Inspection on 04/06/09 for Haydons Lodge

This inspection was carried out on 4th June 2009.

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

Haydons Lodge 08/06/08

Haydons Lodge 16/08/07

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report CARE HOME ADULTS 18-65 Haydons Lodge 6c & 6d North Road Wimbledon London SW19 1DB Lead Inspector Liz O’Reilly Key Unannounced Inspection 4th June 2009 11:00 Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haydons Lodge Address 6c & 6d North Road Wimbledon London SW19 1DB 0208 543 4027 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) haydonslodge@centrusthomes.co.uk Centrust Care Homes Limited Care Home 6 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 2008 Brief Description of the Service: Haydons Lodge is a residential care home for up to six adults who have experienced long-term mental health problems or learning disabilities. The home is owned and managed by a small private company who are linked with a similar service in a neighbouring Local Authority. Accommodation is provided in two separate houses, which are next door to each other. Both houses have a lounge, dining room, kitchen, three single bedrooms, a staff office and garden. Haydons Lodge is situated in a residential area of Wimbledon close to public transport links, shops and leisure facilities. Staff are at the home twenty-four hours a day. The fees vary, depending on individuals assessed needs. The current weekly fees are from £1,000. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means people who use this service experience good quality outcomes. This unannounced inspection was carried out by one Regulation Inspector on 4th June 2009. The inspector had the opportunity to speak with one member of staff and examine records held in the service. At the time of this inspection one person was living at the service. This person declined to speak with the inspector. The service manager has provided the Care Quality Commission with their own assessment of the service which includes plans for future improvements in the service. The inspector has used information from all of the above sources to reach the judgements made in this report. What the service does well: What has improved since the last inspection? What they could do better: The care planning systems could be improved to include clearer goal setting and reviews could acknowledge achievements and changes. The organisation should make sure that systems are in place to keep the gardens in good order and handrails to stairs should be repaired. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 6 The Service User Guide could be made more accessible for people using the service and provide more useful information on what they can expect from Haydons Lodge. The complaints procedure could also be provided in a more easily accessible format and should include information on contacting the placing authority for each individual. The staff rota should be an up to date and accurate record of all staff on duty at any one time. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Haydons Lodge DS0000068623.V375754.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 Haydons Lodge DS0000068623.V375754.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before anyone moves into the service a full assessment of their individual needs is carried out. A Service User Guide is in place but could be made easier to read. EVIDENCE: We looked at the records of assessment carried out before one person moved into the service. Staff have access to the assessments made by the placing authority. In addition staff have carried out their own assessments. We found these assessments to be comprehensive and focused on the strengths and needs of the person. This information can then be used by staff to set up an initial care plan. A Service User Guide is available to each person using the service. This document should be reviewed to make sure that it is easy to read and provides relevant information on what a person can expect from the service. Consideration could be given to including photographs of the service and staff. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 9 Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are consulted about the support they need and how they would like this provided. Risk assessments are carried out. Staff respect the rights of individuals to make their own decisions about their lives. EVIDENCE: We looked at the care plan in place. Good information has been sought through the assessment process on the strengths, needs and wishes of the individual. However this has not been fully reflected in the care planning. Consideration should be given to documenting clear goals with timescales. This will assist in ensuring that the individual needs and wishes of people who use the service are acted upon. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 11 We found staff have been carrying out a review of the care planning but this was repetitive with no information on any changes for the person since they moved into the service. Discussions with staff indicated that staff had supported the individual to do things they had requested and that real improvements had been made in promoting independence. This was not documented in the review of care planning. Staff should consider including information on improvements, changes and goals achieved in the review of care planning which can lead to amendments in the care plan. We saw risk assessments have been carried out and reviewed on a regular basis. This assists in ensuring that individuals are appropriately supported to lead the lives they wish. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 12 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): This is what people staying in this care home experience: 12, 13, 15, 16 & 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are supported to maintain and improve their independent living skills. Individuals make their own choices about their day to day activities. People are encouraged to participate in domestic chores and activities. EVIDENCE: Discussion with staff and examination of the records kept showed that individuals make their own, informed choices, about their lives. Records showed that consideration is given to expanding the opportunities for individuals to attend further education or employment if appropriate. Staff informed us that plans were being made for a holiday later in the year. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 13 We saw that individuals are supported to maintain personal and family relationships. Friends of individuals visit them in the service and join in activities and meals. Individual are supported to be independent with staff available to offer support if needed. Records showed that individuals go out with friends or on their own on a regular basis. Individuals are supported to assist with meal planning, shopping and cooking. People are supported to keep their own rooms clean and each person is provided with a key to their room which supports their privacy. The record of food provided showed that the preferences of individuals are taken into account in the meals on offer. