Inspection on 07/10/05 for Laglin Lodge

This inspection was carried out on 7th October 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Laglin Lodge 30/04/08

Laglin Lodge 13/01/05

Laglin Lodge 28/09/04

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

CARE HOME ADULTS 18-65 Laglin Lodge 7 Eardley Road Streatham London SW16 6DA Lead Inspector Louise Phillips Unannounced Inspection 7th October 2005 07:20h Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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 Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Laglin Lodge Address 7 Eardley Road Streatham London SW16 6DA 020 8769 8655 020 8265 8340 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 Patricia Elizabeth Modile Mr Hussain A Modile Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th April 2005 Brief Description of the Service: Laglin lodge is a registered care home for six service users with mental health needs. The home is a three storey house and each service user has single room accommodation and the use of a spacious lounge, conservatory and kitchen/ dining area. There is a small car parking area to the front and a large garden to the rear of the house. The home is close to bus and rail links which provide access to the shopping areas of Streatham, Tooting and Mitcham. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day for approximately 5 hours. Time was spent talking to service users, staff, and the Registered Persons of the service. What the service does well: What has improved since the last inspection? What they could do better: Areas where the home could be doing better were discussed with the Registered Persons. These include improvements to confidentiality of information about residents and how staff convey information to each other. A further area that the home needs to focus on is the recruitment checks of new Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 6 staff coming to the home, where a number of discrepancies were noted and requirements made to address these shortfalls. 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. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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 Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 There has been good progress to provide detailed information about the home. Improvements have also been made to the assessment process to ensure that the home is the right place for new resident to move to. EVIDENCE: Appropriate developments have been made to the information contained in the Statement of Purpose to provide relevant and accurate information about the home, staff qualifications, etc. The manager spoke about the process of new people moving to the home, describing how this is planned based upon the needs of the potential resident. Most residents have been living at the home for some time, however the newest residents’ file was observed to maintain a good record of their admission/ assessment process. From this a plan of care setting out how this resident’s needs and wishes are to be met had been put in place. An initial risk assessment had also been completed to ensure that any risks identified could be managed by the home. The records of their moving to the home are well-maintained and demonstrated that there had been a number of visits and overnight stays prior to their actually moving in. This assessment also included the residents already living at the home, where the records show that following the visits a discussion took place with the current residents about how they would feel if the new person were to move into the home. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 9 Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 and 10 The care plans are in a format that enables residents and staff to jointly plan work to progress towards meeting needs. This ensures that the residents get care and support that they want. Good progress has been made to ensure that the daily activities of the service users have been assessed for level of risk. Improvements are needed to ensure that staff respect the confidentiality of information they receive and pass on about residents at the home. EVIDENCE: The records for two residents were looked at and indicate that for each one there was a current plan of care which set out the needs of the resident and how they were to be met by the home, with evidence that these were being reviewed regularly. The care plans cover a number of relevant areas such as the residents’ employment, relationships, social activities, assistance with finances, physical health and religious needs. The format of the care plans is easy to follow and recognise the actual care received by each resident. The records indicate that residents are involved in reviewing their care plan monthly with their keyworker to ensure that it is upto-date and covers their needs and wishes. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 11 In addition each file contained an assessment of any areas where there was considered to be any risk to the resident, along with how these risks were to be dealt with and reduced as far as possible. One resident has a programme of activities structured mainly around personal care and in-house chores. The resident also attends a local day centre with the assistance of staff. The involvement of staff in this is well detailed in the risk assessment to ensure the safety of the resident when they are out of the house. The format for assessing risks is of a good standard, allowing for information about the residents’ history, current level of risk in relation to self harm, violence, self neglect, smoking, etc. and a plan in place of how to manage any risks identified. Since the last inspection the residents files are now stored in a locked filing cabinet to promote confidentiality. However, the inspector observed a ‘handover’ taking place, where the staff coming off shift verbally ‘handed over’ information about each resident to the staff member coming on shift. Throughout this time the door to the office was wide open and at least one resident was up and about. The previous inspection identified a similar incident of confidential information about a resident being discussed by staff with the door to the area being left open. Following the findings of the most recent inspection this is now the subject of Requirement 1, whereby the Registered Persons must arrange for all staff to undertake training in confidentiality to ensure that the privacy and dignity of residents is maintained at all times. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 12 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): 14 and 17 The service provides residents with the option of taking a holiday away from the home. The food provided by the home demonstrates that residents are offered choice and their nutritional needs are being met. EVIDENCE: Staff at the home and the Registered Persons spoke about the holiday that residents had been on earlier in the year to Blackpool. They spoke with great enthusiasm about how everyone who went enjoyed themselves and the positive changes that were observed in the behaviour and mental state of all the residents went in a different environment. The menu offered by the home is planned with residents at the monthly meeting, with a weekly shop being carried out to ensure a consistent supply of food to the home. The cupboards and fridge in the kitchen were seen to be well-stocked with cereals, condiments, tinned and fresh foods. The records for one resident demonstrates that they prefer to cook their own meal, and the Registered Persons stated that they provide the necessary finances for this to occur. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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): 19 and 20 Residents are supported to take control of and manage their mental health needs. Laglin Lodge has a medication system that needs some further improvement to ensure residents receive their medicine safely. EVIDENCE: The care files examined demonstrate that the resident’s mental health needs are being met. The input received from Community Psychiatric Nurses and Social Workers varies depending on the needs of the individual, and is enhanced by the care approach of the home. For one resident this was seen to be through the use of a ‘voice monitoring chart’ to monitor frequency and intensity of ‘voices’. This supported the resident to examine the voices that they hear, identify possible triggers and the intensity of these. A staff member described that the aim of using this technique is to develop a plan for the resident to manage their voices better to anable a better quality of life. Another resident file contained a guide for the use of ‘PRN’ (as required) medication. It was pleasing to see that the guide identified this as a ‘last resort’, with the resident being encouraged to use other tactics such as listen to music/ playing a game in order to distract themselves from hearing voices, whilst also learning to manage them. The previous inspection made a number of requirements to develop the system for managing medication. Most of these had been met, apart from one, which Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 14 required that the medicine chart contains the form of medication administered. The description of medication was only seen for one medicine only, where it said ‘capsule’, and such description was not seen on any other medicine chart, therefore this requirement has been restated. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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 and 23 The home has an adequate complaints system. Adult protection in this home is being addressed through staff training to enhance understanding of adult protection issues and reduce the risks of abuse to residents. EVIDENCE: The home has a satisfactory complaints procedure and format for the logging of complaints. The procedure has been updated to include CSCI contact details for the Wimbledon area office. The home has policies and procedures in place in relation to adult abuse awareness and the procedures to follow in the event of this happening at the home. The Registered Persons discussed that training in this is arranged for all staff on the 12th October 2005, with the Protection of Vulnerable Adults coordinator for Lambeth coming to the home to run the session. Evidence of this planned training was observed in a notice to staff on display in the office area. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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 and 30 Residents at Laglin Lodge enjoy a very homely and comfortable living environment that, along with the good standard of cleanliness and hygiene, adds considerably to their quality of life. EVIDENCE: The home continues to maintain a modern and homely feel, with a high standard of décor and furnishings throughout. This has been maintained by the close attention to detail by those working at the home. Throughout the inspection the Registered Persons and staff were seen addressing hygiene and cleanliness issues as they arose, so ensuring a good, comfortable environment for the residents. Since the last inspection locks had been added to kitchen cupboards to ensure that hazardous cleaning products are appropriately stored. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Residents benefit from living at Laglin Lodge because the staffing levels of the home work in the best interests of the residents. In addition, the home is working towards having a competently trained staff team to ensure they can meet the needs of the residents. Further work is needed to ensure that staff are adequately supported in their work. The current recruitment procedures do not protect the residents at the home. EVIDENCE: The previous inspection made a number of requirements to ensure that the home is adequately staffed at all times, staff are appropriately trained and supported in their work. The Registered Persons have worked very hard on these requirements, particularly ensuring the safety of staff and residents by having a minimum of two staff on duty at all times. One member of staff commented that “…I feel a lot safer working with another member of staff…”. In addition to this the staff rota also records that an additional member of staff works a 10am-6pm shift on ad-hoc days throughout the week. The Registered Persons described that this is to enable the staff to take a resident out who, for personal safety reasons, requires an escort when out of the home. These developments to the staffing at the home are significant and demonstrate that the home is committed to protecting the staff and residents, whilst also supporting the needs and rights of individual residents. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 18 The training of staff at the home is being worked on, with most staff having been registered to undertake the NVQ Level 2 in Care. A training plan for the staff team has been developed with training in food hygiene, fire safety, health and safety, basic first aid and moving and handling. The training plan states that all this training will be completed by staff by the end of March 2006. Since the last inspection supervision sessions have been introduced at the home. The Registered Persons stated that they supervise all staff on an individual basis, with the aim of the sessions occurring once every two months. The records for this indicate that since the last inspection some staff had received one supervision, others a maximum of two. This requirement is restated to ensure that staff receive appropriate support for their work. Findings from staff files demonstrate that the recruitment procedures need to be tightened up to ensure that thorough pre-employment checks are carried out on staff. An example of this is where the application form for one staff member gave their employment history dating from 2003 only, and there was no indication that gaps in their employment had been checked with them at interview. For another member of staff their last place of employment had been for one month only. A reference had also been requested from this employer and where they stated that they were unable to give a reference because of the short time of employment a reference had been gained from the team leader of the same service. The other reference for this person had been from a neighbour of the staff member. Two staff had a Criminal Records Bureau (CRB) check from a previous employer, with no evidence of a new check having been applied for this position. There were no interview records for the newest member of staff employed, and no checks had been carried out to confirm that new staff are suitable for working with vulnerable people. This issue was discussed with the Registered Persons, and information given to enable them to carry out these checks, known as POVA First, for all staff when completing new CRB checks. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 41 The home is working well towards meeting the relevant standards for the smooth running of a care home. Record keeping in the residents files are of a high standard. EVIDENCE: The findings from this inspection demonstrate that the Registered Persons are committed to developing the service and ensuring it meets the requirements of the Care Homes Regulations 2001. Since the last inspection the home has implemented a system of seeking feedback on the service from the residents, where they are invited to complete a questionnaire that enables residents to comment on various aspects of the service, eg. food, premises, management, care received, etc. A monthly residents meeting also allows for group discussion and planning on these areas, plus suggestions for activities and choosing the fortnightly takeaway meal. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 20 The residents care plans and daily records are of a good standard, with staff paying close attention to detailing all activities carried out by individual residents, plus recording their observations of their mental state and behaviour throughout the 24 hour period. Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X N/A 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Laglin Lodge Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score X X 3 X 3 X X DS0000035525.V257124.R01.S.doc Version 5.0 Page 22 YES 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. 1 2 Standard YA10 YA20 Regulation 12(4)(a) 13(2) Requirement The Registered Persons must ensure that all staff receive training in confidentiality. The Registered Persons must ensure that the administration record contains the form of medication administered. (Previous timescale not met) The Registered Persons must ensure that all staff have a Criminal Records Bureau (CRB) check carried out for all staff with them as the current employer. The Registered Persons must ensure that: - all documentation as required in Schedule 2 of the Care Homes Regulations is contained in each staff file - a written record is maintained of the interview for all new staff The Registered Persons must ensure that staff receive training in fire safety, moving and handling, first aid and food hygiene. The Registered Persons must ensure that all staff receive supervision a minimum of six DS0000035525.V257124.R01.S.doc Timescale for action 31/03/06 30/11/05 3 YA34 19, Sch 2 31/01/06 4 YA34 19, Sch 2 31/10/05 5 YA35 18(1)(c) 31/03/06 6 YA36 18(2) 30/10/05 Laglin Lodge Version 5.0 Page 23 times a year. (Previous timescale not met) 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 Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Laglin Lodge DS0000035525.V257124.R01.S.doc Version 5.0 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. 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