Inspection on 14/04/08 for Maple Tree Lodge

This inspection was carried out on 14th April 2008.

CSCI found this care home to be providing an Adequate service.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Maple Tree Lodge 13/04/09

Maple Tree Lodge 23/01/08

Maple Tree Lodge 05/02/07

Maple Tree Lodge 08/11/05

Maple Tree Lodge 07/07/05

Maple Tree Lodge 22/02/05

Maple Tree Lodge 24/08/04

Maple Tree Lodge 28/02/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Maple Tree Lodge 87 Byron Street Loughborough Leicestershire LE11 5JN Lead Inspector Keith Williamson Unannounced Inspection 14th April 2008 09:00 Maple Tree Lodge DS0000001759.V362389.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 Maple Tree Lodge DS0000001759.V362389.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. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maple Tree Lodge Address 87 Byron Street Loughborough Leicestershire LE11 5JN 01509 269637 01509 269637 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) Aspire Lifestyle Limited Julie Ward Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider may provide the following categories of service: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 3 23rd January 2008 2. Date of last inspection Brief Description of the Service: Maple Tree Cottage is a care home providing personal care and support for up to 3 residents with a learning disability. Two residents currently live at the home with the third room being used for storage. The home is a bungalow, located on a quiet residential road in Loughborough. Residents have their own bedrooms and there is a lounge/dining room, bathroom and kitchen. The home has a small garden to the rear with access via a portable ramp. Residents are supported to access a range of day care and leisure activities. The charges for living at the home vary depending on individuals assessed needs and level of support required. Current charges range from £950.00 per week to £1498.89 per week. Details of what is included in the charges can be found in the service user guide (a document which provides relevant information about the home), which is given to all residents on arrival at the home. A copy of the last Commission For Social Care Inspection (CSCI) inspection report is displayed in the kitchen of the home, and copies of this report are available from the acting manager. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections is on outcomes for residents and their views of the service provided. The main method of Inspection used was ‘case tracking’ which involves selecting a sample number of clients and tracking the care they received through talking with them where possible, and looking at their records and accommodation, in this case one resident was chosen. This visit took place over one day, commencing at 9.30am and took four hours to complete. An opportunity was taken to see residents and talk to staff, look around the home, view records, policies and care plans. Information was obtained from the Annual Quality Assurance Assessment (AQAA), which gives information on the home, and is filled in by the manager. Both residents were seen and one staff member and the manager were also spoken with. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. What the service does well: Residents care needs are assessed and a contract is produced prior to moving into the home. Care and life plans are then produced, and these documents are created in an “easy read” format using pictures and symbols. One of the residents signs his care plan. Risks to residents and staff are assessed before activities are undertaken. Staff check some medicines on a daily basis, and make sure others being returned to the chemist are recorded in the paperwork. Overall the medicines are given to people properly. Decisions that the residents make are recorded in the daily notes. Resident’s time during the week is taken up by college courses or social care time, which covers all seven days. Meals and menus are varied and residents have choices and flexibility with social care offered to them. Complaints information is displayed throughout the home, is available in an “easy read” format using pictures and symbols, and copies have been given to the residents. Staff are aware of how the whistleblowing procedure works. The home is comfortable and clean. Both residents’ bedrooms are personalised with various pictures and electrical equipment Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 6 Staff employed in the home have a number of checks before they were allowed to work at the home. Supervision, which is a meeting between the manager and staff on a one to one basis, is continuing. Health and safety is good, with staff doing a number of tests on a regular basis, and the fire risk assessment and escape plan are up to date. The insurance certificate was noted to be in date. 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. Maple Tree Lodge DS0000001759.V362389.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 Maple Tree Lodge DS0000001759.V362389.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 & 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The assessment process is detailed and effective resulting in accurate information for prospective residents and staff. The Statement of Purpose, and Service User Guide have yet to include quality assurance information. EVIDENCE: The Statement of Purpose, which sets out the latest aims, objectives and philosophy of the home, about its services, facilities, and current staffing, was available for inspection on this occasion, though this has yet to be amended with the current staffing details and the latest quality assurance information. Residents’ needs are assessed prior to moving into the home. The two residents currently living in the home have done so for some time. There have been no new admissions to the home since the last key inspection and none planned in the near future. Both residents have a contract on file; these are produced in a pictorial form, which is large writing with additional pictures. These have yet to be completed indicating the residents’ bedroom, and one has been signed by the resident. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are looked after well in respect of their personal care needs and choices. Areas of risk are assessed appropriately. EVIDENCE: Care plans and life plans remain in place for both residents and it was evident that the residents were involved in developing and reviewing these documents. The care plan covers specific areas that the resident needs assistance with as well as indicating the person’s abilities. The life plan gives a good picture of the residents’ social care and support needs. Included in the plan is a plan of activities covering all the seven days in any week. This includes alternatives so positive choices are available to staff if the resident does not want to do a particular activity. Both care and life plans are backed up by a comprehensive range of risk assesments giving staff limits to areas in the plan. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are supported in maintaining a good lifestyle. EVIDENCE: Care plans include details of residents continuing college courses, and leisure time. This is currently in the form of life plan, which gives in detail the planned timetable for the week. This is in two forms, structured where college courses are arranged and staff assist residents to attend. The flexible part of the plan relies on staff being aware of residents’ moods and preferences at that time, to then offer positive choices in pastimes and activities. Meals are varied and flexible, residents participate in menu selection by means of a likes and dislikes list, and personal preference at each meal. From looking at the daily records it was apparent that residents enjoy meals out at various locations each week. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 11 Residents were unable to comment directly on their plans, but one resident was making himself clear about his intentions of wanting to out to his college course. Residents’ lifestyle choices are assisted by one to one staffing. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 12 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. Residents are looked after well in respect of their health and personal care. EVIDENCE: Personal support is offered to residents on a flexible basis, and is reflected in the care plans, and confirmed by staff and enteries in the daily records. Residents’ healthcare is good with evidence of recent health checks with local a General Practitioner. Evidence is also apparent specialist health care staff assisting with care planning and behavioural techniques. The administration of medication remains good with no missing signatures on the medication administration records (these mar charts are used to record what medicine has been given and when). New medication delivered from the chemist was accurately recorded, along with items being returned to the chemist. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 13 Stock levels of medication are kept to a minimum, and all medication is now stored in a purpose built metal cupboard, which has been fitted since the last visit in February 2007. The company policies and procedures to help and instruct how medicine is given to residents have recently been revised, though these were not seen on this occasion. Staff continue to check some medicines on a daily basis, which is seen as good practice in the home. All staff that administer medicines have had training in the safe handling of medication. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 14 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 adequate This judgement has been made using available evidence including a visit to this service. Residents’ are better protected by an improving awareness by staff to accurate recording of personal finances. Shortfalls in safeguarding training leave residents at risk in the home. EVIDENCE: A complaints procedure is in place. A copy of this, which is provided in easy read format is included in the service user guide, which has been given to both residents and a copy is available on the notice board in the corridor of the home. This is displayed so that visitors to the home are aware of what to do if they have a concern or complaint. There have been no complaints received by the Commission for Social Care Inspection since the last inspection. Care staff have not yet been trained in safeguarding adult, the course that was planned was cancelled at short notice, and no alternative date has been planned. There have been no safeguarding issues forwarded to the Commission for Social Care Inspection. The issue of residents’ finances apparent at the last inspection has been dealt with, and both are accurate with the paper balances held, and receipts obtained accordingly. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents live in an environment that is homely, comfortable and clean. EVIDENCE: The home has three bedrooms but only two are currently being used for residents. The third bedroom is used as the office and for some storage. Overall the home provides a comfortable and homely atmosphere however, it was noted that a number of areas within the home are in need of redecoration including the lounge/dining room, residents bedrooms and the kitchen. The kitchen floor is also in need of attention, and items of furniture throughout the home need replaced. There is a plan of refurbishment being compiled by a company specialising in that type of work. This involves major building work, making a utility room Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 16 and providing a conservatory. The registered manager discussed her intention for the residents to be away on holiday from the home at the noisiest times. Both residents’ bedrooms are personalised with various pictures and electrical equipment, one has recently been decorated. Some electrical appliances have been purchased including a new cooker, washing machine and tumble dryer. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 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 current staff training programme, and staff supervision programme have improved the safety for residents in the home. EVIDENCE: Residents are still provided with one to one support throughout the day from 8.00am in the morning until 10.00pm at night and one waking night staff provides support during the night. As well as supporting the residents, staff are also responsible for the cooking of their meals, the cleaning of the home and the residents washing and ironing, though some of these tasks are planned at night when residents are in bed. The registered manager is currently in the process of employing more staff; a formal induction process is required at the start of their employment. No new staff have yet been employed since the last visit in February 2007. Staff Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 18 employed previously have the appropriate pre-employment checks performed before starting employment. Staff training has continued and the courses that staff have undertaken recently, consist of those that by law must be run annually. There are a number of courses that have yet to be arranged and delivered to staff, to ensure the safety of residents in the home. Staff supervision, which is one to one meetings between staff and the manager, continue to form a part of staff development. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Shortfalls in safe working practices continue to put residents and staff at risk in the home. EVIDENCE: The registered manager has worked at the home for five years and has completed her NVQ level 4, and registered managers award. The home has the investors in people award; this is a nationally recognised award, for establishments that have quality assurance built in to their day-today running of the home. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 20 The registered person has commenced his visits to the home, however does not complete a written record of these visits. These are required to ensure the ongoing development and improvement of the home. Copies of these visits are also required to be sent to the Commission for Social Care Inspection. The majority of the current staff group have been provided with first aid training and support workers have now been provided with Moving and Handling training, both issues that were mentioned in the last report. Some areas within health and safety are good, with staff doing a number of tests on a regular basis. The fire risk assessment and escape plan are up to date, but tests on the fire alarm system though performed regularly, have been at intervals longer than that are required. The testing of the electrical system noted in the February 2007 inspection report has not yet been arranged. These issues put residents and staff at risk in the home. The insurance certificate was noted to be in date. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 1 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 1 X Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA23 Regulation 13(6) Timescale for action The registered person shall make 30/06/08 arrangements, by training staff or by other measures, to prevent service users being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person must ensure that all staff are appropriately trained in safeguarding adults procedures. Staff need to know the procedures to follow in order to for them to protect the residents in their care. 2 YA24 23(b) (d) The registered person shall 30/06/08 having regard to the number and needs of the service users ensure that the premises to be used as a care home are of sound construction and kept in a good stated of repair externally and internally. all parts of the care home are kept clean and reasonably Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 23 Requirement decorated. The registered person must ensure that the maintenance issues identified at both this inspection and previous inspections are dealt with. Residents need to be provided with safe and comfortable surroundings. 3 YA35 18 (1) (c) (i) The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of the service users ensure that the persons employed by the registered person to work at the care home receive - training appropriate to the work they are to perform. The registered person must ensure that all staff receive the required training including health and safety. Residents need to know that they are being cared for by qualified and competent staff. 4 YA42 26 The Registered Person shall visit the care home at least once a month; Seek the views of the residents and their representatives, staff, inspect the premises and check the record of events and compliance and prepare a written report on the conduct of the care home. A copy of the report must be sent to the Commission for Social Care Inspection. Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 24 30/06/08 28/05/08 This would ensure the Responsible Individual oversaw continued development of the home. 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. Refer to Standard YA35 Good Practice Recommendations The registered person should provide all new support workers with LDQ (Learning disability qualification) induction training. The registered person should look at ways of obtaining views of others involved with the home including residents’ families, advocates and/or professionals with regard to the service offered. 2. YA39 Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Maple Tree Lodge DS0000001759.V362389.R01.S.doc Version 5.2 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. 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