Inspection on 26/10/07 for Loveys Lodge

This inspection was carried out on 26th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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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 Loveys Lodge 14 Beresford Road Bedford Bedfordshire MK40 3SD Lead Inspector Ansuya Chudasama Unannounced Inspection 26th October 2007 11:40 Loveys Lodge DS0000069646.V350329.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 Loveys Lodge DS0000069646.V350329.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. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Loveys Lodge Address 14 Beresford Road Bedford Bedfordshire MK40 3SD 01234 214 942 01234 241942 No email add. 25/7/07 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) Mr Brian Taylor Mrs Yvonne Smith Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th March 2007 Brief Description of the Service: Lovey’s lodge is a care home for four adults with learning disabilities. The home is a two storey semi-detached house. The home has four single bedrooms. The home also has a lounge, dining room and a kitchen. There is a toilet on the ground floor and a toilet and bathroom on the first floor. The office combined with staff sleep in room is located on the first floor. The home is not able to cater for people who are wheelchair users or have difficulty in managing the stairs. To the rear of the home there is a garden with a patio area. The home is situated on a quiet street near the river, and close to the shops. Public transport and other community facilities are located in nearby Bedford town centre. The fees for staying at the home range from £934-939. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited the home without telling any one that she was going to visit on the 26th of October2007 The inspector spoke to the manager and staff who were on duty. She talked to the people using the service, and asked staff about those people’s needs. She also looked at the medical records and daily notes for one of the people living in the home. This is called case tracking. She watched the staff and the people living in the home do things together. The inspector had a look around the home. At the time of the inspection there were four people living in the home. The home did not have any vacancies. The information from the service users questionnaire’s and the completed Annual quality assurance Assessment (AQAA) form sent to the CSCI have been used in this report. The inspector would like to thank the manager, staff, and the people living in the home for their time in helping with this inspection. This inspection report should be read alongside the National Minimum Standards for Younger Adults (18-65). What the service does well: The home is clean and tidy. The people in the home like living at the home. They feel well cared for by staff and say staff listen and treat them well. They say their privacy is respected. They like the food and activities they do with help from staff. They also know who to tell if they are unhappy. They go on holiday with staff and on outings to the seaside, cinema, swimming, and eat out. The manager and staff help the two people living in the home to learn skills to help them become more independent. They enjoy working at the home. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 6 The staff and people living in the home were interacting well and enjoying each other’s company, and staff were talking to the people living in the home in a positive and caring manner. The staff go on training to help them understand how to meet the needs of the people living in the home. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Loveys Lodge DS0000069646.V350329.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 Loveys Lodge DS0000069646.V350329.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): 1,2,3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service Prospective people using the service and their family had information they needed to make an informed choice about moving into the home. EVIDENCE: The home has a statement of purpose and a service user guide. The service user guide was basic with pictures so the people in the home could understand the information. The statement of purpose needed expanding to include all the information discussed in the standard. Information on what the home charges for the care provided at the home also needs to be included. The families of the people living in the home had information given to them about the home before they moved into the home. Three people living at the home were admitted to the home since 1996 and one person came to the home in 1997. The home has not had any new people move into the home since 1997. The manager stated that if a new person were to be admitted to the home, they Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 9 would undertake a full needs assessment. This was to ensure that the home could meet their needs and make sure the person would get on well with the other people living in the home. It was also stated that most of the people living in the home had visited the home with their family and the funding authority. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service The staff have very good understanding of the needs of the people living in the home but the care plans need expanding to reflect this information to ensure that all needs of the people living in the home are being met. EVIDENCE: All the people living in the home had care plans. The care plan that was case tracked showed that the information needed expanding. This was discussed with the manager at the inspection. Evidence showed that she had a good understanding of what information was required in the care plans. The staff spoken to had very good understanding of the needs of the people living in the Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 11 home. Evidence showed that the staff were reviewing the care plans and the funding authorities were also carrying out their annual reviews. The manager stated that they would be doing person centred planning with the people living in the home. The