CARE HOME ADULTS 18-65
Helene Lodge 115 Talbot Road Bournemouth Dorset BH9 2JE Lead Inspector
Sophie Barton Unannounced Inspection 5 January 2006 09:00
th DS0000004015.V276361.R01.S.doc Version 5.1 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 DS0000004015.V276361.R01.S.doc Version 5.1 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. DS0000004015.V276361.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Helene Lodge Address 115 Talbot Road Bournemouth Dorset BH9 2JE 01202 389901 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) Mrs Joan Pauline Stevenson Care Home 3 Category(ies) of Learning disability (3) registration, with number of places DS0000004015.V276361.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th July 2005 Brief Description of the Service: Helene Lodge is registered to provide residential care for up to three younger people with learning disabilities. Helene Lodge is a large family home. It is situated within walking distance from the local shops at Winton and has access to the main bus routes for other parts of the town. All residents have their own bedrooms, which are individually decorated and styled. One is on the ground floor and the other two on the first floor. The communal space is very generous with two lounges, and a large family style kitchen with dining seating. There is a level garden and patio area to the rear and at the front plenty of off street parking. The home is furnished to a high standard whilst maintaining a comfortable family feel. The Providers (Mr and Mrs Stevenson) and three of their family members also reside in the home and share the communal spaces with the service users. Mr and Mrs Stevenson provide all the care and supervision of the service users within the home, with no further staff being employed at present. Structured day care is not currently provided by the home, but can be arranged at a further cost and contractual agreement. The home provides an individualised residential service to each person living at Helene Lodge ensuring maximum care and independence is maintained according to specific abilities and needs. An application is currently being assessed by the Commission for the registration of a fourth bedroom at Helene Lodge. DS0000004015.V276361.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act 2000. Helene Lodge was assessed according to the Care Homes for Adults (18-65) National Minimum Standards. This was an unannounced inspection on Thursday 5th January 2006 at 9.00am to 12.00pm. Mr Stevenson was present throughout the inspection. Mrs Stevenson arrived at 9.30am. Unfortunately no service users were spoken with as they were unavailable. The Inspector had full discussions with the Proprietors and examined some policies, a service user’s care file and had a tour of the communal areas of the home. Comment cards were sent to service users, relatives and social care and health professionals in order to gather wider feedback on the service for the Commission. Three comment cards were received from service users, three from relatives, and one from a social worker and one from a GP. Reference to these comment cards have been made throughout the report. The Inspector acknowledges that this was a limited inspection which only focused on 11 standards. The home is assessed by the Commission as being a well run home, with no outstanding requirements. What the service does well:
There was far more evidence relating to what the home does well, than evidence found relating to areas where improvement is needed. Following discussions with the Proprietors it is clear that they have a full understanding of the service users’ needs and how these should be met. There are up to date assessments and care plans, and the Proprietors advocate on behalf of the service users with external services to ensure that their specialist needs are assessed and met. The home is described by relatives as “an excellent home and family”, “an exceptionally well run home, our relative is extremely happy there”, and no negative comments were received. The service users are enabled and encouraged to play a central role in the running of the home, having regular resident meetings and being part of the decision making for any prospective new service users. All three service users stated in the comment cards that they feel well cared for, are treated well and like living in the home. The home is furnished to a high standard and is very homely. The Proprietors have proactively sought to update their skills by further training. They have kept on top of good practice guidance and recommendations by attending local ‘Provider Meetings’. DS0000004015.V276361.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. DS0000004015.V276361.R01.S.doc Version 5.1 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 DS0000004015.V276361.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, and 4 The home has a good admissions process with service users and representatives having flexible opportunities to visit and make an informed choice about living there. However, the written documentation needs to be more informative to ensure all information available to service users is correct. Prospective service users needs are fully assessed ensuring that the home acknowledge these needs and meet them well. EVIDENCE: The home has a Service User Guide and Statement of Purpose that was shown to the Inspector. The Proprietors stated that these documents are available to prospective service users, funding authorities and representatives and the inspector noted that they have been updated as required. However, these documents do not make clear reference to the fact that Mr and Mrs Stevenson and three other family members share the home with the service users. This information used to be in the home’s brochure and has not been carried forward into these new documents. The Proprietors discussed at length the admissions procedure for the home, and that Care Management care plans and assessments are sought prior to them meeting prospective service users. Prospective service users can visit the home for tea and an overnight stay before making the decision to move there. The Proprietors are very clear about the needs that can be met by the home, and discussed a previous referral of a prospective service user where they
DS0000004015.V276361.R01.S.doc Version 5.1 Page 9 accepted that the compatibility with the other service users would not be conducive. Existing service users play a central role in the decision making about new referrals to the home, as evidenced in house meeting minutes. The Proprietors have also appropriately requested specialist health assessments for a current service user, to ensure that their changing needs are more fully understood and therefore met. DS0000004015.V276361.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Service users have good quality, detailed and up to date assessments of their needs. However, the care planning and home risk management documentation needs to improve to ensure service users are well informed of how their needs will be met and identified risks minimised. EVIDENCE: The Inspector examined the care file for one service user. It contained a Care Management Care Plan, specialist health assessments and the homes own care plan and assessment. The action noted on the Care Management care plan had been appropriately actioned by the Proprietors and the necessary information carried forward onto their own care plan. The service user had clearly been consulted about their plan and had signed the necessary documentation. The identification of changing needs of the service user had resulted in specialist health assessments and plans to be carried out recently. The care plan had been reviewed appropriately. The areas of need covered by the care planning documentation was extensive but it lacked detail in how the home was to meet the needs. For example the management of the identified risks stated that the home was to “provide appropriate support in all the above areas”. The Inspector considers that the Proprietors need to detail the actual support to be given i.e. “service users money to be kept in the home’s safe” etc. as this will also detail the restrictions placed on them more clearly.
