Inspection on 04/10/05 for Northam Lodge

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Northam Lodge 16/11/06

Northam Lodge 21/10/04

Northam Lodge 20/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Northam Lodge Heywood Road Northam Bideford Devon EX39 3QB Lead Inspector Andy Towse Unannounced Inspection 4th October 2005 10:00 Northam Lodge DS0000022111.V252237.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 Northam Lodge DS0000022111.V252237.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. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Northam Lodge Address Heywood Road Northam Bideford Devon EX39 3QB 01237 477238 01237 422850 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) Northam Lodge Charity Simon De Fraine Tickner Care Home 24 Category(ies) of Learning disability (21), Learning disability over registration, with number 65 years of age (3), Physical disability (21), of places Physical disability over 65 years of age (3) Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th. May 2005 Brief Description of the Service: Northam Lodge comprises three separate residential units, registered to accommodate twenty four adults with learning disabilities and who may also have physical disabilities. The units are set within their own well maintained garden. Northam Lodge has a separate administrative centre, located a short distance away at Rose hill, where there is also a day centre. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over a period of five and a half hours. Although the registered establishment comprises three separate units this inspection focussed on one unit with time spent with residents. The information contained in the report was obtained from discussion with staff, including senior staff, visiting relatives and professionals together with inspection of residents’ files, including care plans and other records held at the home. What the service does well: 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. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 6 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 Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 7 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): Standards 1, 2, 4 and 5 were inspected as part of the announced inspection of 19th. May 2005. At that time it was assessed that the home was meeting the requirements of the National Minimum Standards in respect of these Standards. EVIDENCE: Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 8 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): 9 Although the level of independence experienced by residents in the Northam Lodge Unit is limited by their profound disabilities, records and discussion demonstrated that the unit does endeavour to enable residents to experience as much independence as their abilities allow. EVIDENCE: Service users in the Northam Lodge Unit are the most dependent adults accommodated at Northam Lodge. This restricts the level of independence which they are capable of achieving. Examination of care plans and records held for residents showed, by reference to systems of communication, such as eye pointing, facial expressions and the avoidance by staff of abstract language, that residents’ choices could be determined, thereby giving them a degree of independence. Wherever possible residents were seen to feed themselves. Files were seen to contain risk assessments, including those relating to risks connected with residents going on home visits. The home also has regular contact with professionals such as physiotherapists. Physiotherapists were visiting on the day of the inspection and were involved with adjusting matrix seating on wheelchairs. Physiotherapists give advice to the staff and files contained pictorial advice regarding how staff should move and handle residents. Such advice enables staff to support residents in Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 9 achieving more independence as well as maintaining their safety and comfort. Pictorial instruction relating to actioning the advice of physiotherapists did include photographs of residents, however, in order to preserve their rights to privacy, written consent had been obtained from relatives and guardians for this Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16, 17 The Unit is pro-active in encouraging residents to maintain family links and involve relatives in daily routines and activities. EVIDENCE: This was an unannounced inspection and during the course of the inspection two residents received visitors. In discussion, one set of parents said that they called round twice a week and the other parent spent one day a week at the unit with her daughter. Both sets of parents confirmed that they were free to visit at any time. Both sets of parents said that they attended their offspring’s reviews. One spoke positively of the home being proactive in collecting her from her home in order that she could accompany her daughter to hospital or doctor’s appointments (her attendance was in addition and not instead of staff accompanying the resident.) In discussion the senior support worker spoke about other residents who had regular contact with parents and siblings. In Northam Lodge residents are restricted due to their physical and learning disabilities from being able to have unrestricted access to all parts of the home without staff support. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 11 The home has a policy regarding pets, with two residents having fish and in another instance a gecko. The resident who owned the gecko was said to find it added further stimulation to her environment. During the inspection residents were seen having a meal. In this unit residents do not eat together. This is because the level of support required by those with complex dietary needs means it is not feasible for all residents to dine together at the same time. Meals are therefore staggered to enable staff to support each resident. One parent was seen assisting her daughter during the meal and other staff were helping those residents who required assistance to eat. Those residents who were able, fed themselves. The cook showed menus to demonstrate that the home worked to a four week menu and this also included summer and winter menus. Discussion and observation showed that there is a choice of menu. Residents’ files were seen to contain information concerning residents’ likes and dislikes regarding foods, including, in some cases allergies, and the food given to residents reflected these. Residents’ files also contained a section entitled ‘Drink and Mealtime Guidelines’ which gave information regarding what individual residents should eat, dietary requirements and, where appropriate, physiological information and advice from professionals regarding individual residents ability to swallow. The senior carer said that the menus were discussed with a dietician. This is good practice but could not be substantiated at the time of the inspection. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Residents are protected by the home’s policies and procedures for dealing with medicines and the staff having training and knowledge appropriate to meeting the needs of residents. EVIDENCE: There are no residents in the Unit who have been assessed as having the capacity to self-medicate. Records showed that medication is recorded on arrival and the administration of medication is recorded appropriately. Residents’ files contained information which showed regular contact with general practitioners and visits to hospitals. One file demonstrated that medication had been reviewed regularly and had, following medical advice, been reduced considerably. Some staff had received training in medication administration, such as attending a ‘Safe Handling of Medicines’ course, whilst others had received inhouse, hands on training which involved being shadowed by senior trained staff and on three occasions being seen to administer medication appropriately prior to being regarded as able to administer medication unsupervised. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 13 The home has protocols to be followed in the event of residents having fits. Staff were questioned about these and demonstrated knowledge of the correct procedures. Staff had also received training regarding this. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Residents are protected by Northam Lodge’s robust and well documented recruitment procedures. EVIDENCE: The home has a written complaints procedure. It was seen to be prominently displayed in the Unit. A visiting relative confirmed that she was aware of the complaint procedure however should she have any concerns she would personally address these to the key worker responsible for her daughter, then the unit leader and if resolution was not met, then the registered manager. Since the last inspection two complaints have been received by Northam Lodge. Investigations are both in the process of completion. In one a regulation was recorded as having been breached and in the latter, the registered manager was already taking action to resolve the issues raised prior to receipt of the complaint. The home also has a Whistleblowing Policy which serves to protect those who raise concerns about poor practices. Whilst not familiar with the term ‘whistle blowing’ staff were aware of the right to raise concern about poor practice and the right not to be discriminated against for doing so. The files of recently recruited staff were seen to contain references, and start dates confirmed that these staff only commenced work after their CRBs had been received. There were records of interviews which confirmed that these were thorough, exploring any gaps in employment. This process safeguards Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 15 residents, and it also included prospective staff working for a trial shift as part of their recruitment. The home has policies in its Operational Manual regarding service users’ monies and these are currently being upgraded. The Unit operates a system for recording monies spent on residents’ behalf, which was seen to be regularly audited with receipts verifying expenditure and also involving a system of requisitioning which monitored levels of expenditure. In order that staff are fully conversant with what constitutes abuse they receive training on the subject of the Protection of Vulnerable Adults. There have been two sessions arranged for this during 2005. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 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): All the Standards in this section were examined during the announced inspection of 19th. May 2005. EVIDENCE: Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 were inspected during the announced inspection of 19th. May 2005. EVIDENCE: Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 Although the home conducts monthly audits and relatives attend reviews and are free to visit at any time, the home could be more pro-active in seeking the views of relatives. EVIDENCE: At Northam Lodge the manager conducts a monthly Health and Welfare Audit when care plans are reviewed. The Health and Safety and Building Audit is carried out monthly by the home’s Services Officer. The audits identify any deficits in the service or buildings and state how these should be rectified. Although relatives can attend the review of their relative who is resident at Northam Lodge, other means of obtaining their views and involving them more in the running of the home, such as surveys, satisfaction surveys and group discussions were not evident at the time of the inspection. The manager has also kept relatives informed of events at Northam Lodge through a newsletter, however this has not been published since April 2005. Northam Lodge DS0000022111.V252237.R01.S.doc Version 5.0 Page 19 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 X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X 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 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Northam Lodge Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000022111.V252237.R01.S.doc Version 5.0 Page 20 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. 1 Refer to Standard 39 Good Practice Recommendations Feedback is actively sought from service users (with support from independent advocates as appropriate) about services provided through eg anonymous user satisfaction questionnaires and individual and group discussions. 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