day care services will also be involved. One person’s communication passport had been completed and this was good. The person was observed using this when communicating with staff. The service users questionnaires received stated that two people living in the home can make decisions always about what they would do each day. Two other people stated that this was some times. The majority of the people living in the home stated that they were able to do what they wanted during the day, evening, and weekends. The information also stated that the staff treated them well and listened and acted on what they said. On the day of the inspection the staff were observed listening and talking to the people living in the home in a respectful manner. Risk assessments for one of the person living the people using the service were looked at. These were fine but a few more needed developing in areas of using the garden, going on holiday, vulnerability, and fire risk assessment. The manager was going to get these completed. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 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. 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 The people living in the home engage in appropriate leisure and educational activities to meet their personal development needs. EVIDENCE: Observation on the day of the inspection showed that the staff and the people living in the home had very good working relationships with each other. The staff were observed listening and encouraging the people living in the home to do things in a sensitive manner. It was also good to see the staff and the people living in the home have a ‘laugh and joke ’ in a professional manner. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 13 All the people using the service had families who visited the home and kept in contact with the home. Most of the people also visited their families. Two of the people using the service had two days at the home and three days at the day centre. One person attended the day centre five days a week. One person attended the day centre for three days and went to Parkside centre two days a week. This person was stated to feel unhappy because this centre was closing down. Evidence showed that the people in the home enjoyed a variety of activities and some of these included, going shopping, seaside, picnic, eating out, swimming, and attending social clubs. The people also went on holidays with staff. The staff had very good understanding of the kind of meals the people in the home enjoyed. It would be good to have the meals displayed in picture format so the people can see this. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 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. 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 people living in the home have individual health care plans that give a comprehensive over view of their health needs and this ensures that their needs are met. EVIDENCE: The manager had contacted social services to get the information on Health Action Plans for the people living in the home. However this scheme was not being offered in Bedford. With the information given, the manager devised her own Health Action Plans for all the people living in the home. Those seen were good. Evidence showed that the health professionals were involved in the care of the people using the service. The appointments were recorded well. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 15 Staff who had received the medication training gave out medication. The records seen were satisfactory maintained. The manager noted that she was going to change to Boots pharmacy in the near future. The manager stated that two of the people living in the home choose their clothes. However two of the other people went shopping but did not choose their clothes. The staff had good understanding of what kind of clothes the people liked and helped them to make choices. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 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. 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 The homes policies and procedures ensure that the people living in the home are safeguarded from any kind of abuse and neglect. EVIDENCE: The home had a complaints policy and no complaints had been made since the last inspection. Evidence from the service users questionnaires showed that all the people living in the home knew how to make a complaint. They also know who to speak to if they were not happy. The staff spoken to had a good understanding of the behaviours of the people living in the home. They there fore had very good understanding of when some one was not happy. Three out of four people living in the home were not able to communicate verbally. However observation showed that they were able to use body language and one person used the communication passport book to inform staff what they wanted. An excellent example was when the inspector was asked to leave the home by one of the people living in the home when it was time to eat their evening meal. This showed that the staff empowered the people living in the home to make their own decisions. All the staff in the Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 17 home had received training on safeguarding vulnerable adults (SOVA). The home had not made any referrals under SOVA to the funding authorities. The money checked for the people living in the home was correct. How the home manages the finances of the people living in the home needs to be recorded in their care plan. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 18 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): 24,30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service The Service provides a homely environment and the manager is aware of the improvements required to meet the needs of the people living in the home. EVIDENCE: The manager stated that the external building of the home had been painted and the damaged wood was also replaced on the outside. An Occupational therapy assessment was carried out following an inspection requirement from the last inspection. There were seven recommendation made from the assessment. The inspector was informed that the home was working through these recommendations. The manager had coloured strip put on the edge of the ceiling and wall to raise awareness of the restricted headroom in one of the Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 19 bedrooms. The home had also provided touch lamps and light for the people who were able to use this. The dining room was nice but a few things needed looking at. The two seat settee and two chairs were old and needed replacing or made good. The arrangements in the room need to be better laid out. The inspector observed that when the people living in the home were seated, it was difficult for the people sitting at the back of the table to get out. When the people tried to move out from the back, the table had to be moved forward and the people sitting in the chairs had to get up to let them out. The table was not big enough to accommodate all staff on duty to sit with them. It was also noticed that the sofa in the room needed replacing, as it was too low and old. The people using the sofa were observed struggling to get up. The walls in the room also needed painting. The chairs in the living room were different colours and did not make the room feel homely. These need to be replaced by homely modern furniture that matches. The net curtains on the front window also needed replacing. The home had a big office combined with staff sleep in room. The mattress in the sleep in room needed replacing as the springs were making noises when sitting on it. The garden needs to be made more user friendly for the people using the service. The manager stated that a new fence had been put up and the garden was being landscaped. It was also stated that in the near future they would be having a summerhouse where the people living in the home can ‘chill out’. The bathroom did not have soap or toilet paper. This was because one of the people living in the home was putting this in the toilet. The manager needs to ring the environmental health officer for advice on using alternative methods to overcome this problem. Information in the service users questionnaire stated that the home was always fresh and clean. This was observed on the day of the inspection. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 20 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): 32,33,34,35,36, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service The staff in the home are skilled, and sufficient in numbers to meet the needs of the people living in the home. EVIDENCE: The staff recruitment records inspected showed that the relevant information was being maintained, to safe guard people using the service. The information was easy to find in the files. All the staff except for a new member of staff had NVQ level 2 or 3 or 4. It was stated that the staffing ratio at the home was adequate. The staff training records showed that they undertook all the mandatory training to safe guard vulnerable people. Training on self harm and autism was needed. The inspector is aware that some staff have completed this Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 21 training but a refresher training was needed. Staff were receiving supervision on a three monthly basis and those spoken to enjoyed working at the home. Many of the staff had worked at the home for a long time. This provided continuity to the people living in the home. Comments received from the families of people living in the home stated ‘I am very happy with the care’ the person living in the home receives ‘and the way, as a family, we are treated by the staff’ Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 22 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 people living in the home benefit from a well run home and this ensures that their needs are being met. EVIDENCE: The registered manager has many years experience of working with people with learning disabilities. She has NVQ level 4 in care and the Registered Managers Award. The manager has been at the home since it opened. She manages the home well and enjoys working at the home. The manager has good understanding of the areas that need improving. She stated that the home has a very good staff team and this was observed on the day of the Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 23 inspection. The staff stated that the manager is supportive and training is very good. The fire book seen showed that the fire alarm testing was being carried out on a weekly basis. Fire drills were carried out every six months and the last one was carried out on the 2/4/07. The fire inspector visited on the 30th of November 06. It was stated that the recommendation had been met. This was for a fire risk assessment for the home. The manager had made a good attempt to undertake quality monitoring systems in the home. However some work was still required. She had developed questionnaires for families and the day centre to complete. The accident and incident book looked at for the person that was being case tracked had none recorded. It was noted that only one incident was recorded for 2007 and this was dealt with appropriately. Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 3 4 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 25 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 YA6 Regulation 14,15 Requirement The home must ensure that the care plans meet all the information stated in the regulation to ensure that all the needs of the person are being met. The home must provide written information to state when the recommendation made by the OT that have not yet been met by the home will be completed. This is to be provided by the 15th of December 2007 The home must replace the mattress in the sleep in room and Replace the sofa in the dining room area. Timescale for action 30/01/08 2 YA24 23 15/12/07 3 YA24 23 30/12/07 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 Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Loveys Lodge DS0000069646.V350329.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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