Inspection on 15/12/05 for Lodge Hill (167)

This inspection was carried out on 15th December 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lodge Hill (167) 26/09/06

Lodge Hill (167) 17/02/06

Lodge Hill (167) 22/11/04

Lodge Hill (167) 05/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

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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 Lodge Hill (167) 167 Lodge Hill Abbeywood London SE2 0AS Lead Inspector Keith Izzard Unannounced Inspection 15th December 2005 10:00 Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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 Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Lodge Hill (167) Address 167 Lodge Hill Abbeywood London SE2 0AS 02088548888 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) Greenwich Council Mrs Michelle Capar Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2004 Brief Description of the Service: 167 Lodge Hill is a modern chalet style building situated in the grounds of the former Goldie Leigh Hospital, close to the facilities of Welling and Bexleyheath. There are five single bedrooms for service users with physical and severe learning disabilities. The accommodation is arranged on one floor with a large sitting room/ diner, a large kitchen and level access to a small garden at the rear of the house. The home has its own mini bus to facilitate outings and other appointments for service users. The home is run by Greenwich Living Options part of the London Borough of Greenwich Social Services provision. Twenty- four hour care is provided by care staff and this is supplemented by regular daily visiting by District Nurses to provide peg feeding to two service users requiring this intervention. Service users are provided with a good level of activities and all attend local day centres on a four or five day basis. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two planned but unannounced inspections for this home in the year 1st April 2005 – 31st March 2006. The inspection took place over a period of five hours and included a tour of the building and examination of service user care files, an interview with the manager and two members of staff. Mostly, Key Standards were assessed and any not assessed at this inspection, will be at the next inspection, sometime prior to 31st March 2006. Both reports should, therefore, be read in conjunction with each other. Four response questionnaires were returned to the CSCI and these all provided favourable comments regarding the home and the service provided. A visiting Psychologist involved with training staff members commented; “staff appear, keen, caring and approachable in their manner, an enjoyable and worthwhile service in which to share experience and knowledge.” What the service does well: What has improved since the last inspection? Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 6 Staff members have implemented “Active support” a programme designed to provide a coordinated response from both home and day centre staff in encouraging service users involvement in learning new tasks. Input has been received from a number of people from the Community Learning disability team such as Psychologist and Occupational Therapist. The programme has been warmly received by staff at the home who are seeing the benefits of greater engagement with service users in maximising their abilities. A group of volunteers has made a commendable effort in the garden to the rear of the home. A pergola has been erected and wheelchair height flower beds that facilitate service users being able to plant and tend to flowers. Also a more level and circular path has been made that generally gives better access to all the borders and the garden as a whole. 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. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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 Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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): 1-4 Adequate information was provided about the service in the Statement of Purpose and Service User Guide to enable prospective residents to make a decision to the suitability of the service. Admission procedures were in place to comply with these standards. EVIDENCE: The home has produced a comprehensive Statement of Purpose and Service User Guide that clearly sets out the information required in Schedule 1 Regulation 4 (1) c Care Standards Act 2000. Similarly, the home has produced a clear and comprehensive brochure intended to provide information for all those who might be interested in using the service provided at the home. One new service user was admitted to the home since the previous inspection. The pre assessment information was examined and noted to be comprehensive and well recorded. The service user had a phased move that was planned in conjunction with his family and ample evidence was available that the move was both communicated to the service user and that it was made as smoothly as possible in order to minimise the trauma of moving home. Standards 2 & 3 were met. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6-10 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: Two service user care files were examined and found to be comprehensive in content and evidence was available that developing or changing needs are acted upon and outcomes recorded. The Inspector also cross referenced entries in the daily diary for service users with their care plans and risk assessment folders and noted that entries and actions taken were in accordance with the requirements of individual care plans and that care plans were regularly updated. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 10 Care records of service users and the service user daily diaries provided evidence of service users making decisions for themselves. However, because of the communication difficulties of the service users living at this home, it must be acknowledged that service users are heavily dependant on staff members’ interpretive skills. Recorded information was available describing the subtle variations in both verbal and non-verbal communication specific to individual service users. Owing to the level of learning disability and communication difficulties of this group of service users it would be very difficult to engage them meaningfully in developing and reviewing policies and procedures. However, the Inspector is aware that staff members have developed expertise in communicating in various ways such as signs gestures and pointing to objects or pictures to facilitate communication and have also built up an historical knowledge of service user’s likes and dislikes which further aids communication. This information is recorded in order to assist any