but was not aware of why the restriction had been made. (A recommendation has been made) Residents spoken to had not been informed or involved with the menu for the evening meal. Residents meetings do not take place. (A recommendation has been made) Hastings Lodge Version 1.10 Page 10 Risk assessments were in place but it was not clear when they had been reviewed. (A recommendation has been made) Of the four feedback forms from relatives two people were satisfied with the care their relatives received whilst two were only partly satisfied. Hastings Lodge Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13, 15, Links with the local community are good, and residents are given opportunities for personal development, although none are politically active. EVIDENCE: The home has a positive relationship with the immediate local community. Local amenities are available and used by residents, such as the church, library and shops. The staff are able to give support to residents both within and outside the home. Residents are supported in various employment, education and training according to individual interests and abilities. Day and evening courses and workshops are accessed through the day centres. A resident confirmed that she attended evening classes in creative textiles, literacy and numeracy, and had obtained an National Vocational Qualification in food hygiene. One resident said how much she enjoyed going out in the evenings to the local PHAB club, and to Mencap. Another resident said that he used to attend local football matches but now prefers to stay at home. A resident said ‘ I work at Allen Road as a receptionist two days a week, and go to Riverside three days where I enjoy cookery sessions and swimming.’ He also Hastings Lodge Version 1.10 Page 12 said that he was responsible for picking up the mail, after it was delivered to the home and taking it to the member of staff on duty. Residents are encouraged to maintain relationships with friends and family who are invited to the home whenever they wish to visit. One resident confirmed that his family visited at 8pm every Friday, and he was looking forward to a weekend away with his family to attend a party . Residents are escorted on an annual holiday and a resident proudly displayed photographs of previous holidays No residents have been registered to vote in political elections. (A recommendation has been made. Hastings Lodge Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 The arrangements for planning care in this home are good ensuring that health and personal care needs of people living in the home are fully met. EVIDENCE: Residents confirmed that they are supported in accessing appropriate healthcare services as and when required. The Registered Manager said that the home receives good support from the local health care practice. Healthcare records and action plans were clear and concise. The carers on duty were observed having friendly conversations with residents, which were appropriate and informal, with residents responding in a relaxed way. Staff commented that residents have their own routines for getting up and going to bed, based on commitments and choices. All residents have an annual medical check, and are seen on a regular basis by the Dentist, Optician and Chiropodist. Hastings Lodge Version 1.10 Page 14 Staff, were observed to be mindful of privacy and dignity issues throughout the inspection. Discussion with a residents and staff identified that residents views are taken in to account, regarding staff who assist with their personal care. The feedback cards from residents were generally positive regarding privacy. None of the current home population of residents has been assessed as being safe to administer their own medication. The Home has a contracted Pharmacist and a pre-packed weekly individual system is used. The system used was not satisfactory. For example each resident had one weekly dispensing tray which had been pre packed by the pharmacist. An audit of one residents tablets was carried out during the inspection and it was noted that all of the 4 prescribed morning tablets had been dispensed into one compartment of the tray, thus meaning that it was difficult for staff to differentiate between the tablets, or to check that the correct amount had been received. The carer on duty said that a contract with a new chemist was due to start shortly. One resident buys her own paracetamol, and although there are controls in the home in that she signs each time she requests paracetamol from the home, there was no risk assessment in place. (A requirement has been made) Hastings Lodge Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Residents were not aware of the complaints procedure, therefore there is the potential for residents not to make a complaint. The Residents Financial procedure was unclear, thus potentially leaving residents at risk EVIDENCE: Residents reported that they were not aware of the complaints procedure. Six residents comment cards said that they knew who to complain to. There was no record kept of complaints, although two comment cards received from relatives indicated that they had made a complaint. Two relatives comment cards indicated that they were not aware of the homes complaint procedure. The Registered Manager said that the homes policy is not to hold cash for the residents but that she has the responsibility of paying allowances received by giros into the bank. Some of the residents then pay part of the money back to the home towards their fees. On the day of the inspection the Registered Manager was holding several months giros, which had not been paid into individual bank accounts. (A recommendation has been made) Advice was also given regarding financial records to be kept. This was the subject of a previous requirement Hastings Lodge Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30 The standard of the décor within the home is reasonably good, and the standard of hygiene was high, so that