Inspection on 07/04/09 for Palmers Lodge

This inspection was carried out on 7th April 2009.

CQC found this care home to be providing an Adequate service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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 28/06/05

Palmers Lodge 18/11/04

Palmers Lodge 21/09/04

Palmers Lodge 29/05/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Key inspection report CARE HOME ADULTS 18-65 Palmers Lodge 36 Sidney Avenue London N13 4UY Lead Inspector Jane Ray Unannounced Inspection 7th April 2009 02:00 Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Palmers Lodge Address 36 Sidney Avenue London N13 4UY 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) 020 8889 6231 020 8889 6231 manager.palmtree@aermid.com Aermid Health Care Properties Ltd Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only: Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is 6 Date of last inspection 15th April 2008 Brief Description of the Service: Palmers Lodge is registered to provide care for six adults with learning disability. Currently, there are two residents living at the home. A company called Aermid Health Care Properties Ltd owns the home. This company runs a number of similar care homes. The home is a semi-detached house located in a residential area. The home is built on three floors. The bedrooms are located on all the 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 more independently. The current range of fees in the home is £1061 a week. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The inspection took place on the 7 April 2009 and was unannounced. The inspection lasted for three hours and was the key annual inspection. The inspection looked at how the home was performing in terms of the key National Minimum Standards for Younger Adults and the associated regulations. The inspector was able to observe the support given to the current residents. The inspector was also able to spend time talking to the manager as well as the two care staff who were working. The inspector did a tour of the premises and also looked at a range of records including resident records, staff files and health and safety documentation. The home had provided the inspector with a completed self-assessment questionnaire (AQAA) prior to the inspection. What the service does well: What has improved since the last inspection? The last inspection took place on the 25 November 2008 and was an additional random inspection. Since then the manager has worked hard to ensure that most of the requirements have been met. This has included arranging healthcare appointments and supporting the residents to attend the appointments, completing the person centred plans, ensuring medication records are correct, starting to arrange for residents personal monies to be held in a bank or post office account rather than a company account, sending out quality assurance questionnaires to appropriate people, replacing the sofa covers in the lounge and supporting residents to go out a bit more. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 6 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Palmers Lodge DS0000031152.V374848.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 Palmers Lodge DS0000031152.V374848.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be assured that their individual needs will be assessed and that the staff have the skills and ability to meet these needs. EVIDENCE: “Most of the staff have worked here for several years and therefore they know the residents very well and they do their best to improve their quality of life”. (Extract from the AQAA prepared by the home) We asked the manager if the statement of purpose had been updated to include his details as the manager of the home. He explained that this still needed to take place. We looked at the case notes for the two people who live in the home. They all had assessments that formed part of their person centred care plans that covered their individual likes and dislikes. We discussed the current needs of the people who live in the home with the manager and care staff. They have very specific individual needs linked to their Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 9 sensory impairments and complex behaviours. The staff training records were inspected and showed that the majority of staff had received training in all these areas in the past. In addition staff are accessing training provided by Haringey Social Services on communication skills and autism. Palmers Lodge DS0000031152.V374848.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home can be confident that they will be supported to have a person centred care plan and risk assessments. These will facilitate the staff to understand the preferences and choices of the residents in their daily lives. EVIDENCE: “We have revised all the person centred plans and have invited a PCP specialist from the Enfield Learning Disability Team to train us on how to provide and implement these plans”. (Extract from the AQAA prepared by the home) “We really look after the residents well”. (Quote from staff) We inspected case notes for the two people currently living in the home. We also spoke to the manager and care staff about the care plans. Both the Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 11 residents had now got completed person centred care plans in place and also had professional support goals for the staff to follow. These were clearly laid out and covered all aspects of each persons needs and were written using appropriate language. The professional support goals had all been reviewed on a monthly basis by the key-worker. