Inspection on 30/08/06 for Ivor Lodge Care Home

This inspection was carried out on 30th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Ivor Lodge Care Home 23/09/05

Ivor Lodge Care Home 09/06/05

Ivor Lodge Care Home 13/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Ivor Lodge Limited 452-454 Hinckley Road Leicester Leicestershire LE3 0WA Lead Inspector Kim Cowley Unannounced Inspection 30th August 2006 11:00 Ivor Lodge Limited DS0000043227.V308698.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 Ivor Lodge Limited DS0000043227.V308698.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. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ivor Lodge Limited Address 452-454 Hinckley Road Leicester Leicestershire LE3 0WA 0116 2547141 0116 2547141 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) Ivor Lodge Limited Mrs Sobha Chooramun Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (14) of places Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 23.09.05 Brief Description of the Service: Ivor Lodge is a residential care home for people with mental health needs. It is situated in a large detached house on the Hinckley Road, close to a range of local amenities. The home has ten single and two double bedrooms. There are two lounges, a conservatory where smoking is allowed, and a dining room. To the rear of the house is a small garden with a patio area. Fees are £285.00 per week. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection. During the course of the inspection, which lasted four hours, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that the inspector looked at the care provided to three residents living at the home by talking with the residents themselves; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. Five residents, the Owner/Manager, Owner, and one carer were interviewed. The staff team, premises, Owner/Manager, and resident involvement in the running of the home were commended. What the service does well: Ivor Lodge is owned and managed by experienced mental health professionals and a well-trained and established staff team is employed. The home has a relaxed and friendly atmosphere and visitors are made welcome. All residents interviewed made many positive comments about the home including, ‘We’ve got good food, good rooms, good staff, and have our medication on time’, and ‘We’re all happy here and we get on well. We’re fed properly, have everything we want, the staff are good and the Manager is excellent.’ Activities, education, and training are provided on a individual and group basis depending on residents’ needs. Care plans showed that some residents have a full programme of structured activities while others have more free time and come and go as they wish. Although all residents are encouraged to take part in activities, ultimately it is their choice whether they do or not. One resident commented, ‘I’m very independent here’, and another said, ‘I like the lifestyle we have.’ The home is comfortable and homely throughout. All areas inspected were well decorated, clean and tidy. The Owner/Manager said, ‘It’s important that our residents live in a nice environment, they notice that the home looks good and they are proud of it.’ Residents praised the premises and made the following comments, ‘My bedroom is designed and decorated the way I want it’, and ‘This home is always clean and it always looks nice.’ Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 6 The staff team are established and experienced. They have built positive and supportive relationships with the residents and are commended for this. One resident said, ‘The staff look after us very well and I trust them all.’ Residents’ meetings, which are held every six weeks, are one of the ways in which residents are involved in the running of the home. At these meetings residents can share their views about Ivor Lodge and make comments and suggestions. In addition, weekly meetings are held for residents to plan menus and activities. Residents also have a say in major decisions about the home, for example when areas of the home are being redecorated, residents choose the colour schemes. 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. Ivor Lodge Limited DS0000043227.V308698.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 Ivor Lodge Limited DS0000043227.V308698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ needs are assessed prior to admission to ensure the home is suitable for them. EVIDENCE: The home’s admission procedure was discussed in detail. Most residents are admitted under the ‘Care Programme Approach’ (CPA). This means a multidisciplinary team assesses them prior to admission, as do staff at the home. The Owner/Manager said assessments are always signed by residents to show they agree with them. Records relating to a recent admission were inspected. They showed that the resident in question had been assessed prior to admission and had been given support while settling in at the home. Ivor Lodge Limited DS0000043227.V308698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents care needs are met. EVIDENCE: Since the last inspection all care plans have been reviewed, updated and rewritten. Those inspected were clear and relevant. They showed that staff know the residents well and are quick to respond to their needs. Residents are risk assessed by health and social services staff prior to admission. Risk assessments are then reviewed and updated by staff at the home in conjunction with Community Psychiatric Nurses. A number of residents smoke and they are able to use the conservatory or the garden for this, but smoking is not allowed in any other part of the home due to the fire risk it presents. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 10 Residents who go out unaccompanied are informed of risks and given support and advice. Staff teach them road safety and show them where nearby pedestrian crossings are. Residents take the telephone number of the home with them when they go out. Ivor Lodge Limited DS0000043227.V308698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are encouraged to lead full and active lives. EVIDENCE: Activities, education and training are provided on an individual and group basis depending on residents’ needs. Care plans showed that some residents have a full programme of structured activities, while others have more free time and come and go as they wish. Although all residents are encouraged to take part in activities, ultimately it is their choice whether they do or not. Residents’ comments about activities included: ‘I’m very independent here.’ ‘I go out to the shops on my own.’ ‘I like playing dominoes and draughts. We do this in the evening after dinner.’ ‘I go to day centres to play pool and go on trips.’ ‘I like the lifestyle we have.’ Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 12 ‘I go out most days. I go into town or to the shops.’ All residents are expected to help in the home, depending on their abilities. This helps them to increase their independence skills. They are encouraged to keep their rooms tidy, sort their washing, and help with the washing up. Residents are encouraged to maintain family links and to communicate with their families and friends through visits, letters and phone calls. Staff offer extra support to residents who do not have contact with their families. One resident spoke candidly about how staff at the home had helped him to improve his social skills. He said, ‘Since I’ve been here I’ve improved. I used to bully people and get my own way but the staff helped me not to do that and now I’m a nicer person. I’ve learnt there’s other people besides me.’ The care staff do the cooking and residents are encouraged to help them. Residents shop with staff so they can choose food for the home. There is a regular meeting every Monday when residents discuss and decide the menu. Records showed a varied and wholesome diet being provided. All residents interviewed said they were happy with the food and the following comments were made: ‘You get brilliant food – whatever you want to eat, and seconds if you like.’ ‘My favourite meal is chicken, stuffing, baked potatoes, and cabbage with nice ice-cream after.’ ‘We have very good food here.’ ‘I’m very happy with the food.’ ‘They cook several different meals so you get a choice. If you don’t like something they say, “What would you like then?” and then they make it for you.’ ‘Yesterday we had bacon sandwiches for breakfast, I enjoyed that. For lunch today we’ve got ham salad and pickle.’ ‘We had a barbecue with hot dogs and chicken drumsticks.’ ‘I had a nice meal for my birthday with chocolate gateaux.’ Ivor Lodge Limited DS0000043227.V308698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health and personal care needs of residents are met. EVIDENCE: The Owner/Manager said that all residents are mostly self-caring, although some need prompting or minimal assistance. Staff talk to residents about what help they need and this is recorded in their care plans. Residents can bath/shower as often as they like, for example one resident likes to have two showers a day while another prefers one bath a week. All residents are registered with local GPs and have consultant psychiatrists, some also have CPNs and/or care managers. Local dentists and opticians either visit the home or see residents in the community. Medication is kept securely and properly administered with records kept. Staff are trained in house in medication administration in-house and the home’s contract pharmacist has approved their training. At present no residents selfmedicate, although they are encouraged to do so where possible. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 14 The Owner/Manager said, ‘It’s ‘important for staff to be knowledgeable about medication, particularly when new medications are being introduced. At that time residents need careful monitoring and staff need to know what to look out for.’ Ivor Lodge Limited DS0000043227.V308698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents feel able to talk to staff about any concerns they might have. EVIDENCE: There is a written complaints procedure, which is in the home’s Statement of Purpose and is given to all residents and their representatives on admission. The Owner/Manager said ‘When residents come into the home we got through the complaints procedure and explain it to them. We encourage them to raise any concerns they might have immediately so we can put things right as soon as possible. I work in the home every day and they know they can come to me about anything, or to any other member of staff.’ Staff remind residents about the complaints procedure at residents’ meetings and stress the importance to speaking out if they are concerned about anything. All residents interviewed said they would tell the Owner/Manager or a member of staff if they were not happy about something in the home. One resident said, ‘If you have a problem Sadna will sit down and talk to you about it.’ There have been no complaints since the last inspection. The home has policies and procedures on adult protection and whistle blowing and staff are made aware of these during induction. The Owner/Manager said, ‘The staff know what signs to look for and would tell me straight away if they suspected anything.’ Ivor Lodge Limited DS0000043227.V308698.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents live in an environment that is comfortable and well maintained. EVIDENCE: The home is comfortable and homely throughout. All areas inspected were well decorated. Records showed that the premises are properly maintained with all servicing and safety checks up to date. The home is subject to continual upgrading and improvement. The Owner/Manager said, ‘It’s important that our residents live in a nice environment, they notice that the home looks good and they are proud of it.’ Since the last inspection the following improvements have been carried out: • • • • • • Some bedrooms refurbished New colour television Gardens landscaped Car park and rear patio resurfaced New gates and fencing Dining room and kitchen redecorated DS0000043227.V308698.R01.S.doc Version 5.2 Page 17 Ivor Lodge Limited Residents made many positive comments about the premises including: ‘I love my bedroom because it’s nice and clean and tidy.’ ‘My bedroom is designed and decorated the way I want it.’ ‘This home is always clean and it always looks nice.’ This was an unannounced inspection and the home was clean and tidy throughout. The premises and their cleanliness are commended. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 32, 34, 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Friendly and professional staff meets residents’ needs. EVIDENCE: During the day there are generally two members of staff on duty plus a further member of staff if residents need to go out accompanied. At night there is one waking member of staff on duty and a further member of staff on call. Night staff are responsible for resident care and supervision, and also carry out light cleaning duties. Records showed that all staff have two written references and up to date CRB/POVA checks. This helps to ensure that residents are safeguarded. The Owner/Manager and Owner are responsible for staff induction and training. Both are qualified nurses. The Owner/Manager said, ‘The focus of our training is on treating residents as individuals and giving them autonomy.’ Since the last inspection all care staff have completed a first aid training course. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 19 The staff have built positive and supportive relationships with the residents who made the following comments: ‘The staff are all nice people.’ ‘The staff look after us very well and I trust them all.’ ‘The staff are fantastic.’ Overall the staff are competent, well-trained, and committed to providing good care. This is commended. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 39, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents live in a home that is safe and well managed. EVIDENCE: The Owner/Manager has run care homes for 14 years and is a qualified mental health nurse. In 2005 she completed a BSc Honours degree in Mental Health Care Professional Practice (which includes a Leadership and Management module). She works in the home full-time and is committed to delivering quality care. All residents interviewed praised the Owner/Mananger and their comments included: ‘Sadna genuinely cares. She remembers all of us when she’s on holiday. Last time she bought all 13 of us a present.’ ‘Sadna is lovely and she’s never strict.’ Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 21 ‘When Sadna went on holiday she brought us all a present back. She always does this, every time she goes away.’ The Owner/Manager was commended for the quality of her work. Residents’ meetings, which are held every six weeks, are one of the ways in which residents are involved in the running of the home. At these meetings they can share their views about Ivor Lodge and make comments and suggestions. The Owner/Manager said residents who find it difficult to speak out in a group setting meet with staff privately to ensure their views are heard. In addition weekly meetings are held for residents to plan menus and activities. Residents also have a say in major decisions about the home, for example when areas are being redecorated residents choose the colour schemes. Resident involvement in the running of the home was commended. Polices and procedures are in place for safe working practices and the premises are risk assessed. Recorded showed that the maintenance of the property and its safety systems are up to date. The Fire Officer inspected the home on 16.06.06. The Owner/Manager said he checked the Fire Risk Assessment, which he regarded as satisfactory. He recommended that emergency lighting should be fitted to the rear exterior of the home. This has been done. The Environmental Health Officer inspected the home on 20.03.06. The Owner/Manager said she was asked to produce a more comprehensive risk assessment of the kitchen and this has been completed. Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 22 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 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X 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 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 3 X Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Ivor Lodge Limited DS0000043227.V308698.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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. 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