the residents have a homely place in which to live. EVIDENCE: Some of the residents were willing to show their rooms during the inspection and confirmed that they had been involved in choosing the colour of the paint. General hygiene and domestic maintenance was good. The Home is close to local amenities and is in keeping with the surrounding residential area The Registered Manager said that the home has a maintenance, re-decoration and renewal programme, and a room was seen that had been recently redecorated. Several chairs in the T.V. lounge were noted to require repair or replacement. (A requirement has been made) Hastings Lodge Version 1.10 Page 17 Prior to the inspection a flood in a washbasin had caused a leak into the downstairs lounge. This was being dealt with through insurance, and would require re-decoration to the lounge. During the tour of the home it was noted that both the private and communal space were found to be tidy, appropriately ventilated and smelt fresh and clean. Resident’s rooms showed evidence of personalisation with small items of personal furniture, picture and ornaments in evidence. All were decorated in different styles chosen by the resident. The kitchen area was tidy, with work surfaces clean, and all perishable foodstuffs appropriately refrigerated. Kitchen equipment, such as the cooker, refrigerator, and freezer were suitable in capacity for the needs of the residents. Hastings Lodge Version 1.10 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 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 The homes recruitment procedure was not robust, thus potentially leaving residents at risk. 10 out of 13 care staff have a National Vocational Qualification so that potentially residents receive a reliable service, from a well-trained staff. EVIDENCE: The Registered Manager said that all staff have Criminal Reference Bureau clearance and all newly appointed staff have been checked against the Protection of Vulnerable Adults register. The file examined of a recently appointed member of staff had an incomplete application form, only one reference only and no proof of identity. (A requirement has been made) Information on the pre inspection questionnaire demonstrated that 77 of the staff have a National Vocational Qualification, and staff have received training in food hygiene, fire, medicines, diabetes, and celiac disease during the last 12 months. Hastings Lodge Version 1.10 Page 19 Staff said that all newly appointed staff receive induction training, and that the manager supported them in their work, through informal contact time, regular supervisions and staff meetings. Hastings Lodge Version 1.10 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 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) 42. The well being, health and safety of the residents is promoted, and protected through staff observations and actions, policies and procedures. EVIDENCE: Staff receive regular and updated training on all health and safety issues, and indicated that they have a good understanding of their responsibilities regarding health and safety. Residents demonstrated that they had a good understanding of the fire procedure, and one resident was able to talk knowledgeably about his responsibilities if the fire alarm sounds. The fire logbook was examined and records were seen that the fire alarm was tested regularly. The accident book was satisfactory Hastings Lodge Version 1.10 Page 21 Staff said that faulty equipment was replaced or repaired quickly. Disposable gloves and aprons are readily available for staff assisting with personal care. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Hastings Lodge Score 2 2 2 2 x Standard No 24 25 26 27 28 29 30 STAFFING Version 1.10 Score 2 x x x x x 3 Page 22 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score x 3 2 x 3 x 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 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x Hastings Lodge Version 1.10 Page 23 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. 1. Standard 1 Regulation 4 (1) Requirement Timescale for action 30/06/05 2. 5 3. 23 4. 5. 6. 24 34 The statement of purpose must comply with schedule 1 of the care standards act and must be submitted to the Commission of Social Care Inspection 5 (1) The residents contracts must comply with standard 5 of the care standards act and a copy must be sent to the Commission of Social Care Inspection. 16(2)&17( A system must be introduced 2) that provides a clear audit trail for residents personal allowance.This is an outstanding requirement from 25th Oct 2004 16(2) Chairs that have split covers in the lounge must be replaced 19 Two references must be obtained for new staff before they start work. 30/06/05 30/06/05 30/06/05 05/05/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hastings Lodge Version 1.10 Page 24 1. 2. 23 21 3. 4. 5. 6. 7. 8. 6 7 9 22 8 13 Residents allownces should be paid into individual bank accounts when they are received at the home. Policies and procedures for the ageing illness and death of residents should be established, and submitted to the commission of Social Care Inspection.This was the subjectof a previous recommendation The care-plan should be reviewed with the resident at least every six months. Systems should be introduced that demonstate how individual choices have been made, and record why others have made decisions and why. Risk assessments should be reviewed regularly. The complaints procedure should be written an appropriate language and discussed with the residents. A record should be kept of all complaints. Residents meeting should be introduced. Residents should be registered to vote in political elections. Hastings Lodge Version 1.10 Page 25 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB 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 Hastings Lodge Version 1.10 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. 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!