DS0000004015.V276361.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: These standards were not assessed at this inspection. Please refer to the inspection report dated July 2005 where standards 12-17 were assessed as all being met to a good standard. However it must be noted that in the comments received from service users they all stated that the home provides suitable activities, they would not wish to be more involved in the decision making within the home and that their privacy is respected. These comments demonstrate that the home is achieving positive outcomes. DS0000004015.V276361.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed at this inspection. Please refer to the inspection report dated July 2005 where standards 18, 19 and 20 were assessed as all being met to a good standard. Again it must be noted that the comments received from service users all confirmed that they feel well cared for. DS0000004015.V276361.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service users are safeguarded from harm and abuse by the Proprietor’s knowledge of adult protection, and their robust procedures and policies. EVIDENCE: The home has up to date and clear policies on protecting service users from harm, and detailing what action to take if harm or abuse is suspected. The Proprietors were able to articulate well the procedures they would follow and had a good understanding of what constituted abuse and harm. The Proprietors stated that they discussed informally with service users safe behaviour and what to do if they weren’t happy with things. All three service users attend the local Advocacy Forum where again service users are able to discuss forms of bullying and abusive practices. The Proprietors have attended training in the Department of Health’s guidance ‘No Secrets’. DS0000004015.V276361.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 27 (29 is not applicable to this service). Helene Lodge is a very comfortable and homely and provides a good standard of living accommodation which meets the needs of service users well. The number of bathrooms are limited but adequate. EVIDENCE: The Inspector viewed all the communal areas. These areas are spacious and well presented, being very homely and domesticated. There is adequate seating at the kitchen/dining table and in the lounges. The areas seen were safe, bright with sufficient ventilation and heat. The home offers access to local amenities, either walking or via public transport. The Proprietors confirmed that there is a planned maintenance and renewal programme with two service users recently having their bedrooms redecorated. There is one bathroom upstairs which is shared by two service users, the Proprietors and their three family members. This is only adequate now because the home was registered prior to 2002, but would not meet the new National Minimum Standards which states that one bathroom should not be shared by more than two residents. The Proprietors confirm that because the service users have wash hand basins in their bedrooms the sharing of the bathroom is not a problem. There is a separate toilet on the first and ground floor. One service user has the use of one bathroom located near to her bedroom on the ground floor.
DS0000004015.V276361.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 (31, 34 and 36 are not applicable to this service) The Proprietors are well trained and experienced ensuring that the service users’ needs are met appropriately and that the home is run by competent staff. EVIDENCE: The Inspector spoke to the Proprietors about their training and experience. Mrs Stevenson has completed NVQ 4 in care and management. Mr Stevenson is also undertaking the Health and Social Care level 4 award currently. Both have completed a personal relationships and sexuality course, adult protection and person centred planning. Mr Stevenson has also attended a Makaton course. They have acknowledged that they would benefit from a course in mental health and are currently pursuing this. As the current service users have no physical needs or challenging behaviour the Proprietors have not undertaken any manual handling or restraint training. DS0000004015.V276361.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 Helene Lodge is a very well run home, with service users benefiting from the experience and competency of Proprietors. The views of service users and their representatives underpin the quality monitoring systems within the home, ensuring the service is user led and reflects their aims. However, there needs to be more formal quality assurance systems to ensure that service users receive appropriate feedback on their views. EVIDENCE: The Proprietors stated that there are regular house meetings, and the minutes of the last three meetings were seen by the Inspector. The Proprietors have also recently given questionnaires to the service users and to their representatives on the quality of care provided by the home. The Proprietors have considered the responses. They have not however completed a report or provided formal feedback to the service users or representatives, and there is not an annual development plan for the home. DS0000004015.V276361.R01.S.doc Version 5.1 Page 17 As stated under Standard 35 the Manager Mrs Stevenson is fully qualified and experienced. The comments from relatives stated that Helene Lodge is “an excellent home and family. Our daughter is very fortunate in her caring by them”, “an extremely well run home, our relative is extremely happy there”. A service user commented “I feel happy because I like Joan and Max, they care for me”. All the comments received were positive and confirmed that the aims for service users are met. The Proprietors keep on top of good practice guidance, and aware of Sector Skills Council training targets. DS0000004015.V276361.R01.S.doc Version 5.1 Page 18 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 3 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 x 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 3 28 x 29 N/a 30 x STAFFING Standard No Score 31 N/a 32 x 33 x 34 N/a 35 3 36 N/a CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 x x 2 x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x 3 x 2 x x x x DS0000004015.V276361.R01.S.doc Version 5.1 Page 19 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. 2 Refer to Standard YA6 YA9 Good Practice Recommendations The home’s care plans need to provide more detail about how needs are to be met, including the reasons and details of any restrictions on choice and freedom. The home needs to develop its risk assessments more fully, to include the description of what action is to be taken to minimise the identified risks. The Proprietors should complete an annual development / review report detailing the outcome of quality assurance reviews, and make this report available to service users and representatives. 3 YA39 DS0000004015.V276361.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000004015.V276361.R01.S.doc Version 5.1 Page 21 - 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!
