Inspection on 08/06/08 for Haydons Lodge

This inspection was carried out on 8th June 2008.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haydons Lodge 04/06/09

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 28/09/2008.

CARE HOME ADULTS 18-65 Haydons Lodge 6c & 6d North Road Wimbledon London SW19 1DB Lead Inspector Emma Dove Key Unannounced Inspection 8th June 2008 3:30 Haydons Lodge DS0000068623.V365743.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 Haydons Lodge DS0000068623.V365743.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. Haydons Lodge DS0000068623.V365743.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.V365743.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2007 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. Information about the CSCI is included in the Statement of Purpose and Service Users Guide. The fees vary, depending on individuals assessed needs. The current weekly fees are from £1,000. Haydons Lodge DS0000068623.V365743.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 1 star. This means people who use this service experience adequate quality outcomes. This unannounced inspection took place over three hour on the 8th June 2008. One regulation inspector visited, looked at records, spoke with the manager and staff. Questionnaires were sent to placing social workers, health professionals and staff. We have not received any completed questionnaires. We did not receive a completed Annual Quality Assurance Assessment (AQAA) in the given timescale, which prevented us from using the services own information. What the service does well: What has improved since the last inspection? What they could do better: To ensure that people’s health needs are fully met, medication records must be signed and up to date with the balance of medications correct and any anomalies explained. New staff should complete the local authorities safeguarding training to ensure that they are familiar with local practice. The Statement of Purpose and Service Users Guide should be updated to ensure people have up to date information about the service. Risk assessments should be reviewed on a regular basis. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Haydons Lodge DS0000068623.V365743.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.V365743.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): 1, 2 and 4 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. Admissions are not made until a full needs assessment has been completed. People thinking about moving in are invited to visit, as a part of the decision making process. EVIDENCE: The Statement of Purpose and Service Users Guide give people information about the services provided, staff, activities, reviews and how to make a complaint. These documents should be updated to include details of the new manager and the change in contact details for the CSCI. The manager said that they have a prospective new person who has been to look at the home, had an assessment of need and is due to visit again to help decide whether to move in. We saw assessments in case files completed by both placing social workers and the registered person. Haydons Lodge DS0000068623.V365743.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): 6, 7 and 9 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service involves people in planning their care. Care plans are person centred and agreed with the individual. Staff understand the importance of people being supported to make their own decisions. Risk assessments are completed as a part of the care plan. EVIDENCE: We saw detailed care plans developed with people who use the service from the assessment of need. We saw regular reviews of the care and support provided. People make decisions about their lives with support from staff, the manager and owner. The home operates a key work system, which enables staff to work on an individual basis with people who use the service. Risk assessments are in place, however they must be reviewed on a regular basis. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a commitment to enabling people to develop or maintain their skills including social, emotional, communication and independent living skills. People are involved in daytime activities of their choice. People who use the service have the opportunity to develop and maintain important personal and family relationships. People are encouraged to be involved in the day-to-day running of the home and are expected to do help with domestic chores, particularly their rooms, meal planning and cooking. EVIDENCE: The manager and staff said that people decide what they want to do during the day and they offer support for people to attend classes, groups and college when required. The manager also said they would offer support to people who are looking for employment. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 11 People are supported to identify goals and work to achieve them. The manager said they will support people to have realistic goals and ‘be there’ if things don’t go well for an individual. The manager and staff said they support people to maintain important relationships with family members and friends. The manager said that the menu is varied and takes into account peoples religious, cultural and medical dietary needs and individuals likes and preferences. They are also working with people to promote healthy eating. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People have access to appropriate healthcare professionals. People receive personal and healthcare support using a person centred approach. Medication records are generally up to date, with records of medicines received, administered and disposed of, although they are not always correct. EVIDENCE: We saw that peoples health care needs are recorded in care plans. People have access to community health professionals including a GP, optician, and dentist and specialist health care professionals can be involved when needed. Records are kept of appointments attended and any changes to health care needs are noted. Medication is appropriately stored. We saw Medication Administration Record Sheets signed with one exception. Two medications for one person were not signed on one day. The manager said that this was due to the person being away from the home. Staff must sign that this is the case so we can see peoples health needs are being met. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 13 A count of two medications identified the balance correct for one. The tally for one medication was not correct, the number of tablets left did not add up to the number received and the number administered. The manager investigated and reported that this was a mathematical error by staff and confirmed that medication had been administered as prescribed. Failure to comply with this requirement may lead to enforcement action being taken. The medication policy should be updated to reflect the Care Standards Act 2000 rather than previous legislation. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clearly written and easy to understand. Appropriate policies are in place for safeguarding. EVIDENCE: The complaints procedure is included in the Statement of Purpose and Service Users Guide, which are given to all people who use the service. Records are kept of complaints. The service has not received any complaints since the last inspection in August 2007. We have not received any concerns or issues about the service in the last year. Appropriate policies are in place for safeguarding. New staff should complete the local authorities training to ensure they are familiar with local practices. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to meet the needs of the people who live there. Bedrooms are single and people are encouraged and supported to personalise their rooms. There are sufficient bathrooms and toilets. Communal areas enable people to meet friends or relatives in private. The home is well lit, clean and tidy. EVIDENCE: Accommodation is provided in two separate houses, which are next door to each other. People have access to a lounge, dining room, kitchen, three single bedrooms, a bathroom, shower room, toilet, office and a garden in each house. The environment is well maintained. Bedrooms are single. The manager told us people could personalise their bedrooms. All areas of the home were clean. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 16 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): 32, 34, 35 and 36 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. There are enough staff available to meet the needs of people using the service. The staff recruitment procedure is good, with systems in place to ensure appropriate checks are made, although records are not always in place to confirm this. EVIDENCE: One member of staff is on duty during the day and at night. The manager is available in addition to these hours some weekdays. We saw these staff levels to be sufficient to meet the needs of people currently living there. When more people move in, more staff will be required. The manager is aware of this. The staff rota was updated during our visit to show the managers hours. The rota must be up to date at all times and reflect the staff on duty. The manager is aware of the need to recruit staff from similar backgrounds as the people who use the service, to ensure individuals needs can be met. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 17 One new member of staff has been appointed since the last inspection in August 2007. We saw staff files contain confirmation that a Criminal Records Bureau check has been completed before the person started work. One staff file only had one written reference. The manager said the second reference is probably at the organisations office. Care must be taken to ensure that all references and information regarding staff is available at the home. We did not see staff training records. Staff said they do training relevant to carry out their role. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. A new manager has been appointed who has the knowledge and experience to run the home. The manager has an understanding of the principles and focus of the service. EVIDENCE: The new manager has been at the home for four weeks. The manager said he has previous experience in similar health service settings and is aware of the needs of the people who currently use the service and people thinking of moving in. The manager will need to apply to register with the CSCI and is aware of the process. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 19 The manager has failed to audit the administration of medication sufficiently to ensure peoples health needs are fully met. The manager said that house meetings have not been held due to the small number of people living in the home. Health and safety records were generally up to date. The fire alarm was tested weekly in March 2008, but only once in April and June 2008. The manager said that the alarm is not tested every week if the people who live there are away or out. The fire alarm must be tested weekly to ensure people who use the service, staff and visitors are safe. Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 20 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 3 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 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 2 X 2 X 2 X X 2 X Haydons Lodge DS0000068623.V365743.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? YES 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 Medication must be signed for at the time of administration and the GP should be consulted when people refuse to take medication, to ensure people’s health needs are fully met. (timescales of 08/10/07 and 01/02/08 not met) Timescale for action 25/07/08 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 Statement of Purpose and Service users Guide should be updated to include the name of the manager, to ensure people have the correct information. 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