Inspection on 31/08/07 for Meesons Lodge

This inspection was carried out on 31st August 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

CARE HOME ADULTS 18-65 Meesons Lodge 1 Henry de Grey Close Meesons Lane Grays Essex RM17 5HR Lead Inspector Helen Laker Unannounced Inspection 31st August and 5 September 2007 10:00 th Meesons Lodge DS0000069079.V352498.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 Meesons Lodge DS0000069079.V352498.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. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meesons Lodge Address 1 Henry de Grey Close Meesons Lane Grays Essex RM17 5HR 01375 383267 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) www.caremanagementgroup.com Care Management Group Ltd Mrs Faidat Bolanle Fatunla Care Home 10 Category(ies) of Learning disability (10), Physical disability (6) registration, with number of places Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Not applicable Brief Description of the Service: Meesons Lodge is a care home with nursing for nine residents with severe learning disabilities. It is situated in Grays close to local shops and transport. Accommodation is on two levels. Public transport by both rail and bus is available approximately 1 mile away. The home has its own minibus. All bedrooms are single occupancy and the home provides nursing care for 10 adults with severe learning disabilities and physical disabilities. Services provided include personal, psychological, social, emotional and educational care by a multidisciplinary team and enabling the service user to remain as independent as possible. Service users within the home can access a range of formal day care placements and are encouraged to participate in leisure pursuits within the local community. There is a large garden to the rear which is available to all the residents. The Service User Guide and Statement of Purpose are available and are updated as required. The residents and their representatives are provided with this information and it can be displayed for reference along with current Commission for Social Care Inspection reports also. At the time of this report the homes fees for current service users were not ascertained with the range from lowest to highest per week but are assessed according to individual needs. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection, a routine, unannounced inspection which took place over two days with one inspector in the home. There was a tour of the premises and grounds and an inspection of records and documentation. Time was spent discussing the care of the seven service users in the home. The manager and three members of staff were spoken with one relative and one visiting professional. Twenty two National Minimum Standards were inspected on this occasion, sixteen overall outcomes were met and four requirements and two recommendations is detailed in the full report. Discussion of the inspection findings took place with the manager at the end and throughout the inspection and guidance was given. Further feedback was also received from service users and staff through survey and discussion. Responses have been included in the relevant sections of the report. A pre-inspection questionnaire AQAA was provided on this occasion and other reports and correspondence provided by the staff on duty were used as evidence to inform this report. What the service does well: What has improved since the last inspection? Since the agencies registration visit, Meeson’s Lodge have ensured that they provide a consistent professional service to current service users. They have appropriately dealt with some management problems which are now resolved. The premises provide space for equipment, meetings and training. Also, ground floor facilities are accessible to disabled service users. The company has quality inspectors which compile quality assurance reports internally on the homes in line with the national minimum standards. Requirements and recommendations highlighted at this first inspection have been discussed with the manager. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Meesons Lodge DS0000069079.V352498.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 Meesons Lodge DS0000069079.V352498.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): 2 Quality in this outcome are is good This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a contract directly with the home if privately placed EVIDENCE: Documentation reviewed for the last two admissions was seen to be appropriate. Service users are offered the choice of home after a full needs assessment has been undertaken by the home’s referral and admission team and through partnership working with service user, family, care manager/social worker, and or advocate where appropriate. This is characterised by visits to the home and agreement by all concerned, then followed by a transition plan/ trial plan. The trial plan continues after admission for a period of 3 months after the date of admission to ensure the service user is happy in their new home environment and whether the service practically meets the service users needs. Meesons Lodge DS0000069079.V352498.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 and 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Each service user has an individual plan and service users are supported to take risks as part of an independent lifestyle via a process of assessment. The health needs of service users are well met however the development of better documentation would ensure clarity of needs. Due to service users profound learning disabilities they are only able to make limited decisions but staff can facilitate this as much as possible. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 10 EVIDENCE: Care plans were seen to be generally comprehensive and person centred. Reviews on a regular basis were not all evident and attention is required to ensuring signatures and dates are fully documented. Care plans included assessments but evidence of involvement of service users and their families/representatives needs more prominence. A person centred approach is used in meeting service users needs in agreement with each service user and their family. Service users are offered expression of choice in relation to lifestyle including meals, rights, privacy, working towards goals and ambitions that is coordinated by an allocated keyworker. Staff enable service users to take responsible risks The inspector was informed that the home care planning system is in the process of currently reverting to Person Centred Planning (PCP). The Therapy team will assess new referrals to ensure that the home is fully equiped and trained to meet all new service users needs and comprehensive moving and handling assessments were seen and discussed with the physio on the day of inspection. Risk assessments are contained in all service users files. These were seen to generally be to a good standard and detail how staff are to manage the risk. Not all were seen to be regularly reviewed or in the case of bedrails and restraint detail the risk of entrapment or injury. Consent issues were discussed with the manager and individual cases where mattresses were on the floor, lap belts are used or baby monitors were being used. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Social activities take place and service users are generally happy with the choices in routine available to them. Links with families, friends and advocates are good and contact is maintained. Visitors are made welcome and overall the service users rights and responsibilities are recognised in their daily lives. EVIDENCE: Service users are supported to participate in appropriate activities, both in the home and in the community. None of the service users are able to gain employment. All the residents have person centred plans which include their individual needs and wishes regarding their lifestyle and daily living which includes activities. The home does not have an activities co ordinator or a formalised activity plan. The residents living at the home have regular meaningful experiences such as swimming and weekends away at a holiday home in Clacton. No annual holidays have taken place yet. Each week service users are taken to day care on two allocated days each. Service users are Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 12 encouraged and supported to access all community facilities. The home has it’s own vehicle which staff are authorised to drive. Risk assessments and guidelines should be available for each service user when travelling in cars and the minibus. The Manager informed that all families are invited to be involved in the service user’s care. The home endeavours to keep relatives up-to-date with their service users care. The home has an open visitors policy. Service users have access to all communal areas of the home, apart from the kitchen where access must be supervised. The manager said that the routines of the home are flexible. Staff were observed to interact with the service users sensitively throughout the inspection. Staff encourage service users to maintain and improve their general life skills. The main meal is taken at lunchtime. The home operates a four week rotating menu. Menus are based on experience of service users’ likes and dislikes. All the service users need assistance with eating and the Manager informed that generally sittings are held to ensure service users are given appropriate assistance. Staff do all the cooking and cleaning which is considered appropriate if it does not detract from the care of the service users. With the current dependency of the current service user the proprietor should ensure that appropriate staff are employed for cooking and domestic duties Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome are is good This judgement has been made using available evidence including a visit to this service. Good arrangements are in place to ensure that the health care needs of service users are identified and met. EVIDENCE: Wherever possible service users are encouraged to choose their own clothes and hairstyles. Service users receive specialist input as and when required. Service users are allocated Key workers. Personal care is carried out either in private in service users bedrooms or in the bathrooms. Service users likes and dislikes are recorded in their care plans. Service users are supported to obtain all health care services. Records of visits are maintained in their care plan. Medication records were found to be accurate although staff are advised to ensure two signatures are evident for transcribed medications and some minor recording issues were discussed. Appropriate protocols were seen to be in place. Only trained staff administer medication. The home intends to employ a qualified nurse to closely monitor each service users health and ensure any potential complications and problems are identified and dealt with at an early stage and to get more staff trained and accredited on medication handling and administration. Medication was seen to be stored appropriately and securely. Meesons Lodge DS0000069079.V352498.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 and 23 Quality in this outcome are is good This judgement has been made using available evidence including a visit to this service. The home has effective procedures in place to ensure that service users are protected from abuse, neglect and self harm. EVIDENCE: The home has the Proprietor’s comprehensive complaints procedure, comprehensive abuse and whistle blowing policy and a copy of the local authority’s Protection of Vulnerable Adults Procedure. Most staff have received training and others are booked for training in the near future. Staff spoken with were aware of the whistle blowing procedure. A complaints book was available in office and information displayed in the home for service users that is user friendly. Evidence of staff acknowledging that they have read and understood the policy and procedures around concerns, complaints and protection of service users is in place. Money is held securely. Meesons Lodge DS0000069079.V352498.