Inspection on 28/06/05 for Palmers Lodge

This inspection was carried out on 28th June 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Palmers Lodge 07/04/09

Palmers Lodge 15/04/08

Palmers Lodge 18/09/07

Palmers Lodge 08/05/07

Palmers Lodge 23/05/06

Palmers Lodge 13/12/05

Palmers Lodge 18/11/04

Palmers Lodge 21/09/04

Palmers Lodge 29/05/04

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Edenvale

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Chatsworth Care - Dawson House

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Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 PALMERS LODGE 36 Sydney Avenue London N13 4UY Lead Inspector Tony Brennan Unannounced 28 June 2005 @ 10.00 am 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 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 Stationary 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. PALMERS LODGE Version 1.10 Page 3 SERVICE INFORMATION Name of service Palmers Lodge Address 36 Sydney Avenue, London N13 4UY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8446 4445 Dr Sanjeev Kanoria of Aspire Lifestyle Ltd Ms Maria Kalathaki PC Care Home Only 6 Category(ies) of LD Learning Disability registration, with number of places PALMERS LODGE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 18 November 2004 Brief Description of the Service: Palmers Lodge is registered to provide care for six adults with learning disability. Currently, there are four service users living at the home. The home is owned by Aspire Lifestyle Ltd., a company that runs a number of similar care homes. The home is a semi-detached house located in a residential area. The home is on three floors . The bedrooms are on the ground and first floors. Communal areas in the home include a lounge, dining room, kitchen, bathrooms, toilets and a sensory area. The home aims to support people with learning disabilities, challenging behaviour and autistic disorders to live independently. PALMERS LODGE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken as part of the annual inspection process. The inspector also sought to confirm that the twelve areas for improvement found at the last inspection were addressed. The inspection took place over one day. The registered manager, Maria Kalathaki, assisted the inspector. The service users are mostly non-verbal so the inspector observed interaction and how staff interacted with them to establish how care is provided. The inspector toured the building and examined a range of records relating to the care and management of the home. What the service does well: What has improved since the last inspection? What they could do better: Seven areas of improvement were identified at this inspection. Information provided to those who live at the home needs to be put in a format that they can understand. Half of the staff in the home need to achieve the National Vocational Qualification in care. Training also needs to be provided on food hygiene, challenging behaviour and the Learning Disabilities Award Framework. The home needs to comply with the recommendation in the fire officer’s report to ensure the safety of those living at the home. Please contact the provider for advice of actions taken in response to this PALMERS LODGE Version 1.10 Page 6 inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. PALMERS LODGE Version 1.10 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 Standards Statutory Requirements Identified During the Inspection PALMERS LODGE Version 1.10 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 standard(s) 1 2 3 5 Service users do not have information on the service in formats that they can understand. Service users needs are assessed prior to admission to the home. The home meets the assessed needs of service users. Service users are provided with a contract outlining their rights and responsibilities. EVIDENCE: The statement of purpose and service users guide were clearly written and contained all the information required. The service users guide still needed to be put in a format that could be understood by service users as they mostly use symbols and signs for communication. The inspector found that all service user files contained comprehensive assessments of their needs. There were assessments from social workers and other professionals. The inspector observed staff working with service users and found that they understood how to support them. Staff spoken to showed that they understood the needs of the service users. The inspector found that contracts were available for all service users that contained information on their rights and responsibilities. The registered manager said this document was not available in a symbols format, which the service users could understand. PALMERS LODGE Version 1.10 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 standard(s) 6 9 Care plans provided detailed information on how the needs of service users would be met. Risks to the service user were assessed. EVIDENCE: The inspector observed staff working with service users and found that they demonstrated that they knew how to meet their needs. The inspector saw that care plans contained detailed information on how the needs of service users can be met. The registered manager explained that the health needs of service users had been monitored and the inspector found that records showed the involvement of health professionals. Since the last inspection, monthly key worker reports have been written to monitor the progress of service users. The risk assessment contained detailed information of behaviour and other areas where the service users may be at risk. These assessments specified the level of support that service users needed and actions to alleviate risks. PALMERS LODGE Version 1.10 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 standard(s) 11 12 14 17 Service users are supported to develop their independent living skills. Service users are offered a range of stimulating therapeutic and leisure activities. The service user is provided with a choice of varied and balanced meals. EVIDENCE: Care plans outlined the level of support and areas that service users could be independent. The inspector observed that a service user was supported to wash their clothes. The inspector saw that there was a detailed activities programme in place and that service users attend day centres. Since the last inspection the registered manager has planned holidays for the service users. The inspector saw that records showed that service users attend local clubs. The menu showed that nutritionally balanced meals were offered. The registered manager showed the inspector a record of the intake of food for service users. This was used to ensure that the menu reflected the preferences of service users. The inspector observed that service users were involved in the preparation of the meal. PALMERS LODGE Version 1.10 Page 11 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 standard(s) 19 20 Service users have access to the medical care they need. Service users are protected by safe procedures for handling medication. EVIDENCE: The inspector found that service user records showed that medical support was provided. Information on dietary and other medical needs of service users from different ethnic backgrounds was available and staff spoken to understood these issues. The records showed evidence that service users had been supported to attend various health care appointments. Records of medicines received, administered and returned were complete. The policy on medication administration was complete. Since the last inspection medicines had been stored at the required temperature and this was recorded. Staff were observed administering medicines and the appropriate checks were carried out. There was clear guidance in place regarding each service user’s medication for the management of challenging behaviour. PALMERS LODGE Version 1.10 Page 12 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 standard(s) 22 23 Service users are confident that their complaints will be listened to, taken seriously and acted upon. Service users are protected from abuse. EVIDENCE: The complaints policy explained how to make a complaint and how it would be dealt with. The complaints record showed actions taken to resolve complaints. There were comprehensive policies on handling abuse and protection. Staff spoken to understand the signs that might indicate abuse is taking place and how to respond if they believe it is. The inspector found that training was being provided on adult protection. PALMERS LODGE Version 1.10 Page 13 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 standard(s) 26 27 28 30 Service users bedrooms promote their independence. Toilet and bathroom facilities meet the needs of service users. Service users have access to a range of communal spaces that meet their needs, but these are in need of redecoration. The home is clean and hygienic. EVIDENCE: The service users bedrooms where found to have the appropriate furnishings and are personalised. Since the last inspection, sinks and vanity units which were broken had been replaced. The home has adequate toilet and bathroom facilities. Since the last inspection, the bathroom on the ground floor has been refurbished. The home has a sitting room, dining room and kitchen which are accessible to service users. There is a garden to the rear of the building in which service users can sit and relax. The inspector found that the communal areas are in need of redecoration. The registered manager agreed to ensure that this was done. The inspector found that the home was clean and hygienic. Staff spoken to understood how to prevent cross infection and equipment was provided for this purpose. The laundry equipment had been moved to a safer part of home away from service users. PALMERS LODGE Version 1.10 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 34 35 36 Staff have clearly defined roles that ensure the needs of service users are met. Staff do not have all the skills to meet the needs of the service users. There are sufficient staff to meet the needs of the service users. The service users are not protected by the home’s recruitment procedures. Staff are supervised to ensure that the needs of service users are met. EVIDENCE: The inspector found that the job descriptions outlined the tasks required to meet the needs of the service users. Staff spoken to were aware of their roles and responsibilities. Staff were observed working with the service users and were seen to be offering appropriate and sensitive support. Staff spoken to understood the needs of service users. The registered manager informed the inspector that the home still needs to get 50 of staff trained to NVQ in care at level 2. The training records showed that staff had received training in medication administration, first aid, fire and manual handling. The staff had not received training in food hygiene and had not begun the Learning Disabilities Award Framework training. The inspector saw records that confirmed that staff had gone through an appropriate induction. The service users all have some form of challenging behaviour, but records and staff showed that not all staff had received training in this area. The rota showed that a consistent level of staff is maintained at all times. Staff spoken to felt that there were sufficient staff. The inspector examined four staff files and PALMERS LODGE Version 1.10 Page 15 found that they did contain all the required documentation relating to the recruitment of staff. Staff spoken to confirmed that they had regular supervision and demonstrated an appropriate response to the needs of service users. There were records of supervision sessions and staff meetings. PALMERS LODGE Version 1.10 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 40 41 42 43 Service users views and feedback are used as the basis for developing the home. All the necessary policies and procedures are in place to protect service users. Records are maintained to ensure the safety of service users. Service users and staff health and safety is not promoted. The home has robust financial procedures that benefit service users. EVIDENCE: The registered manager explained that a survey had been carried out of the views of relatives, professionals and other interested parties to ensure that a quality service is provided. The inspector saw a sample of these surveys and the registered manager explained that a report outlining the findings and action to be taken is being prepared. Policies were in place to cover all the required areas. These were clearly written and accessible. The inspector found that all the records examined were clearly written and contained the necessary information. Staff had received training in first aid and manual handling. The temperatures of food cooked and the fridge and freezer were recorded. The inspector found PALMERS LODGE Version 1.10 Page 17 that a record of accidents was in place. The required certificates for gas, Legionella and electrical safety were in place. The registered manager explained that hard wiring tests had not been carried out. The home had a risk assessment for all working practices in the home. The Fire Officer had made a number of recommendations in their last report. The inspector found that these still needed to be complied with. The fire door in the downstairs hallway needs to be moved to comply with fire safety regulations. The fire procedure and the risk assessment need to be put in place. The inspector found that there had been regular fire drills, alarm testing and training taking place. The registered manager showed the inspector accounts and a budget plan for the home that confirmed that the home is financially viable. The registered manager explained that if the home admits more service users then the budgets would be increased. The home has the required insurance. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 3 x 2 Standard No 22 23 ENVIRONMENT Score 3 3 Standard No 24 Version 1.10 Score x Page 18 PALMERS LODGE INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score 25 26 27 28 29 30 STAFFING x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 2 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 3 3 2 3 PALMERS LODGE Version 1.10 Page 19 yes 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. 1. Standard 1 Regulation 5(1)(b) Requirement The registered persons must ensure that the statement of purpose and the service users guide are available in formats which service users can access. (Previous timescale of 10/1/05 was not met). The registered persons must ensure that 50 of staff achieve NVQ in care. The registered persons must ensure that staff receive training in food hygiene, challenging behaviour and the Learning Disabilities Award framework. The registered persons must ensure that the fire procedure is updated. The registered persons must ensure that a fire risk assessment is put in place for the home. The registered persons must ensure that the fire door on the gound floor is moved in line with the fire officers report. The registered persons must ensure that a hard wiring test is carried out. (Previous timescale of 1/2/05 was not met). Timescale for action 1/11/05 2. 3. 32 35 18(1) 18(1) 31/12/05 30/11/05 4. 5. 42 42 13 13 1/10/05 30/8/05 6. 42 13 30/8/05 7. 42 13 30/8/05 8. PALMERS LODGE Version 1.10 Page 20 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. 2. Refer to Standard 5 Good Practice Recommendations The registered persons should ensure that the statement of terms and conditions is in a format which service users can understand. PALMERS LODGE Version 1.10 Page 21 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA 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 PALMERS LODGE Version 1.10 Page 22 - 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!