Inspection on 05/07/05 for Lodge Hill (145)

This inspection was carried out on 5th July 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 but made no statutory requirements on the home.

Other inspections for this house

Lodge Hill (145) 14/11/07

Lodge Hill (145) 30/11/06

Lodge Hill (145) 17/02/06

Lodge Hill (145) 01/03/05

Lodge Hill (145) 06/09/04

Lodge Hill (145) 28/01/04

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Chatsworth Care - Tudor Lodge

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

CARE HOME ADULTS 18-65 145 Lodge Hill Abbey Wood London SE2 OAY Lead Inspector Keith Izzard Announced 5 July 2005 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 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 Stationary 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. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 145 Lodge Hill Address Abbey Wood, London SE2 OAY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208-312-4865 0208 312 4865 Milbury Care Service Limited Care Home 8 Category(ies) of Learning Disability registration, with number of places 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1.03.05 Brief Description of the Service: This home is one of a group of six homes for adults with learning disabilities. All of the homes are situated in the London Borough of Greenwich and are managed by Milbury Community Services Limited. 145 Lodge Hill is located in the grounds of what once was Goldie Leigh Hospital. The house is divided into two self-contained flats, each with their own lounge, kitchen, dining room, bedrooms, toilets and bathrooms. Service users have use of a large hall on the ground floor which has been converted into a shared lounge and dining area. The home is registered with the CSCI to provide personal care for eight service users with a learning disability, all have their own single bedrooms, as a recent change in policy has determined that no service users will be accommodated in double rooms. The Registered Person recently applied for a variation in registration reduced the numbers registered for the home from nine to eight. . 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out on one day over a period of 6.5 hours. The home was clean, tidy and safe and staff members were observed to be both caring and professional in the way they related to the resident at home at the time of inspection. This inspection included observation of the care provided and talking to staff and management. Inspecting records, safety systems and the premises. What the service does well: What has improved since the last inspection? The handyman and staff members have made a very commendable improvement to the garden area for residents. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 6 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. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 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 standard(s) 1-5 The home provided adequate information about the service. Introductory visits were part of the admission process. Admission procedures were in place to comply with these standards. EVIDENCE: The Statement of Purpose ands Service User Guide had been updated and the document complied with Regulation. How well the home meets these standards has yet to be assessed in practice as no new residents had been admitted to the home since the introduction of the National Minimum Standards. All residents have a contract that meets the requirements of this Standard. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 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 standard(s) 6-10 Care plans and risk assessments viewed were up to date and comprehensive and reviewed on a regular basis. Annual Life Plans were also up to date and showed that residents were involved and family or representatives and professionals involved had been invited. Residents were involved in decisions about them and records about them were handled appropriately to maintain confidentiality. EVIDENCE: Care provided to two residents was tracked. Care plans were well written and were supported by up to date assessment of need and individual risk assessments. It was evident in the care plans that residents or relatives were involved in care planning. However, it was recommended that a formal six monthly review be introduced as an intermediate step between annual life plans and that this should include relatives and involved professionals in addition to staff from the home. Recommendation 1. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 10 Staff interviewed said they endeavoured to involve residents in any decisions regarding them as individuals. This was dependant on their communication and comprehension. Staff members were observed communicating with residents and involving them in whatever was going on throughout the inspection. Records were appropriately managed and stored in lockable cabinets. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 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 standard(s) 11-17 From the evidence provided and the information obtained the staff team were working towards providing residents with lifestyles suited to their abilities and personal preferences. EVIDENCE: Some residents attended day centres or other outside agencies where they had the opportunity to develop life skills. Staff supported residents to develop daily living skills in line with their individual ability. Other residents do not have day centre placements for historical reasons and this was the subject of a requirement made at the previous inspection. It was evident that referrals have been made for five residents and they are currently on a waiting list. The home had appropriately involved an advocate in this process. Currently, the home provides a range of outings and activities for theses service users to compensate for the lack of day centre placements available. Recommendation 2. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 12 It was evident from records examined that residents were supported to access leisure activities of their choice and to integrate with the community. They said they enjoyed outings such as to pubs, cinemas, shops, local parks, sport activities, games, sightseeing and annual holidays. Records were kept of these events and included resident’s comments on how they enjoyed the event. Residents were enabled to choose how they were presented in terms of hairstyle and clothes and were supported in theses activities when accompanied by their key workers on regular shopping trips. Residents were supported to maintain positive relationships with their family. Residents who did not have family had been referred to the Greenwich Advocacy Service. Five residents are on a waiting list for the provision of advocates and two for “befrienders”. Varied and nutritious meals were provided to meet resident preferences. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 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 standard(s) 18-21 Resident’s needs were being met based on assessment of need and with the involvement of the resident. Medicines were safely managed. EVIDENCE: Care plans and daily records showed how personal care was provided. Staff spoke with knowledge and confidence about resident’s individual needs and preferences. For example, around times for getting up, going to bed, whether they preferred to lie in, preferences for a bath or a shower and generally promoting opportunities for residents to exercise choice in their daily living. All residents were registered with a G.P and it was evident from the records examined they were supported to access other health care such as dental, optical, dietician and chiropody. Specialist health care was accessed through G.P referral and the local Community Learning Disability Team. Residents had access to an aroma therapist on a privately funded basis and some of them used and benefited from this therapy. None of the residents have the capacity to manage medication themselves. The system for managing medication was examined and found to be well organised and accurate in terms of recording. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 14 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 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 standard(s) 22-23 Adequate systems were in place to ensure residents were protected from abuse and to manage complaints about the service. The system for dealing with the finances of residents was robust and accountable. EVIDENCE: The home had local policies and procedures to deal with complaints and allegations of abuse. Staff have received training on adult protection and displayed their understanding of this. Any suspicions or allegations of abuse would be referred to the Greenwich Community learning disability team for investigation Accidents records were well maintained and unexplained injuries would be referred to CDLT for investigation. Robust systems were in place to safely manage resident’s personal finances and none of the staff acted as appointee for a resident. The ledger and records and amounts held in individual wallets for residents was examined and found to be accurate and accountable. The home is subject to a financial audit every three months and additionally spot checks can be undertaken at any time without notice. There were no allegations of abuse made about the service to the home or the Commission since the last inspection. No complaints had been received by the home or the CSCI. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 16 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 17 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 standard(s) 24-30 The premises were as homely in appearance as is possible in such a building and decorated to a satisfactory standard, in part. The environment was comfortable and safe. The bedrooms of residents reflected their lifestyles and promoted their independence. Toilets and bathing facilities need refurbishment and upgrading but were adequate. The home was clean and hygienic. EVIDENCE: The premises were suited to meeting the needs of the current residents. As residents age or develop mobility problems the suitability of the environment must be monitored to ensure it continued to meet their needs. Residents’ bedrooms reflected their own preferences in respect of furnishings and contents and two had been redecorated in colours chosen by the 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 18 individual. An ongoing programme was in place to redecorate all residents. Residents were encouraged to have personal items in their rooms to reflect their interests and hobbies. At the previous inspection five requirements were made in respect of the building. One regarding inadequate ventilation in a shower room and another to do with the overall adequacy of the water system for the building were either complied with or are currently being attended to. The three other requirements have been restated, as they have not been complied with. The Registered Person must review the state of the carpeting throughout the building and the standard of decoration and furnishings and submit a written action plan to the CSCI as to when improvements will take place. The Registered Person must also confirm in writing to the CSCI, whether or not, plans exist regarding the relocation of residents to another replacement building and if so how this will be managed. Requirements: 1,2,3. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-36 The staff team had the skills, support and training to meet the resident’s needs and those observed and interviewed were clear about their roles and responsibilities. Staff had access to relevant training and supervision. Staffing records examined met this Standard and Regulation. EVIDENCE: Staff members interviewed were knowledgeable regarding the needs of residents and observed in practice to be professional and caring in the way they related to residents. The home currently employs the required 50 qualified to level 2 NVQ and evidence was available from training files examined that the required level of specific training was being provided and planned for staff for staff members. Training certification provided for staff members dealing with Peg feeding should be incorporated into their training files. Recommendation 3. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 20 Records of the formal supervision provided for staff were examined and showed that the requirements of this Standard were met. Staffing records complied with the requirements in respect of recruitment documentation and were appropriately stored in locked cabinets. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37-43 The acting manager has applied to be Registered Manager for the home and this is currently being processed by the CSCI. The manager has already gained the required NVQ 4 qualification. Staff members reported that the manager was approachable and evidence from minutes and other records showed that residents benefit from good management and leadership of the staff team. Policies and procedures were in place and records maintained that showed that residents’ rights were both promoted and safeguarded. Records examined showed that health and safety matters received appropriate attention. EVIDENCE: Staff members were complimentary about the support they received from management. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 22 The policies and procedures in place ensured the safety and protection of residents were addressed. A sample of safety records including fire safety were inspected and showed systems and equipment were maintained and regularly serviced. It was unclear if the HI/LO bath had been included in the required six monthly examination of hoisting equipment. Whoever inspects hoisting / lifting equipment should attach labels indicating the last date of inspection to assist staff members and subsequent inspection of the equipment. Requirement 4, & Recommendation 4. A yearly development plan is being developed however the home needs to implement an annual survey of resident’ views and also those of relatives, advocates and professionals involved with the home. Requirement 5. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 23 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 145 Lodge Hill Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 3 3 3 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 24 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. Standard 24 Regulation 23 Requirement The Registered Person must review the state of carpeting throughout the building but in particular the upstairs lounge, the corridors and the manager’s office.Restated requirement (previous time scale of 1/12/04 and1/06/05 not met) The Registered Person must provide in writing what proposal exist regarding the relocation of service users in a new building and what interim arrangements would be provided for them. Restated requirement (previous time scale of 1/12/04 not met) The Registered Person must ensure that the overall standard of decoration and furnishings are revie and an action plan detailing what will be redecorated and refurbished sent in writing to the CSCI. The registered Person must ensure that hoisting equipment is inspected/ serviced every 6months The registered Person must ensure that surveys of the views of residents,relatives, advocates 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Timescale for action 1st December 2005 2. 39 24 1st December 2005 3. 24 24 1st December 2005 4. 42 23 1st December 2005 1st december 2005 Page 25 5. 39 24 145 Lodge Hill Version 1.40 and involved professionals regarding the service provided are conducted annually. 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. 3. 4. Refer to Standard 6 11 32 42 Good Practice Recommendations The Registered Person should ensure that reviews involving relatives and other professionals are held at least six monthly. The Registered Person should ensure that continued efforts are made to arrange day centre placements for five residents without this facility. The Registered Person should ensure that certification provided for staff members dealing with Peg feeding should be incorporated into their training files. The Registered Person should ensure that hoisting equipment is clearly marked showing the last date it was examined. 145 Lodge Hill 51-G01 S6764 l45 Lodge Hill V286167 05-07-05 Stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Sidcup Area Office River House 1 Maidstone Road DA14 5RH 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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