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 and 30 Quality in this outcome are is good This judgement has been made using available evidence including a visit to this service. Meesons Lodge was clean, bright and well maintained and provided the service users with homely and comfortable surroundings. EVIDENCE: The premises is a large detached house with large garden area. The home is purpose-built with appropriate aids and equipment. The home on this inspection was found to be light, airy, comfortable and safe for its service users. Window restrictors were seen to not be appropriately secure both to stop harm and from a security point of view. This was discussed with the manager on the day of inspection. The home has a designated budget and a planned maintenance programme. The dining and lounge areas are comfortably furnished to a good domestic standard. Bedroom sizes meet this standard. Those bedrooms seen were furnished according to the individual service users’ needs. They were seen to have good natural ventilation, lighting, heating and appropriate window space. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 16 The home has adapted bathrooms and adequate communal toilets for the service users’ needs. The home has a large lounge/dining room and one garden area. Kitchen and laundry facilities were to a good domestic standard. There are call-bell systems in all rooms. Bedrooms are fitted with tracking hoists where appropriate to meet the service user’s needs. The home has grab rails fitted throughout the home. The premises were seen to be clean and tidy throughout. There is an infection control policy. Meesons Lodge DS0000069079.V352498.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): 32, 34 and 35 Quality in this outcome are is adequate This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment and training of staff generally have safeguards in place to offer protection to people living in the home. The home has an effective and competent staff team. EVIDENCE: Recent staff files inspected were found to contain most of the relevant information required. Although CRB checks are undertaken evidenced POVAfirst checks are not and this is considered best practice along with the checking of permissions to work with regard to permits. This was discussed with the manager on the day of inspection. One staff file checked did not have an application form. The home has a training budget and a designated people responsible for the training and development programme. The manager advised that all new staff are registered on accredited induction and foundation programmes, and use the Learning Disability Award Framework and skills for care to underpin knowledge for progression onto NVQ qualifications. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 18 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 and 42 Quality in this outcome are is good This judgement has been made using available evidence including a visit to this service. There is leadership, guidance and direction to staff and the home has in place practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: A qualified, competent and experienced acting Home Manager has been appointed to run the home and have overall responsibility to ensure that the home meets its stated purpose, aims and objectives. An application for registration is still to be made. The home manager undertakes periodic training and development meetings to ensure to ensure the management approach of the home creates an open, positive and inclusive atmosphere that is open and transparent. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 19 There is a development plan for the home that is based on systematic cycle of planning, action and review. Our company policies and procedures are reviewed regularly in compliance with changing legislation and good practice advice from relevant authorities. The home manager takes responsibility to ensure staff compliance around safe working practices and records are maintained within the home according to relevant legislation. Staff have received mandatory training and updates and further training has been arranged. COSHH items were appropriately stored. All health and safety inspections and servicing of equipment were up to date. The home sends out it’s own questionnaires and has quality inspectors within the company to monitor it’s service delivery and quality assurance reports are compiled. Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 20 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 X 2 3 3 X 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 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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 YA7 Regulation 13 (7) & (8) Requirement Timescale for action 15/12/07 2 YA17 18 (1) a c 3 YA24 13(4) Service users must not be restricted with lapbelts or similar permanently for any reason or be subject to any form of restraint. This also with reference to bedrails and where mattresses are on floors Consideration must be given to the issue of formulating individual plans within a riskmanaged strategy. The registered person shall, 15/12/07 having regard to the size of the care home, the statement of purpose and the number and needs of service users and shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. This with specific reference to the employment of staff for specific roles such as cleaning and cooking. Arrangements must be made to 15/12/07 ensure that all parts of the home DS0000069079.V352498.R01.S.doc Version 5.2 Meesons Lodge Page 22 4 YA34 7, 9, 19 (1) to (7) Schedule 2 to which service users have access are, so far as is reasonably practicable, free from hazards to their safety. This with particular reference to window restrictors being robustly fitted and tamper free. The registered person must operate a robust and thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. 15/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations Plans of care must be drawn up including consultation with service user families and significant multidisciplinary personnel, to be reflected in the care plan and reviewed comprehensively monthly. Consideration should be given to the employment of an activities co ordinator and the formulation of a formal activities plan. 2 YA12 Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Meesons Lodge DS0000069079.V352498.R01.S.doc Version 5.2 Page 24 - 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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