Inspection on 14/11/06 for Hunters Lodge

This inspection was carried out on 14th November 2006.

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

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

Other inspections for this house

Hunters Lodge 26/01/09

Hunters Lodge 21/11/05

Hunters Lodge 19/05/05

Hunters Lodge 14/10/04

Hunters Lodge 02/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

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 09/07/2008.

CARE HOME ADULTS 18-65 Hunters Lodge 26 Berridges Lane Husbands Bosworth Leicestershire LE17 6LE Lead Inspector Ruth Wood Unannounced Inspection 14th November 2006 10:00 Hunters Lodge DS0000001745.V318336.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 Hunters Lodge DS0000001745.V318336.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. Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hunters Lodge Address 26 Berridges Lane Husbands Bosworth Leicestershire LE17 6LE 01858 880538 01858 81185 hunters_lodge@lineone.net 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 Christine Anne Gilbert Ms Claire Gilbert Care Home 17 Category(ies) of Learning disability (17), Sensory impairment (4) registration, with number of places Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. No person falling within category SI to be admitted to the home unless that person also falls within category LD - ie dual disability. The home may not accommodate more than a maximum of 4 persons falling within the categories LD/SI (dual disability). The home to revert to 16 persons when/if one of the married couples leaves. 21st November 2005 Date of last inspection Brief Description of the Service: Hunters Lodge care home cares for seventeen adults with learning disabilities, some of who may have an additional sensory impairment. The property was originally a farmhouse and is situated in the village of Husbands Bosworth near to the market towns of Lutterworth and Market Harborough. It is close to shops and other amenities and easily accessible by private and public transport. Accommodation is spread over two floors with communal rooms and some bedrooms being located on the ground floor. There are eleven single bedrooms (seven with en-suite facilities) and three double bedrooms. There is a secluded garden at the back of the home. Current weekly fees are £324. Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a weekday between 10am and 5pm. How three people’s needs are met was looked at closely. This involved studying their support plans, observing how staff interact with them and speaking with them and the registered and deputy manager about their needs. The inspector also looked at documents such as staff recruitment and training records as well as fire and maintenance records. Questionnaires in which service users, staff and relatives had given their opinion of the home were also seen. All areas of the home were looked at and the inspector spoke to other service users about their day and leisure activities and to a relative who was visiting about their impressions of the home. What the service does well: What has improved since the last inspection? What they could do better: To further improve an already very good quality assurance system the opinions of people such as GPs and commissioning social workers should also be sought. Hunters Lodge DS0000001745.V318336.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. Hunters Lodge DS0000001745.V318336.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 Hunters Lodge DS0000001745.V318336.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): 2 Quality in this outcome area is good Good assessment procedures make sure that service users’ needs and aspirations can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care file of a service user who had recently moved into the home was examined and the circumstances surrounding their admission were discussed with the registered and deputy manager. New service users are offered the opportunity to visit the home and to get to know the people who live and work there before they move in. The new service user’s file contained a comprehensive assessment of need from the placing care manager and an assessment completed by the registered manager. Their placement had been recently reviewed and there were arrangements in place for ongoing monitoring. Staff were observed to communicate effectively with the service user and to have a good understanding of their needs. Hunters Lodge DS0000001745.V318336.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, 9 Quality in this outcome area is good. Service users are involved in day to day decisions, are supported to take reasonable risks and support plans accurately reflect their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three service users’ support plans were examined; these appeared to reflect actual need as discussed with the manager and service users and observed by the inspector. Plans were clearly written and outlined service users’ personal care needs, communication needs and aspirations. Care plans are currently being updated and presented in ways that are individual to each service user and written primarily from their perspective, in line with the principles of person-centred planning. Plans showed evidence of regular review and the involvement of the service user and outside professionals. Good systems are in place to facilitate choice by using a variety of communication techniques such as photographs and picture books. Service users’ meetings are held every month and are recorded in an easy to read format. Discussions are held about activities that people would like to try and Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 10 changes they would like to see in the home. Service users also have access to the advocacy group ‘People First’ through their day centre. Service users are supported to manage their finances. Records are kept of all transactions and three service users’ records were checked at random together with the balance of monies recorded. These were found to be accurate. Good systems are in place relating to risk management. Of particular note were assessments in place in relation to independent travel and participation in activities. These detailed contingencies (such as service users carrying identification and contact numbers) should anything go wrong. Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 – 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15, 16, 17 Quality in this outcome area is excellent Service users have excellent opportunities to engage in vocational, leisure and community activities, are given good support in maintaining links with family and friends and enjoy good, nutritious food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are involved in a variety of daytime activities including paid and voluntary work, college courses and attending specialist day services. One service user talked about their voluntary work at a local museum another showed the inspector their weekly timetable, which included a mixture of all the activities described. Service users are well know in the local village and visit the shops and pub regularly, as well as using the facilities in the nearby towns of Market Harborough and Lutterworth. Discussion with service users indicated that they enjoy active and rewarding social lives, which reflect their individual interests and allow them to try new experiences. Service users have the opportunity to go on at least one holiday per year in small groups with staff support. Holidays have included trips to Spain as well as various destinations in the UK. One service user showed the Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 12 inspector pictures of their activity holiday in the Lake District. Two service users were going to see a Cliff Richard Concert later that evening and another service user said that they were going to see Status Quo concert later in the year. The manager discussed the strategies used to maintain links with families and friends. Relatives can visit at any time and service users can invite friends for a meal or to join in social events. A newsletter is produced to send to relatives who may live some distance from the home. One relative who visited during the inspection spoke very positively about the welcome they received saying it was “like a family”. Good interaction was observed between staff and service users and relationships appeared to be warm, friendly and open. A rota was posted in the kitchen outlining service users’ responsibilities for domestic activities such as setting tables. Menus are discussed on a monthly basis and suggestions for changes are incorporated. Some staff have received training in nutrition and menu records showed that a balanced and interesting diet is served. Service users are encouraged to make their own packed lunches (with support if needed) and there is an ongoing debate as to how these may be made more interesting. Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good Service users receive appropriate personal support and their health and medication needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users receive appropriate personal support tailored to their individual needs and this is reflected in their support plans. There is flexibility in times for getting up and going to bed, meals and other aspects of daily life. Specialists such as occupational and speech therapist have been contacted to enhance aspects of service users’ day to day life such as appropriate adaptations and the use of different communication methods. Provision for managing health care is good and the home’s GP spoke very positively on the Comment Card about the standard of care and support that service users receive. The manager is particularly pro-active in ensuring that service users have access to regular health screening both in relation to their general health and in relation to specific conditions they may have. Service users with diabetes are well supported having their sugar levels monitored on a daily basis and receiving appropriate advice and support with their diet and exercise. Health care records are detailed and there are summaries available should information about a service user need to be given in the case of an emergency hospital admission. Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 14 All staff have received appropriate training in the administration of medication and the manager and deputy manager have recently attended additional training, which has highlighted aspects of the home’s medication policy, and practice that could be improved. Medication Records examined appeared accurate and medication was stored appropriately. Ways are also being explored to enable some service users to administer their own medication. Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good Service users are listened to and good systems and practice are in place to protect them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Complaints procedure is outlined in the service users’ guide and service users are encouraged to bring any concerns to the monthly service users’ meetings. There are also easy to understand complaints forms for service users or their relatives to use. Service users also have access to an advocacy service through the day centre which they attend. There are procedures in place relating to adult protection and staff have received training in this area. One service user said that they felt safe in the home and others observed seemed relaxed and comfortable in the presence of staff and other service users. Good recruitment practices are in place to ensure that those that present a risk to vulnerable adults do not work at the home (See Standard 34). Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 29, 30 Quality in this outcome area is good. Service users live in a clean, comfortable and personalised environment, which meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A full tour of the home was made. All areas appeared to be clean, tidy and well maintained. Staff have received training in infection control and bathrooms and toilets were supplied with suitable hand washing materials. Service users’ bedrooms were highly personalised reflecting their own tastes and interests. One service user spoke about their room and how much they liked the colour it had been painted. Adaptations had been made to some bedrooms (such as handrails) to meet people’s increasing physical needs and all bedrooms have a call bell. Modifications are to be made to the fire alarm system for one service user who has recently experienced deterioration in their hearing. All areas are accessible to service users and the home is located near to public transport and local amenities such as a pub and shops. Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good Service users are supported and protected by well-trained staff and effective recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion was held with the manager and deputy manager about training arrangements, and documentation (including certificates) were seen to verify that training discussed had taken place. Just over fifty per cent of staff have completed at least a level 2 National Vocational Qualification and two care staff have just completed their level 3 Qualification. Staff have also received training appropriate to meeting the needs of people living in the home with particular syndromes or conditions as well as more generic training such as in risk assessment. Staff were observed to communicate well with service users altering their mode of communication as necessary to suit the needs of the individual. Two recruitment records were examined; these contained all required information including two written references and evidence of criminal record bureau checks. Hunters Lodge DS0000001745.V318336.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, 42 Quality in this outcome area is good Very good systems are in place to ensure that service users’ views inform the way the service is delivered, monitored and improved and good health and safety practice ensures their welfare is promoted This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager hopes to complete her Registered Manager’s Award in December and has already achieved National Vocational Qualifications in management and care and levels 4 and 2 respectively. The manager, along with her deputy manager and staff also undertake regular training to update their skills; recent examples include person-centred-planning and medication training. Very good systems are in place to ensure that service users have regular input into the running of the home and that their views are central to the development of the service. Service users’ meetings are held on a monthly Hunters Lodge DS0000001745.V318336.R01.S.doc Version 5.2 Page 19 basis and service users’ views are sort formally on an annual basis by means of a written questionnaire. This is written in plain English with the addition of pictures to aid understanding; service users receive support in completing this from staff at the day centre. A range of questions is asked covering all aspects of the service. The information is gathered and collated and then the response to any issues/ suggestions raised is clearly documented. Staff and relatives are also surveyed in a similar manner and again their views are taken into consideration in subsequent planning for the home. Effective systems are in place to ensure the health and safety of those who live and work in the home. Fire systems and appliances are regularly checked and serviced, as are gas and electrical systems. Staff have received training in moving and handling, infection control and first aid. Hunters Lodge DS0000001745.V318336.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 33 34 35 36 3 3 X 3 X X 4 3 4 3 3 3 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 3 X X 3 X Version 5.2 Page 21 Hunters Lodge DS0000001745.V318336.R01.S.doc No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations To further enhance the quality assurance system it is recommended that the views of stakeholders (such as GPs and commissioning social workers) be sought. 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