Inspection on 05/10/06 for Laetus Lodge

This inspection was carried out on 5th October 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Laetus Lodge 171a Tooting High Street London SW17 0SZ Lead Inspector Adrian Gordon Unannounced Inspection 5th October 2006 10:00 Laetus Lodge DS0000066295.V313007.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 Laetus Lodge DS0000066295.V313007.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. Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laetus Lodge Address 171a Tooting High Street London SW17 0SZ 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) 01737 551612 01737 555150 Mr Mark Anthony Peake Mr Eamonn Dominic Doherty Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection N/A New service Brief Description of the Service: Laetus Lodge was registered in May 2006 and provides accommodation for a maximum of eight adults with learning disabilities. Staff support is provided 24 hours a day. The home is situated in Tooting convenient for local shops and leisure facilities. Bus, train and tube services are close by. It provides spacious accommodation over three floors. Information about Laetus Lodge is available in the Statement of Purpose and Service User Guide. Current fees start at £893 per week. Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection for the service. It was unannounced and took place over the course of one visit taking 5 hours. It consisted of examination of records, tour of the premises and involved speaking to residents, staff, manager and owner. Feedback questionnaires were also received from two residents and two staff. Residents commented that they liked the home. One said ‘I am really enjoying it’. Another resident said ‘I am glad to be here’. The inspector was made welcome and wishes to thank residents and staff for their help. What the service does well: What has improved since the last inspection? What they could do better: In order to show that residents are included they must be encouraged to sign their own care plans and receive a copy. Care plans and risk assessments must also be dated so as to ensure reviews take place on time. To make sure working practices are as safe as possible staff must receive training in the administration of medication. In order to protect residents all the necessary recruitment checks must be in place before staff start at the home. Any hazardous substances must also be stored safely. Laetus Lodge DS0000066295.V313007.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. Laetus Lodge DS0000066295.V313007.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 Laetus Lodge DS0000066295.V313007.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, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions are well planned and managed which ensures that residents settle into their new home quickly. EVIDENCE: The first three residents were admitted in September 2006. All residents had a detailed needs assessment on file which included a biography and information on lifestyle, emotional wellbeing, support needs and health. Staff spent an ‘awayday’ at a hospital where residents had been living in order to get to know them better. One resident confirmed that they had been told a lot about the home at this time. Residents confirmed that they had been able to visit Laetus Lodge before deciding to live there and that they were much happier at the home than their previous placement. Laetus Lodge DS0000066295.V313007.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 adequate. This judgement has been made using available evidence including a visit to this service. Good care plans are in place and staff work with residents to identify goals that are important to them. Residents are encouraged to make decisions and take risks. EVIDENCE: All residents have a comprehensive care plan which provides good information about how their needs are to be met in the home. Two care plans were not signed and dated by the resident. However, it is clear from files that residents are involved in decisions. Minutes from transfer meetings and reviews include comments by residents. Two residents were well informed about their own needs and the why decisions were being made. For example, having to be escorted whilst outside the home. Risk assessments are of a good standard and include appropriate responses to minimise risks. However these were not signed and dated. Residents stated Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 10 that they are hoping to live more independently now they are at Laetus Lodge and are confident that this will happen. One staff member felt that ‘the home is very good in promoting residents independence and making sure the home is run around their needs’. Laetus Lodge DS0000066295.V313007.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, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to be part of the local community and to take part in activities of their choosing. Relationships with family and friends are encouraged. EVIDENCE: All the new residents come from outside London and are getting used to being in an inner city environment. Residents spoken to on the day of the inspection were glad to be there, and were closer to family and friends. The area is also more reflective of their cultural identity. One resident said that they see their father at weekends and go to the pictures, pub, shopping, walking or take a bus somewhere. Another resident has joined a local snooker hall. Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 12 Residents were unhappy that they were on Section 17 leave of absence with a limitation that they must be supervised by staff while outside the home. This is affecting their freedom to go out, as it is dependant on staff being available. However, staff work hard to ensure residents go out as much as possible and the condition was due to be reviewed the following week. Records of menus are kept and these showed that a suitable range of food is available for residents to enjoy. Laetus Lodge DS0000066295.V313007.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. This judgement has been made using available evidence including a visit to this service. The home receives a good level of support from external agencies to help meet residents health needs. Medication systems must be made safer. EVIDENCE: Staff were observed to treat residents with respect and residents are able to make choices about how they prefer to live. For example, how they have their rooms and what time to get up and go to bed. The staff team reflects the cultural background of residents. All residents have been registered with a local GP. External support is provided by the Learning Disability Team and a Community Psychiatric Nurse. There is a large amount of information on file about residents health needs and staff are well informed. A pharmacy inspector visited the home as part of the registration process and was satisfied with the systems in place. However, there has not yet been any Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 14 training for staff on the safe handling of medication. The manager said a local pharmacist has agreed to do this. Medication Administration Record (MAR) sheets have been completed appropriately and a record of medication received and disposed of is maintained. A medication profile must be put in place for each resident, detailing medication taken, any possible side effects and allergies. Laetus Lodge DS0000066295.V313007.