Inspection on 02/12/08 for Jacobs Lodge

This inspection was carried out on 2nd December 2008.

CSCI found this care home to be providing an Good service.

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

Jacobs Lodge 06/06/06

Jacobs Lodge 10/01/06

Jacobs Lodge 06/01/05

Jacobs Lodge 22/07/04

Jacobs Lodge 18/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Jacobs Lodge Jacobs Gutter Lane Hounsdown Southampton Hampshire SO40 9FT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Craig Willis     Date: 0 2 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Jacobs Lodge Jacobs Gutter Lane Hounsdown Southampton Hampshire SO40 9FT 02380661205 02380661206 paul.anderson@hantspt-sw.nhs.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Paul Anderson Type of registration: Number of places registered: Hampshire Partnership NHS Trust care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 7. The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary needs on admission to the home are within the following category: Learning Disabilities - Code (LD) Date of last inspection Brief description of the care home Jacobs Lodge is a short break service located just outside Totton on the same site as the Hythe and Waterside Day service. The home is purpose built, all on one level, and allows easy access for people who use wheelchairs. The service is owned by Hampshire County Council and managed by Hampshire Partnership NHS Trust. There is a kitchen, dining room, lounge and laundry facilities and each service user has their own bedroom when they come to stay. There is also a large garden providing additional recreational Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 7 Brief description of the care home space. Fees are assessed by the local authority adult services teams so will vary for each service user. The full cost of the service is 142 pounds per night. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The evidence used to write this report was gained from the information we have received from the service since the last inspection. This includes the annual quality assurance assessment completed by the manager. A site visit was made to the service on 2 December 2008. During the visit we spoke with visiting relatives, staff on duty and the manager. Due to the communication needs of the people staying at the service during the visit we did not have direct conversations with them, but observed their interactions with staff. We received surveys from eight people who use the service and eight staff members. The communal areas of the building were viewed and documents relating to the running of the service were inspected during the visit. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems to assess peoples needs before they stay at the service. This helps to reassure people that the service will be able to meet their needs. Evidence: The manager reported in the annual quality assurance assessment that people are referred to the service from Hampshire adult services, following a care management assessment. Following this referral, the service completes their own assessment with the person and plan the support that they would need for their stay. People are invited to visit the service for a meal and an overnight stay prior to a more prolonged stay. Since the last inspection the service has introduced a revised assessment, more focussed on peoples needs during a short stay. During the visit we looked at the records of three people who have used the service. All three records contained a care management assessment and the assessment completed by the service. This assessment was completed with input from the person using the service, their relatives and health professionals where appropriate. The assessment included communication, mobility, personal care support, sleeping, Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: healthcare, medication and community involvement. Each person is given a service users guide, which sets out what the service provides and gives details of the complaints procedures. This guide was not inspected during the visit. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are excelent care planning and risk assessment systems, which involve people in making decisions during their stay and helps staff to provide the support that people need. Evidence: The records of three people who use the service were inspected during the visit. All three had a care and support plan, which set out how their assessed needs should be met. The plans are reviewed every six months and there was evidence that plans had been amended where peoples needs have changed. A requirement was made following the last inspection that risk assessments must be completed for the activities people are supported to undertake and the assessments must be reviewed. Risk assessments were in place for all three people whose records were inspected. These assessments cover the identified risk to the person and what measures are required to make the risk acceptable. There is clear information on the action staff should take when supporting people and the assessments have been reviewed. This requirement Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: has been met. The manager reported that the service is committed to ensuring people are involved as far as possible in all aspects of their care and support. There is information in peoples records about the way they communicate and how staff should support them to make decisions. We received surveys from eight people who use the service. All said staff listen to them and act on what they say. We received surveys from eight staff at the service. All said they are given up-to-date information about the needs of the people they support. The relatives of one person who uses the service were spoken with during the visit. They reported that all the staff know their daughters needs very well and ensure they are met. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides good support for people to take part in a range of activities, to maintain contact with familty and friends and to maintain a healthy diet. Evidence: The assessment that is completed before people use the service includes details of the activities people enjoy and the support that they need. Many of the people who stay at the service also use a day service, which is located next door. The service has close links with the day service and there are clear lines of communication to ensure peoples needs are met. The service has an activities programme that is flexible to respond to peoples needs and choices. A record of activities is completed for each person using the service. Eight people who use the service completed a survey for us. All said they were able to do what they wanted during the day, evening and weekends, although one person added that they would like to be able to get out a bit more at the Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: weekends. The manager reported in the annual quality assurance assessment for us that he plans to provide greater support for people to access community activities over the next year. All eight people who completed a survey for us also said they were able to make decisions about what they do each day. Peoples support plans contained detailed information about their communication needs and how they express themselves and make decisions. People are supported to maintain contact with their family and friends during their stay. The relatives of one person who uses the service were spoken with during the visit. They reported that the service always contact them if their daughter is unwell or if there are any other problems during the stay. During the visit a staff member made a call to a relative to inform them that their son had visited the doctor due to a minor illness. The service has a menu that has been developed by the service users forum. The menu provides two choices for the main meal and three choices of breakfast and lunch. The manager reported that in addition to these choices, an alternative meal would be provided on request or to meet peoples specific dietary needs. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and healthcare is well met by staff who know their needs and there are good systems to safely store and administer peoples medication. Evidence: Support plans contain clear details of the personal care support people need and how it should be provided. Eight people who use the service completed a survey for us and all said staff treat them well. Staff spoken with during the visit demonstrated a good understanding of peoples needs and the support they should provide to meet them. People use the service for short stays and therefore access most of their health services from their home. The service has an arrangement with a local GP surgery that people can access them as visiting patients if necessary. During the visit one person was supported to visit the GP as a result of a minor illness. Details of the consultation were recorded and the prescribed medication was added to the record. The service also supports people to receive any ongoing health appointments during their stay, for example, physiotherapy. Medication is stored in a locked cabinet in the office or a locked drawer in a bedroom for people who are able to administer their own medication following an assessment. A Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: record is kept of all medication coming into the service and returned at the end of peoples stay. A requirement was made following the last inspection that medication must only be given in food following a decision made by all people involved in the persons care and evidence that this will not cause the medication to be ineffective. Since the last inspection the service has consulted with the persons GP, care manager and relatives about the method of administering the medication and records are kept on the persons plans. The GP has written that the medication will not be affected by administration with food and the manager has contacted a pharmacist about this, but has not yet had a response. This requirement has been met. The medication administration records for three people were checked and had been fully completed. The home does not currently have a specific controlled drugs cabinet. There were no controlled drugs being held at the time of the visit, although some of the people that use the service are prescribed controlled drugs. The manager agreed to ensure a specific controlled drugs cabinet was installed if controlled drugs are going to be held in the service again. Staff who administer medication have all received training. Staff spoken with demonstrated a good understanding of peoples needs in relation to medication and the procedures for them to follow when administering medication. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems for dealing with complaints and responding to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. Evidence: The service has a complaints procedure, which is provided to everyone who stays at the service. Of the eight people who use the service that completed a survey for us, seven said they know who to talk to if the are not happy and how to make a complaint. The service has received two complaints in the last year. One was from a day service about supporting a person to attend the centre when they were unwell. This was investigated and found that staff at Jacobs Lodge had acted appropriately in their support for the person. The other complaint concerned the loss of clothing during a stay at the service. The investigation to this complaint found that staff at Jacobs Lodge were not at fault. We have not received any complaints about the service in the last year. The manager reported that he was planning to make the complaints procedure more accessible to people who use the service and to introduce an end of stay comment card to receive feedback about peoples stay. The relatives of one person who uses the service were spoken with during the visit. They said they were confident that any complaints would be thoroughly investigated and acted upon. A requirement was made following the last inspection that the service must have a policy and procedure in place regarding safeguarding vulnerable adults. These Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: documents are now available and clearly set out the role of adult services in the safeguarding procedures. This requirement has been met. Staff spoken with demonstrated a good understanding of different types of abuse, signs that someone may be being abused and the action to take if abuse is witnessed, reported or suspected. All staff working in the service have completed training in abuse and the safeguarding procedures. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well maintained and provides a clean, comfortable and safe environment for people. Evidence: All of the communal areas of the service were viewed during the visit and a sample of the bedrooms. The service is well maintained with good quality domestic furniture and fittings. People staying at the service have access to a lounge, dining room, small kitchen and garden. There are accessible toilets, bathroom and shower room and some of the bedrooms have been fitted with aids for people with mobility needs, for example hoists and adjustable beds. The manager reported that over the last year new furniture has been provided for the lounge, entrance hallway and bedrooms and new equipment has been provided, for example digital televisions with integrated DVD players for all the bedrooms. The manager reported that he is trying to extend the kitchen so that it can be made more accessible for people who use the service. The service has a seperate laundry room that is fitted with machines capable of washing soiled clothing. The service is clean throughout and there are suitable handwashing facilities in the laundry room, kitchen, toilets and bathrooms. There are infection control procedures in place and staff have received infection control training. Eight people who use the service completed a survey for us. All said the service was Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: kept fresh and clean. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and there are good systems to check staff before they work in the service. This helps to keep people who use the service safe and ensure staff can meet their needs. Evidence: The manager reported that eight of the ten permanent staff have completed the National Vocational Quaification at level 2 or above and one person is about to start the course. Staff were observed responding to people in a sensitive and respectful way. Staff spoken with said they felt there were enough staff on each shift to provide the support people need. The manager reported in the annual quality assurance assessment that all staff working in the service over the last year have had satisfactory pre-employment checks. The file of the one staff member who has started work since the last inspection were viewed during the visit. The file had written references, confirmation that a criminal records bureau disclosure had been obtained and that the person was not on the protection of vulnerable adults list as unsuitable to work in a care home, a full work history and confirmation of the identity checks that were completed. The person had been employed for approximately three weeks at the time of the visit and was being supported to complete a comprehensive induction, based on the skills for care Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: common induction standards. The service has an on-going training programme and staff reported they receive good training, which helps them meet peoples needs. Staff training records indicated people had completed an induction and courses including medication administration, safeguarding adults, moving and handling, infection control, food hygiene, fire safety, first aid, epliepsy, autism, positive risk taking and communication. The manager reported he was planning to arrange further training in dementia for people with learning disabilities. All eight staff who completed a survey for us said they received training which is relevant to their role, helps them meet peoples individual needs and keeps them up to date with new ways of working. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and there are good systems to assess the quality of the service provided and plan improvements. Evidence: The manager has been in post for approximately two years and has six years management experience. The manager has completed the registration process with us and has completed the National Vocational Qualification in care at level 4 and the Registered Managers Award. Staff spoken with said they felt well supported by the manager and able to raise any concerns with him. We also received positive comments about the manager from the relatives spoken with during the visit. A locality manager for Hampshire Partnership NHS Trust visits the service each month to assess the quality of the service being provided. Reports of these visits are made and include any actions that are required. The reports are sent to the manager and the responsible individual for the Trust. Surveys are sent to people who use the service and their relatives and the collated results are used to develop an action plan. The service has a formal quality assurance system which is used to assess the quality of Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: the service that is being provided. The manager reported that they are in the process of amending this system to make it more relevant to a short stay service. The service has a service users forum, which meets regularly and gives feedback about how the service is operating. The information from all these quality assurance systems is used to develop measurable success criteria, which set out how people will be able to judge whether the service is making the improvements it has identified as necessary. A requirement was made following the last inspection that all staff must receive regular fire safety training. Fire safety records demonstrated that all staff have now received suitable training and further training is planned every six months. This requirement has been met. The manager reported in the annual quality assurance assessment that equipment in the service is regularly serviced and checked to ensure it is safe. We sampled records for the fire alarm, fire fighting equipment, hoists, adjustable beds and gas system and found them to have been suitably checked and serviced. Risk assessments have been completed for hazardous areas and tasks in the service and include actions that should be taken to minimise the identified risks. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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