Inspection on 13/10/05 for Mimosa Lodge

This inspection was carried out on 13th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mimosa Lodge 27/07/07

Mimosa Lodge 14/11/06

Mimosa Lodge 06/06/05

Mimosa Lodge 23/09/04

Mimosa Lodge 13/04/04

Mimosa Lodge 08/01/04

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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 Mimosa Lodge Winchester Road Botley Southampton Hants SO32 2DH Lead Inspector Mrs Pat Hibberd Unannounced Inspection 13th October 2005 08:30 Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 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 Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 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. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Mimosa Lodge Address Winchester Road Botley Southampton Hants SO32 2DH 01420 564028 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) ILIACE Limited Mr Benjamin Jon Tindell Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 06.06.05 Brief Description of the Service: Mimosa Lodge is one of a number of Homes owned by Iliace Ltd a private company. Mr Ben Tindell is the Homes manager. The Home opened in September 2003 and provides care and accommodation for seven Service Users with a learning disability. The Home is a large detached property with seven bedrooms. There is ample communal space and a number of bathrooms some of which have shower facilities. To the front and rear of the property are large gardens which are secured by fencing and a gate. There is a separate office in the grounds. Mimosa Lodge is situated on the outskirts of the village of Botley and within 20 minutes drive of the city of Southampton which has a range of leisure, shopping and recreational facilities. The Home have their own transport which is unmarked and provides transport for service Users to access both the local and wider community. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four and a half hours and was the second unannounced inspection of the 2005/2006 inspection programme. Thirteen of the forty three Standards relating to Younger Adults were assessed during this inspection. There were no areas of improvement identified on this occasion with all of the four requirements identified at the last inspection having been met. All of the core standards for younger adults have now been inspected during the 2005/2006 inspection programme. The inspection included a tour of the Home; including two residents’ bedrooms and the garden. Discussions were held with three staff members on duty, the Home’s administrator and one of the responsible individuals for the Organisation who attended the inspection due to the manager being on leave. Discussions were also held with three residents . However, due to the limited verbal communication of some of the residents accommodated the inspector observed practices in the Home with a view to gaining an understanding of how needs were being met. Three residents’ files were viewed and care provided by the Home assessed and discussed with staff. What the service does well: What was evident throughout the inspection was the commitment to ensuring residents are central to all care provided and lead a full and positive life style. Residents are involved in a range of community based activities and are encouraged to be as independent as possible within a risk management framework of care. Residents spoken to described the care as “nice” and “carefree” and that they liked living at Mimosa Lodge. The Home was comfortably furnished with the Organisation having a planned programme of redecoration. Staff indicated that they feel well supported, receive ongoing training and regular supervision. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 6 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. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 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 Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 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): 1and 2 Service users have the information they require to make an informed choice as to whether they wish to live in Mimosa Lodge with a comprehensive assessment process undertaken to ensure service users needs are identified by the Home prior to admission. EVIDENCE: The Home has an extremely comprehensive process of assessment, which includes four areas of need. The first is a personal profile of the individual, the second skills maintenance, the third work placements and finally behavioural guidelines. The assessment would be undertaken by the home’s manager who has had the relevant training. However, at the last inspection one file viewed relating to a recent admission to the Home had no evidence of risk assessments being undertaken or care plan having been completed to inform care staff of the individuals support needs. On inspection of a file of a resident who has recently been admitted there was a care plan, risk assessments and guidance to staff as to how to support the individual. In discussion with two staff they were able to indicate their understanding of the care plan and, that they had received sufficient information to support the resident and ensure their needs were being met. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 9 The inspector had a discussion with the resident as to how they considered their needs were being met and was satisfied that the individual was being appropriately supported. A requirement outstanding from the last two inspections relating to the need for Service User Guides to be produced in a format that is accessible for those for whom the service is intended has been met. All residents have a photo album which the responsible individual indicated was a document that was constantly developing as the service and individuals “ grow” and develop themselves. One resident was able to explain their understanding of their residency at Mimosa Lodge and that they had a photo album to further assist them. There is a Statement of Purpose available in a written format. However, due to there being no residents who can read this would be shared with all interested parties with photos and makaton symbols used to enable the resident to have some understanding of the document. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Service Users are encouraged to make choices about their daily life within a risk management framework. The arrangements for care planning are consistent for all Service Users ensuring their care needs are met. EVIDENCE: Residents are encouraged to make decisions about their lives through menu planning, personalising their bedrooms and, identified needs in relation to how they choose to spend their day. Residents’ meetings are not held as staff indicated that it would be difficult engaging individuals in a meeting together. Three residents’ files were viewed and care “tracked” with staff and all residents through discussion and observation. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 11 Care plans had been completed for all individuals with the information containing details of the support required to ensure their needs are being met. For those residents with limited communication their views as to care provided have been captured through a continuous process of monitoring /observation by the staff team and daily documentation in the “daily record” folder. Families/professionals and advocacy are also involved as necessary to ensure residents are independently represented. There were Care Management assessments available in some of the residents’ files with evidence that the local Community Health Teams were involved with individuals as necessary. Reviews had taken place for all residents. A requirement identified at the last inspection in relation to the lack of risk assessments and behavioural guidelines for one resident who had been accommodated since December 2004 has now met. Risk assessments viewed were detailed and had been compiled in conjunction with care staff with the manager having responsibility for their implementation and review. Time was spent with three residents to enable the inspector to observe practices in the Home and gain an understanding of care received. Particular emphasis was placed on staff communication with the individual in relation to how they were to spend their day and how it reflected identified needs in their care plan. Residents described the care as “nice” “carefree” and, that they were happy living at Mimosa Lodge. One resident was able to indicate who their key worker was and when they were next on duty. Choices are offered daily to residents which include meals, how they wish to spend their day and through observation by staff . Discussions held with staff confirmed that they were aware of residents’ needs and care plans were being implemented. Daily records are completed for all residents with shift “handovers” taking place with a view to ensuring continuity of care. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 16 Links with the local community are good with service user’s having opportunities for appropriate activities based on their interests and, with recognition of their rights and responsibilities in their daily lives. EVIDENCE: The Organisation has an ‘activities ‘ team and together with the home staff they endeavour to ensure residents have a community presence by devising programmes of activities within a risk management framework of care. These include cooking, shopping, craft, swimming and a number of community based activities. Three files viewed confirmed that residents’ interests are pursued through planned programmes. The Home’s two Communication Coordinators have developed in house programmes, which are compiled in both pictorial formats and through objects of reference to ensure residents can identify how they are to spend their day. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 13 Two residents were able to indicate what they were doing on the day and who was supporting them. There was information available in the Home in pictorial formats as to local activities available in the community to enable residents to have knowledge and choices. Rotas confirmed that there are three staff on duty during the evening and weekends to support activities identified with staff indicating that they considered the staff complement to be appropriate and, that activities are not cancelled. The Home has two unmarked vehicles with the majority of staff insured to drive residents to their activities or community events. Staff advised that the majority of residents accommodated would have no understanding of the concept of voting although one resident has been supported to vote by their parents. Staff confirmed that this would be pursued if appropriate for an individual. In discussion with one staff member they were able to explain their understanding of the Disability Discrimination Act 1995 including recent amendments and the impact upon residents using the community. Residents have access to all parts of the communal areas in the Home and are encouraged to partake in household tasks if they so wish. In discussion with the Home’s housekeeper it was evident that residents are supported to hoover, polish their bedrooms, assist with cooking and do their laundry. One resident was seen to be supported to polish the lounge and indicated that they were enjoying the task. Risk assessments are undertaken for any task undertaken by residents. There are currently no residents who have their own bedroom door key . However, this is under constant review and in discussion with one resident they indicated that they were not interested in having a key. Staff were seen throughout the inspection to use residents preferred form of address as seen in their care plan and, to treat residents with dignity and respect. There are no residents who smoke at present. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The Home has a satisfactory medication policy and procedure . EVIDENCE: At the last inspection there were two areas that required improvement in relation to “as required “medication administration and the need to update the relevant policy. From three care plans viewed it was evident that guidelines/instructions to staff in relation to the administration of prescribed “ as required “ medication for three resident’s had been met. The Home’s medication policy and procedure relating to invasive procedures had been updated to reflect the Organisation’s guidance to staff of which the Commission had been sent a copy last year. Training records indicated that the majority of staff had received in house safe handling of medication training. All new staff are undertaking the training and would not administer medication until they have been deemed competent by the Training Manager and the Home’s manager. There is always a trained member of staff on duty to administer medication to residents. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 15 Staff have received rectal diazepam training from a health professional with clear guidance in care plans instructing staff as to when they should administer the medication. This training is regularly updated. There are no residents who self medicate due to their individual needs. This Standard was not fully inspected on this occasion having been inspected at the last inspection with all areas satisfactory with the exception of the aforementioned requirements which have now been met. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The complaints policy and procedure is accessible to all service users and relatives, ensuring their concerns are addressed. Arrangements for protecting service users are satisfactory. EVIDENCE: The Organisation are currently piloting a monthly service user satisfaction survey in one of its other homes. This is with a view to enabling residents to have an appropriate format in which they can voice any complaints/concerns, express their views and comment on service provision. This will shortly be introduced across all of the Iliace homes. In the interim staff indicated that residents’ views are sought through daily discussion/observation and record keeping. All parents and representatives also have a copy of the Organisations complaints procedure. In discussion with two residents they indicated that they would talk to staff if unhappy or their family. There have been no complaints since the last inspection. Staff interviewed demonstrated an awareness of the Hampshire Adult Protection policy and procedure and their role in the event of an allegation of abuse. All staff have undertaken Adult protection training. Due to there being residents accommodated who exhibit challenging behaviour Strategies In Crisis For Prevention And Intervention (SCIP) training is undertaken by all staff. Details of approaches to be taken were detailed in three residents’ files viewed. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 17 Residents’ monies are held securely in the safe with the accounts audited six monthly by the Organisations Finance Manager. One record viewed indicated that there are satisfactory systems in place to ensure the safe management of individuals’ finances. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There were no standards inspected on this occasion. EVIDENCE: Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 There are satisfactory recruitment practices in place to ensure service users are protected. EVIDENCE: The Organisation have a recruitment policy and procedure with all staff being interviewed by the home’s manager and a personnel officer. However, at the last inspection during discussions held with the manager it was evident that two staff had been employed and were working in the home without a Criminal Record Bureau (CRB) check having been received or, a POVA (protection of vulnerable adult) FIRSTcheck having been undertaken. This practice is no longer in operation with all staff employed having a POVA FIRST check before they commence employment and close supervision until a satisfactory Criminal Record Bureau check is received. From discussions held with staff it was evident that the recruitment practices in place meet the required standards and policies and procedures of the Organisation. Files were not fully inspected as they were inspected at the last inspection with all other information as required in the standards viewed and considered satisfactory. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 20 Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 There are effective quality assurance systems in place to ensure the aims and objectives and statement of purpose of the Home are achieved. The health and safety practices in the Home are satisfactory ensuring the safety and protection of service users and staff EVIDENCE: Quality assurance systems in place to ensure the needs and views of residents are central to all service provision include regular reviews of their care by staff, management and statutory agencies, staff meetings and support from an independent advocacy organisation as required. As also detailed in previous sections of this report the Organisation have also produced a resident “feedback pack “ which is shortly to be piloted in the home. This will be followed up at the next inspection. The administrator indicated that the Home has an annual development plan. However, due to the manager not able to attend the inspection due to being on leave this will be followed up at the next inspection. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 22 Staff spoken to confirmed that they have access to the Homes’ health and safety policies and procedures which are shared with them during their induction and ongoing as required. The administrator advised that new members of staff would be shown fire procedures during their first shift in the Home. This was also clarified with two staff spoken to. All staff have received fire training with the exception of some new staff who are due to shortly attend the course. This will be followed up at the next inspection. Staff spoken to was aware of the fire evacuation procedure and their role and responsibilities in such an event. One resident spoken to was able to explain where they would go if there was a fire in the Home. However, due to individual needs of residents accommodated there are risk assessments in all files in relation to fire evacuation which are shared with all staff and regularly reviewed. Fire records viewed were up to date. Cleaning materials were seen to be safely stored and clinical waste appropriately disposed of. COSHH (Control Of substances Hazardous To Heath) sheets were also available for staff who indicated that they are required to sign to confirm they have read them. Fridge and freezer temperatures were generally up to date although there were some omissions. A discussion was held as to the Home ensuring there is an adequate system in place to monitor the recording of the temperatures. This will be followed up at the next inspection. The Organisation have designated two personnel (the maintenance manager and training manager) to have responsibility: alongside the manger for undertaking health and safety risk assessments of the Home environment. A risk assessment of the building has recently been undertaken with the administrator confirming that it has been shared with all staff. Health and safety in the Home is generally satisfactory with a range of training in place including fire safety, first aid, food hygiene, health and safety, infection control and manual handling. Due to the majority of residents accommodated having little concept of risk, a range of risk assessments have been undertaken of the environment which are shared with staff and regularly reviewed by the team. The administrator confirmed that appliances are maintained and fire safety checks carried out on a regular basis. There is a routine for securing the building at night undertaken by night staff. Accidents and incidents were appropriately documented. Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 3 x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Mimosa Lodge Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x DS0000052790.V257696.R01.S.doc Version 5.0 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 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 Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Mimosa Lodge DS0000052790.V257696.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!