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are supported to access health care services in the community. Individuals are supported to maintain their personal appearance in the way they wish. Systems are in place to monitor and administer medication if necessary. EVIDENCE: Records showed that individuals are supported to have regular health care check ups. Individuals had seen an optician and were receiving regular treatment from a chiropodist. Staff informed us that people who use the service are registered with local GP services. We saw that individuals are encouraged to manage their own health care by making and keeping their own appointments with staff support if needed. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 15 At the time of this inspection no medication was being administered. We looked at the records kept from the last time medication was administered and these were seen to be in good order. At the time of this inspection no one needed direct assistance with personal care. Staff were offering advice and support. Assessments seen included some information on how individuals liked to keep their appearance. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A complaints procedure is in place. This procedure needs to be up to date and accessible. Staff receive training on safeguarding people. EVIDENCE: People who use the service are provided with a copy of the complaints procedure within the Service User Guide. This information could be produced in a clearer more accessible format. The procedure should also include the contact details of the placing authority through which individuals can also raise any concerns they have about the service. The information on the Commission needs up dating. Staff have recently received training on safeguarding people through the local authority. Staff informed us that they have a good understanding of their role and responsibilities in reporting any allegations or suspicions of abuse. The service does not hold any money or valuables for individuals. Staff informed us that arrangements were in place for people using the service to manage their own finances. Haydons Lodge DS0000068623.V375754.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are provided with a comfortable environment which meets their needs. Certain maintenance issues need to be dealt with. EVIDENCE: The service is provided over two separate, adjoining houses. The environment is largely well maintained. However the gardens for both houses had become overgrown. The organisation needs to set up system for the regular up keep of the gardens. One handrail to the stairs in the occupied house was missing and one was not securely attached to the wall. The paintwork in the stairwell was scuffed. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 18 Individuals are provided with their own single bedroom and each house has a lounge, dining area, conservatory and bathroom facilities. All areas of the service seen were fresh and clean. Haydons Lodge DS0000068623.V375754.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 & 36 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are available to meet the present needs of people using the service. As the service is not running at full capacity the staff group is very small. The staff rota is not always kept up to date and accurate. Staff files were not examined during the course of this inspection. These will be examined at the next visit to the service. EVIDENCE: One member of staff is on duty at all times during the day and a member of staff sleeps on the premises at night. These staffing levels are sufficient to meet the present needs of the service. The registered manager informed us that when the service is operating more fully staffing levels would be increased. At the time of the last inspection of the service the staff rota was found to be inaccurate. At this visit the rota was again not up to date and accurate. An Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 20 accurate record of who is on duty at any one time should be maintained. Information on when the registered manager is available in the service should also be maintained. At present the registered manager is also the Clinical Director of the organisation. The present manager informed us that they are working towards another member of staff taking up the post of manager for this service and would be applying for this person to be registered with the Commission. Staff informed us that they were provided with good opportunities for training. Recent training had included safeguarding people, health and safety, food hygiene and working with the new mental capacity legislation. One member of staff has completed NVQ level three and is now working on the Registered Managers Award. Staff told us that despite working alone on each shift they felt well supported by the organisation and could always ring the manager for advice or support. Haydons Lodge DS0000068623.V375754.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The present management arrangements are sufficient to meet the needs of the service which is not operating to capacity. Regular checks are carried out to assist in ensuring the health and safety of people who use the service, staff and visitors. EVIDENCE: At present the registered manager is also the Clinical Director of the organisation. The present manager informed us that they are working towards another member of staff taking up the post of manager for this service and would be applying for this person to be registered with the Commission. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 22 Staff informed us that consultation on how the service is operating is carried out on a day to day one to one basis. We looked at a sample of the records kept on health and safety checks. Records showed staff are checking the fire alarm system every week. Fire drills are carried out on a regular basis. A record of any accident or incident is kept along with actions taken. Haydons Lodge DS0000068623.V375754.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 2 2 3 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 n/a X 3 X 3 X X 3 X Version 5.2 Page 24 Haydons Lodge DS0000068623.V375754.R01.S.doc Are there any outstanding requirements from the last inspection? no 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 YA1 Good Practice Recommendations The Service User Guide should be up dated, made more relevant for this particular home and be produced in more accessible formats. This will ensure that individuals will have good information on what they can expect from the service. A review of care planning should be carried out. Consideration should be given to including individual goals with timescales for people using the service. Reviews of care planning should include any changes in the strengths and needs of individuals and a review of goals achieved or still to be actioned. The complaints procedure should be reviewed and updated. The procedure should be produced in a more easily read format and include information on how to contact any placing authority involved with an individual. Repairs should be made to the handrails to the stairs in the occupied house. The gardens for the service should be kept in good order. DS0000068623.V375754.R01.S.doc Version 5.2 Page 25 2. YA6 3. YA22 4. YA22 Haydons Lodge 5. YA33 A clear, accurate and up to date record of all staff on duty at any one time should be kept. Haydons Lodge DS0000068623.V375754.R01.S.doc Version 5.2 Page 26 Care Quality Commission South East The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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