staff that may be new or temporary in the home. Service user questionnaires are sent to relatives once a year that provides a facility for relatives to influence how the home is run. The manager has also referred service users to Speech and Language Therapy and Advocacy in an attempt to maximise better communication for and on behalf or service users and also further training for staff has been provided in advanced sign language. Two service user’s care files were examined which showed that risks in relation to individuals are assessed at the point of admission and thereafter reviewed on a regular basis, or immediately, in response to significant changes in behaviour. Risk assessments have been drawn up in respect of each of the service users and are recorded both within care plans and a specific file that is readily available to new or temporary staff to quickly identify what to be aware of in respect of individuals’ needs. The home has an unexplained absence procedure that should ensure a swift response to such circumstances with descriptive information including photographs of service users readily available to facilitate this. A policy is available in the home requiring staff to implement confidentiality. Care files on service users are kept in a locked filing cabinet in the manager’s office. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11-17 Attention was given to meeting the leisure and social needs of the residents, enabling community participation and developing educational and occupational abilities. Meals provided were varied and planned to meet the resident’s choice and preferences. EVIDENCE: Service users have access to the local Speech and Language Therapy, Occupational and Physiotherapy services and attend day centres on a daily basis. These facilities assist with the development of social emotional and living skills in addition to the care and support provided by the home care staff. The Inspector examined a list of activities for service users that is updated weekly and notes are recorded in the daily diary and staff communication book of those activities that are planned for service users. Valued and fulfilling activities are provided both within the home and via outings provided. A range Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 12 of activities is provided for service users including shopping, either individually with their key workers or together on a group outing. Occasionally, trips are organised with service users from a neighbouring home in order to increase contact for service users with other people. The home has a number of musical instruments audio equipment and television. One service user likes to watch TV in his own room and another is particularly keen on soaps. A variety of art materials, puzzles and board and ball games are available that staff members assist service users to participate in when required, or requested to. The records clarify whether staff assistance is needed and those staff allocated to provide this support. Staff members have implemented “Active support” a programme designed to provide a coordinated response from both home and day centre staff in encouraging service users involvement in learning new tasks. Input has been received from a number of people from the Community Learning disability team such as Psychologist and Occupational Therapist. The programme has been warmly received by staff at the home who are seeing the benefits of greater engagement with service users in maximising their abilities. This group of service users are heavily dependant on staff assistance to go out from the home because of their disabilities and the manager reported that the home does now have a number of staff who are able to drive the mini bus. It was noted that the home has managed to recruit a number of staff that can drive the mini- bus and has done much to facilitate outings for service users. Owing to the level of disability of the service users in this home, none of them have been assessed as having the capacity to maintain employment or further education. However, all service users attend day centres and Greenwich Forum and have access to the local Speech and Language Therapy service. This provides a work type routine and facilitates social contact with other people outside of the home. One of this group of service users has an identified spiritual need and receives communion in the home once a week from a Catholic Priest. Service users are provided with a good level of contact with people outside of the home and good efforts are made to maintain family links. Varied and nutritious meals were provided to meet resident preferences and a rota of meals provided was seen over a period of four weeks and a good supply of both fresh and frozen food was seen stored in the home. Two of the service users require a special peg feed diet administered by District Nurses attending twice daily. The other service users do not require special or culturally appropriate diets, but some require their food to be cut up, soft or liquidised. Two require specific assistance from staff to enable them to eat safely and ensure adequate intake. Relevant risk assessments addressed these issues Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 13 and had been completed by a member of the speech and language therapy service to advise staff members. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18-21 Resident’s needs were being met based on assessment of need and with the involvement of the resident. Medicines were safely managed. EVIDENCE: All of the five service users receive assistance with personal care owing to the extent of physical disability. Staff members provide sensitive and flexible personal support and are sensitive to the privacy and dignity of service users. . The home is not registered to provide nursing care, but that required, is provided by the District Nursing service staff, they provide professional supervision for two service users who use peg feeds on a daily basis. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 15 All service users are registered with a local GP and are supported by staff to attend any surgery visits, or alternatively are seen within the privacy of service user’s own rooms. Three service users have individual needs around the management and monitoring of Epilepsy. Since the previous inspection there has only been one admission to hospital and this was in relation to the need to change a catheter tube for one service user. Evidence was available from service user care files that regular and prompt attention is given to the ongoing health needs of service users. Due to the level of disability, service users are not able to self medicate and would not be able to do so without a high degree of risk. Medication is stored in a locked cabinet in the manager’s office. The medication for the two service users on peg feeds is entirely administered by the visiting District Nurses. Medication is the responsibility of the designated person in charge on all shifts and only permanent staff that have received training are authorised to administer medication. Overall, the administration, receipt recording, handling and disposal of medicines met the Standard. In respect of Standard 21, the staff members of this home have had experience in this area and the Inspector is confident that that the requirements of this Standard would be met. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22-23 Adequate systems were in place to ensure residents were protected from abuse and to manage complaints about the service. EVIDENCE: The home had policies and procedures to deal with complaints and allegations of abuse and whistle blowing. Staff members have all received training on adult protection. Any suspicions or allegations of abuse would be referred to the CLDT for investigation under adult protection procedures, as would any unexplained injuries. There have been no complaints received either by the home or the CSCI since the previous inspection of the home. There have not been any incidents in respect of adult protection issues. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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 the following standard(s): 24-30 Service users live in a homely and comfortable environment that is safe clean and hygienic. The premises were homely in appearance and decorated to a satisfactory standard. Individual and communal accommodation suited residents’ needs and service users are provided with specialist equipment as required. EVIDENCE: Service user bedrooms were seen and all were clean, tidy and appropriately furnished with sufficient space for personal belongings and equipment. A bathroom/ toilet, separate shower room and a separate toilet are provided for service users that meet this Standard. A previous requirement to address ventilation / extraction problems in the bathroom was complied with. A range of comfortable, safe and fully accessible shared spaces is provided both for shared activities and for private use. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 18 Two service users have been provided with special beds and equipment for administering peg feeds. . The home does not currently use a hoist for moving and handling except in the bathroom supplied with an ARJO bath and following a previous requirement this item was replaced because of frequent breakdown. On the day of inspection the home was clean, bright and airy and free from offensive odours throughout. Systems are in place to prevent the spread of infection. Overall, it was noted that the laundry area was well designed with adequate equipment for dealing with soiled articles. The domestic assistant interviewed was aware of COSH procedures and the need to keep the cupboard containing cleaning and hazardous products locked. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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 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): 32-35 Service users are supported and cared for by competent and qualified staff members who act as a team to meet their needs. Recruitment practice was satisfactory. EVIDENCE: Staff members have clearly defined job descriptions, including their responsibilities as key workers for particular service users. All staff members are clear as to who the designated person in charge is, in the absence of the manager and this is recorded clearly in the staff rota. Staff members are familiar with the standards of conduct/practice set by the General Social Care Council Staff members are familiar with the standards of conduct/practice set by the General Social Care Council. Training records for individual staff members were seen and this showed that a good level of training had been provided and was being planned for the future. Induction training had been provided for new staff and foundation training following this. Overall, a comprehensive spread of training had been provided for staff members and included annual updates in fire training and moving and handling, as required. Three personnel records were seen in relation to newer staff members and it was noted that all the requirements of Regulation 19 and Schedule 2 of the National Minimum Standards had been complied with. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 20 Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37&42 Service users benefit from a well run home. The health and welfare of service users are promoted and protected. EVIDENCE: The acting manager is experienced and has almost completed the NVQ4 qualification. Staff members interviewed stated that she is approachable and supportive and would not hesitate to discuss any concerns about the home or the welfare of service users with her. Communication within the home was of a good standard with team meetings held regularly and the manager, overall, complies with the requirements of Standard 37. The manager has undertaken training in order to update skills and knowledge. The home however, needs to appoint a registered manager as soon as practicable. See Requirement 1 A number of records to do with safety and maintenance were seen by the Inspector and were found to be up to date and well recorded. The manager Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 22 confirmed that all staff had annually updated fire training and that night care staff had taken part in at least two fire drills over the past year. In respect of other checks fire drills, alarm tests and checking of fire prevention equipment was recorded and up to date. Evidence was available that routine servicing and testing had taken place on the electric, gas and water systems. The manager had also provided a comprehensive check- list within the pre inspection questionnaire. Overall, health and safety requirements had been well attended to. Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 3 3 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 X X X X 3 x Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 24 NO 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 YA37 Regulation 8 Requirement The Responsible Person must appoint a registered manager as soon as practicable. Timescale for action 01/04/06 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 Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup 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. Extracts may not be used or reproduced without the express permission of CSCI Lodge Hill (167) DS0000036908.V276184.R01.S.doc Version 5.1 Page 26 - 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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