Inspection on 12/09/07 for Palm Lodge

This inspection was carried out on 12th September 2007.

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

Other inspections for this house

Palm Lodge 01/02/07

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Palm Lodge Palm Lodge 59 Kings Road London Colney Hertfordshire AL2 1ES Lead Inspector Jeffrey Orange Key Unannounced Inspection 12th September 2007 08:15 Palm Lodge DS0000067751.V342157.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 Palm Lodge DS0000067751.V342157.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. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Palm Lodge Address Palm Lodge 59 Kings Road London Colney Hertfordshire AL2 1ES 07759402987 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) Bowmans Lodge Limited Maleega Pyneandee Care Home 5 Category(ies) of Past or present alcohol dependence (5), Past or registration, with number present drug dependence (5), Learning disability of places (5), Mental disorder, excluding learning disability or dementia (5) Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are none Date of last inspection 1st February 2007 Brief Description of the Service: Palm Lodge is a privately owned and run care home, registered to provide care and accommodation for up to five adults between the age of 18 -65 who have had a past drug or alcohol dependency and /or have a learning disability or a mental health disorder. The home aims to offer a supportive environment, to enable service users to gain or regain skills and to recover the confidence necessary for them to be able to move on and live even more independently within the community. The home is situated in a residential area of London Colney, with accommodation over two floors, including communal areas and office/sleep-in provision for staff. The home has a rear garden which is accessible to service users. There is limited parking available to the front of the home with additional on street parking subject to availability. There are good local public transport links and local shops and the home is also close to a large retail park. The home has a statement of purpose and service user guide, which includes contact details for the Commission for Social Care Inspection (CSCI) and copies of the latest inspection report by the CSCI are available in the home. Current fees are in the range £650- £717 per week. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Although this was the second key inspection for Palm Lodge since it was first registered in August 2006, it was the first inspection carried out following the admission of the three current services users. Two service users had previously been living in an associated registered home and this inspection site visit provided an opportunity to discuss the move into Palm Lodge with them, and to find out how their developing care needs were now being met, together with their plans for the future. One person living in the service has moved into Palm Lodge from a healthcare setting and as well as talking to them, it provided an opportunity to look in detail at the pre admission assessment process of the home. As well as looking at some key records, such as care plans and medication this site visit provided an opportunity to discuss the operation of the home with the registered manager and the responsible individual. This report also draws on information received from the home in their Annual Quality Assurance Schedule, which is a self-assessment process that requires care services such as Palm Lodge to record how well care outcomes for the people living in their service are being met as well as providing a range of statistical information about the service. People living in Palm Lodge have been provided with survey forms to complete if they choose to do so and any information will be assessed as it is received. This report also draws on conversations held with health and social care professionals associated with people living in Palm Lodge as well as any other information received by the CSCI about Palm Lodge since the last inspection in February 2007. What the service does well: People living in Palm Lodge are receiving support from experienced and wellqualified staff and are being provided with a stable, structured home environment that helps them to maintain their existing level of independence and independent living skills and to develop their potential for increased independence at a realistic pace in line with their own wishes and their changing health. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Palm Lodge DS0000067751.V342157.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 Palm Lodge DS0000067751.V342157.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): Standards 2 & 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admissions to Palm Lodge are only made following a comprehensive needs assessment that establishes that identified needs can be fully met. This assessment process involves the individual who is the prospective resident, together with any health and social care professionals responsible for them and includes the opportunity to visit the home in order to determine if they feel it is somewhere they would feel comfortable and at ease. This process should ensure that only those whose needs can be appropriately met and who feel positive about Palm Lodge are admitted. EVIDENCE: The two people who moved into Palm Lodge from an associated home had previously spoken very positively about the prospective move and confirmed that they had been able to visit the home and to select the specific rooms they were to occupy. The pre-admission documentation for the third person living in Palm Lodge was reviewed and found to be comprehensive, including input from a range of associated health and social care professionals. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 9 The manager of Palm Lodge indicated that they had conducted their own assessment, and this was recorded. In conversations with her, it was established that some third party assessments are not always confirmed when the home conducts their own assessment and that in some cases prospective placements have not been accepted as a result of this robust approach. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home demonstrates the capacity to involve residents in decisions about their care and development and actively supports them to acquire the necessary skills and experience they need to make the transition to more independent living settings wherever possible. The home operates within a risk-assessment framework that enables people living in the service to take reasonable risks as they seek to increase their independent living skills and experience. EVIDENCE: Care plans for each person living in the home were seen and included evidence of a regular, structured review process, involving the individual and a range of health and social care professionals. Individual goals were established, for example in one case the possibility of undertaking French conversation classes. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 11 Minutes of a recent resident’s meeting were seen and in conversation with them it was confirmed they feel that they are reasonably well involved in decisions about the home and how it is run. A robust and realistic system of risk assessments was seen to be in place. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Palm Lodge are able to develop interests, build relationships and pursue leisure activities in the home and community. EVIDENCE: One person living in the home has begun voluntary work at a local aircraft museum, in line with their care plan and their long-standing interest in mechanical engineering. They were able to reduce the time spent at day centre as they felt this no longer met their needs as its focus had become more therapeutic and they preferred to attend the more social day care activities. Another person living at the home on the other hand found the more structured ‘therapeutic’ approach helpful. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 13 Each person spoken to had a range of personal contacts and was able to access the local community independently. Care plans and reviews seen provided evidence that the individual needs and preferences of people living at Palm Lodge are recorded and acted upon. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assisted and encouraged to maintain their health, including complying with their medication and to have access to those community healthcare services they require. To encourage independence it is important that the possibility for increased levels of self medication are always kept actively under review and re-assessment. EVIDENCE: Medication records were checked and discreet self-medication monitoring observed, the basic process and records seen are robust and accurate. Care plans contain considerable evidence of the involvement with residents of a range of community healthcare services such as general practitioners, psychiatrists, community psychiatric nursing services, dentists and opticians. Residents are prompted and assisted to make and keep healthcare appointments, whilst retaining responsibility themselves as appropriate. Palm Lodge DS0000067751.V342157.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are provided with opportunity to appropriately influence and control their own lives, with support and guidance and are offered protection from abuse by policies, procedures and staff training. Each person living in the home has substantial, independent contact with a range of interested parties outside of the home. EVIDENCE: Policies, procedures and staff training records have been seen which should ensure that the identification and reporting of abuse is prompt and appropriate in the event that it is suspected. Residents are articulate and capable of making their views known and all have a range of family and professional contacts outside of the home, including advocacy services. Residents retain full control over their own finances, the manager will, if requested, assist with budgetary advice. Palm Lodge DS0000067751.V342157.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is essentially domestic in scale and layout and provides a comfortable and safe environment for residents. Not all people living in the home felt that they were able to fully personalise their rooms by fixing pictures or posters to the walls and this was brought to the attention of the home’s manager. EVIDENCE: The home was registered as a new service in August 2006 when it was considered suitable for purpose and met most of the basic requirements of the National Minimum Standards. The walls in individual rooms were noticeably free from any pictures or posters and people living in the home seemed to think that they were not allowed to fix things to the walls. This was discussed with the manager and responsible Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 17 individual who indicated that they would clarify the position with people living in the home, as this was not the case. Those rooms seen, at the invitation of the individual, contained items such as gym equipment and sound systems that reflected their personal taste and interests. People living in the home take some responsibility for cleaning and laundry and on the day of this visit the home was reasonably clean and tidy. Fire certificates and insurance certificates have been seen to be in force. Palm Lodge DS0000067751.V342157.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A well-qualified staff team who have the experience and expertise to meet the needs of the residents appropriately supports the people living in the home. Whilst the recruitment process for staff is essentially sound, a full employment history for applicants must be recorded in each case and a satisfactory health declaration received, to ensure that applicants are fit to work in the home and so that people living in the home can be fully protected from the employment of unsuitable people. The management of the home, whilst effective, should be clearly individual to Palm Lodge and have a distinct identity compared to any associated home in order to avoid confusion as to management roles and responsibilities. EVIDENCE: All managers and staff have considerable experience of working with this service user group. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 19 The majority of staff are part-time and currently work at other times within the public mental health services, which provide an opportunity for additional training and for keeping up to date with current best practice. This should be beneficial for all residents and the quality of care that they receive. The recruitment file seen for a recent applicant did not include a full employment history and there was no health declaration as to their fitness for employment. Several documents submitted to the CSCI and discussions with the people living in the home support the view that the distinction, in management terms, between Palm Lodge and its associated home is not always clear. This does not mean that the home is badly managed, but that staff and people living in the home may potentially be confused as to the roles and responsibilities of the management team. Palm Lodge DS0000067751.V342157.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 42 & 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Palm Lodge provides a safe and supportive environment for its residents. Some documentation and management practices, for example staff supervision, do not adequately differentiate between this home and an associated registered home or distinguish clearly enough the respective roles in Palm Lodge of the registered manager and the responsible individual. This has the potential to cause some confusion and should be addressed at this early stage in Palm Lodge’s operation so that necessary changes can become established as soon as possible. This does not imply that the home is badly managed or that people living in the home have been adversely affected at this stage. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager of the home has been registered by the CSCI as a fit person to manage a residential care home. Residents were very positive about the home and its management. Care plans, reviews, records of equipment servicing and insurance cover in place all provide evidence of a robust and genuine concern for the holistic welfare of residents. The standard of record keeping seen on this occasion, including that for medication was found to be good. Additions to the recruitment records were discussed to ensure that people living in the home are fully protected from the employment of unsuitable people to provide them with care and support. The annual quality assurance return made to the CSCI by the home, includes details of a system of quality assurance that seeks feedback from professionals and stakeholders associated with the home. The annual quality assurance return was completed by the responsible individual as ‘manager’. Several documents and records bear the name of the associated home rather than of Palm Lodge. People who live in the home were not entirely clear who managed the home overall although as indicated above, care outcomes were agreed to be good. Staff supervision is being carried out by the responsible individual and not the registered manager. Palm Lodge DS0000067751.V342157.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 X 2 3 3 X 4 3 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 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 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 3 3 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 3 3 3 X 3 X 3 X X 3 2 Palm Lodge DS0000067751.V342157.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 YA26 Regulation 23 Requirement Timescale for action 12/09/07 2 YA34 People living in the home must be enabled to reasonably personalise their individual rooms with pictures and posters. 19(1)(b)(1) A full employment history and a 12/09/07 declaration as to their physical and mental health must be obtained in respect of each person applying for employment in the home. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations The degree of self-medication possible for each person living in the home should be kept under active regular review in order to ensure that the maximum possible degree of self-medication is achieved within a risk assessment framework. The review should be recorded in the care plan documentation for that person. The respective roles of the registered manager and the responsible individual should be clarified so as to avoid DS0000067751.V342157.R01.S.doc Version 5.2 Page 24 2 YA31 YA43 Palm Lodge potential confusion for staff and people living in the home. Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Palm Lodge DS0000067751.V342157.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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