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. This judgement has been made using available evidence including a visit to this service. Staff are well informed about adult abuse issues which helps to protect residents. Residents views are listened to by staff. EVIDENCE: An appropriate complaints procedure is in place. Residents confirmed that they have a copy and that they knew how to complain if they needed to. No complaints have been received since the home opened. There are suitable policies and procedures in place for the protection of vulnerable adults. The manager was well informed about the new procedures being introduced by the London Borough of Wandsworth. Staff have been made aware of adult abuse issues and a representative from Wandsworth will be discussing the protection of vulnerable adults with the team in the near future. Laetus Lodge DS0000066295.V313007.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, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean and comfortable environment. EVIDENCE: Laetus Lodge is situated in Tooting, very close to local facilities and convenient for buses, tubes and trains. The home is laid out over three floors and all areas were seen to be clean and tidy. A number of communal areas are available for residents to make use of, including a lounge, quiet room, dining area and kitchen. Communal rooms are well furnished and comfortable. On the ground floor there is access to a rear patio area with tables and chairs. The décor is of a good standard but needs to be made more homely. Now that residents have moved in staff should discuss with them what sort of ornaments and decoration they would like. Laetus Lodge DS0000066295.V313007.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. This judgement has been made using available evidence including a visit to this service. Staff are well informed and committed to providing a resident focussed service. In order to fully protect residents, recruitment checks must be properly completed. EVIDENCE: Staff spoken to on the day were knowledgeable about the needs of residents and spoke with enthusiasm about the future of the service. As part of induction staff went to visit prospective residents to see where they were living. Two staff commented that this became a bonding experience for the team and has led to them working more effectively together. One staff said ‘I feel supported and can ask questions whenever I want’. Three staff files were examined. These showed evidence of application forms contracts and Criminal Records Bureau disclosures. However, one file did not have a photo of the staff concerned, and one file had no employment references. The manager explained that he knew the staff member from Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 18 previous employment and that references had been sought. However for the protection of residents all the necessary checks must be in place before staff commence work at the home. One member of staff said that they have had team training on risk assessments, health and safety and food hygiene. They have also discussed a training plan with the manager. The manager confirmed that it is planned to start some staff on NVQ’s in the future. Because the team is currently quite small it has been possible to meet regularly between shifts to discuss resident needs and any issues in the home. All staff who fed back said they felt supported. Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 19 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. This judgement has been made using available evidence including a visit to this service. The manager has worked hard to ensure that residents receive a safe and effective service. EVIDENCE: The manager was registered when the home opened in May 2006. He is very experienced in the area of learning disability and mental heath. He has a good understanding of the needs of the new residents. Throughout the inspection the manager was well informed about day to day operations in the home, being open and responsive to issues raised. The manager said he is well supported by the provider of the service. However, because the provider does not have a background in care it may be necessary for the manager to have Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 20 access to an experienced professional consultant on a regular basis to provide peer support. Observation on the day and feedback from residents confirmed that their views are taken into account. The manager has developed questionnaires for residents to feedback more formally in the future. The first monthly monitoring visit was due to take place later in the week. All the necessary environmental certificates were in place at the time of registration. The fire system was checked on 2/10/06 and weekly fire point test are being carried out. Appropriate risk assessments for Control of Substances Hazardous to Health (COSHH), fire, food safety and falls/slips are in place. Staff have been trained in COSHH, however potentially hazardous cleaning materials were found in one toilet. Portable appliance testing must be carried out on equipment brought into the home by residents. Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 21 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 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 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 2 X 3 X 3 X X 2 X Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15(2) Requirement The registered person must ensure that Care Plans are signed by the resident and dated. The registered person must ensure that risk assessments are signed and dated in order to be reviewed as necessary. The registered person must ensure that staff receive training in the safe handling of medication, and that all residents have a medication profile. The registered person must ensure that all necessary recruitment information is in place before staff start work at the home. The registered person must ensure that all COSHH materials are stored appropriately and that a portal appliance test is carried out on equipment residents bring into the home. Timescale for action 01/11/06 2 YA9 13(4) 01/11/06 3 YA20 13(2) 01/11/06 4 YA34 19, Sch 2 01/11/06 5 YA42 13(4)(a) 01/11/06 Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 23 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 YA24 YA37 Good Practice Recommendations The registered person should ensure that the environment is made more homely with the input of residents. The registered person should ensure that the manager has access to an experienced consultant to provide peer support and supervision. Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 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 © 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 Laetus Lodge DS0000066295.V313007.R01.S.doc Version 5.2 Page 25 - 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!