Inspection on 30/05/06 for Melody Lodge

This inspection was carried out on 30th May 2006.

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

Other inspections for this house

Melody Lodge 09/08/07

Melody Lodge 19/01/06

Melody Lodge 02/08/05

Melody Lodge 18/03/05

Melody Lodge 19/07/04

Melody Lodge 05/01/04

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 Melody Lodge West Keal Hall Hall Lane West Keal Lincs PE23 4BJ Lead Inspector Vanessa Gent Key Unannounced Inspection 30th May 2006 04:00 Melody Lodge DS0000057722.V298094.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 Melody Lodge DS0000057722.V298094.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. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Melody Lodge Address West Keal Hall Hall Lane West Keal Lincs PE23 4BJ 01790 752700 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) skitini@hotmail.com Skitini Care Homes Ltd, T/A Melody Lodge Mrs Dawn Wigley Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Melody Lodge Care Home provides personal care and accommodation for up to eleven people of both sexes, below the age of 65 years, who have a learning disability. Nine residents live at the home at present. The home is a two-storey manor house dating from the early 1600’s, set in four acres of tranquil, well-kept gardens, within the quiet Lincolnshire village of West Keal. It is being extended with a two-storey building at the back of the home. There is a village church and café nearby. The care staff support the residents to get to shops, pubs, a bowling alley, tourist attractions, the Gateway Club and the leisure centre in the nearby towns of Spilsby, Boston or Skegness. The home is owned by Skitini Care homes Ltd. The residents are currently housed in two shared and five single rooms until all the rooms have been renovated and made into single, ensuite accommodation. The fees range from £425 to £780. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit was made to the home as part of a key inspection. It started at 16.00, when all the residents had returned from their daytime activities and lasted four and a half hours. Information already held on file was used to plan the visit. The site visit focused on key inspection standards and regulations and checking whether requirements from previous inspections had been met. The inspector took a full tour of the home, with all the residents assisting, and a sample of residents’ records was inspected. The main method of inspection used is called ‘case-tracking’, which involves selecting a proportion of residents, and tracking the care they receive through the checking of records, discussion with them, the care staff and observation of care practices. Three residents’ assessments and care plans were examined. The two staff on duty, all of the nine residents and three relatives spoke with the inspector at the visit to the home. The inspector spoke with the manager by phone. No comment survey forms had been received at the time of the site visit. What the service does well: What has improved since the last inspection? The renovation programme means that several residents are now housed in single, pleasantly decorated and furnished ensuite bedrooms that are Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 6 personalised to their tastes. The remainder of the rooms are either in the process of or are awaiting major improvements. 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. Melody Lodge DS0000057722.V298094.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 Melody Lodge DS0000057722.V298094.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a good admissions procedure which clearly enables prospective residents to know what services the home provides and that their needs will be met. EVIDENCE: The home has a clear statement of purpose, which contains relevant information pertaining to the services provided. A suitable service guide is written in clear, simple English with picture format for easy reading. The last person to come to live in the home was given a service user guide on admission. Prospective residents are introduced to the people already living in the home and are assessed before they are admitted to the home to ensure that their needs will be met. Melody Lodge DS0000057722.V298094.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Care plans are comprehensive documents that involve the residents to ensure their needs, wishes and decisions are fully taken into account and that they can lead as full lives as possible within a safe environment. EVIDENCE: Care plans examined showed full involvement of the residents, from their creation with the keyworkers, to the monthly reviews, where they have the capacity and the desire to be involved. They are comprehensive documents that inform staff of how to care for their needs and that make sure that they have made decisions for themselves and that their wishes and choices are taken into account. Staff stated that the advice and support from healthcare professionals are accessed as necessary. Consideration is being given in the renovation of residents’ individual rooms, such as sensory and independent living rooms, to ensure that their healthcare, physical and holistic needs will be met. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 10 Care plans showed and residents confirmed and demonstrated that they can take risks to enable them to be as independent as possible. Melody Lodge DS0000057722.V298094.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Activities and contact with family, friends and within the local community are in accordance with the residents’ wishes. Residents are given responsibilities within their capabilities. They are offered a balanced, nutritious diet that the residents have a choice in. EVIDENCE: Residents are transported into neighbouring towns for daytime activities; most returned during the inspector’s visit to the home and were enthusiastic to tell what they have been doing. One resident proudly displayed the intricate work she had produced at a local college and said she really enjoyed attending the sessions and courses available. Other residents told of leisure activities undertaken on a regular basis and the holidays that they went on together with staff. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 12 Contact and involvement with families and friends is encouraged where possible although some families live far away from the home. All residents are encouraged and some residents are given responsibility for activities within the home such as gardening and feeding the turkeys, which they say they enjoy doing. The food for main meals is now supplied in pre-prepared packets for individual consumption, supplemented with fresh vegetables being prepared and offered with each meal and fresh fruit available at any time. The provider feels this will provide more choice and ensure that residents are offered a balanced, nutritious diet. They also have takeaway meals such as fish and chips or Chinese meals as a treat or for special occasions such as birthdays. Residents all said that they really enjoy their food and being given plenty of choice. Melody Lodge DS0000057722.V298094.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent. This judgment has been made using available evidence including a visit to this service. The quality of the outcomes for Standards 18 and 19 have been exceeded by giving lots of personal support, flexible support plans and maintaining their dignity and independence. The procedure for administration of medications does not protect the residents from a risk of ahrm. EVIDENCE: Residents say that their dignity and independence is respected by staff, which ensures that the residents are well-catered for. All the residents said they are very happy at the home, are able and encouraged to do exactly what they want and enjoy their lives to the full. One resident, who was unable to get out of her wheelchair when she was admitted, has made great improvements in her mobility through positive and supportive staff input and effort and is now able to walk for short distances. All the residents are happy, outgoing people who say they love the staff and living in the home. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 14 Medication practices including pre-dispensing, keeping medications in an unlocked facility, the keeping of an out-of-date reference of medications and the informal status of the staff training in the safe administration of medications may put residents at risk of harm. It is advisable that the manager should seek the advice and training of a professional such as the pharmacist who supplies the home with their medications for all staff and that regular updates are accessed by staff thereafter. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Complaints and accidents are recorded and managed appropriately according the homes policy. Residents are kept safe by staff who are aware of and follow the home’s policy and procedure regarding the safeguarding of vulnerable adults. EVIDENCE: The complaints file and accident book were examined during the visit to the home - no complaints were recorded and the manager says none have been received. A minor accident occurred to a resident just prior to the inspector’s visit which was handled appropriately and an accident form completed. Residents said that they love all the staff who keep them safe and happy. Staff said they are trained at induction to keep residents safe and protect them from harm or abuse and know who to go to if an untoward incident occurred. Training was accessed early in 2006 for staff to update their knowledge in adult abuse awareness and for managing challenging behaviour more effectively. Residents say their rights and independence are supported by staff. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 16 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, 26, 29, 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home provides a clean, tidy and personalised environment in which residents feel confident, happy and well-cared for. EVIDENCE: At previous inspections, residents rooms were found to be homely and personalised and the home generally clean, tidy and well-organised with a good standard of hygiene throughout. This was confirmed at the visit to the home. The inspector was given a full tour of the building by most the residents, who were all eager to show how their rooms are personalised and kitted out to their tastes and wishes. Improvement is ongoing in providing all residents with single ensuite accommodation and specific, individually designed rooms with specialised adaptations which will assist them to live a fuller and more active life and meet their indvidual specialist needs. The residents are involved personally and collectively at all stages. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 17 A Fire inspector in November 2005 detected shortfalls in the fire retardation of several doors and made requirements for these to be improved to the required standard. At the visit to the home, it was noted that no alterations have been made, but the ongoing renovation programme includes the replacement of these doors. The legislative fire safety officer discussed this with the provider at the time and stated that if the area is occupied by residents then the doors must comply with legislation. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 18 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, 34, 35, 36 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. A good recruitment and training procedure is in place which enables staff to care for residents safely. Staff would benefit by more comprehensive supervisions. EVIDENCE: The staff duty rota indicates that there are always two staff on duty at any given time. This was confirmed by the staff on duty at the visit to the home. Staff say that induction is a thorough process during which new employees work supervised by more senior staff and the manager oversees the induction period. An induction booklet is given to new employees to complete during this period to document their competence in caring for the residents. Staff say that the manager encourages training for all staff to improve their knowledge and caring for the residents. Recent training undertaken includes managing challenging behaviour and adult abuse awareness. Although staff files were not available at the visit to the home, the manager stated in the pre-inspection questionnaire that (re: training) Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 19 Supervision has taken place for some staff but has not been on a regular basis as recommended. Staff supervisions should take place six times per year. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 20 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, 38, 39, 42 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The home promotes the health, safety and welfare of its residents and staff by providing a safe environment, allowing risk-taking and independence within the residents’ capabilities and wishes and by staff training and support. EVIDENCE: The manager has previous qualifications in management and is currently taking the Registered Manager’s Award. Staff say they can talk to the manager and that she is supportive of them. Residents said that their views are listened to and evidence was seen of the residents’ meetings that the activities organiser has with them on at least a monthly basis. The residents are also asked regularly on an informal basis if they are happy and if the service provided is appropriate to their needs, tastes Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 21 and wishes, as they do not want to fill in formal survey questionnaires. Residents and staff spoken with confirmed this. Their care plans are personal with their full involvement within their capabilities in evidence. Health, safety and welfare of the residents is provided within a safe environment, as seen on the tour of the home, except for the requirements set by the legislative fire officer as described in the previous section. Residents are allowed to take risks, and independence within the residents’ capabilities and wishes is supported by the provider, manager and staff. Staff received robust staff training and support. Residents said they are very happy and love the staff and living at the home. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 22 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 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 3 25 X 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 X 3 3 4 X X 3 X Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA20 Regulation 13.2 Requirement Timescale for action 31/07/06 2 3 YA35 YA36 18.1 18.2 All staff who administer medications must be trained by an appropriately qualified person to ensure that residents are not put at risk of harm. Staff training must be up-to-date 31/08/06 to ensure residents are cared for safely and to meet their needs. All staff must receive regular 31/07/06 supervision to ensure that they can carry out their jobs to fully meet the needs of the residents and care for them safely at all times. 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 YA36 Good Practice Recommendations It is recommended that supervisions should be undertaken six times per year for all staff. Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Melody Lodge DS0000057722.V298094.R01.S.doc Version 5.2 Page 25 - 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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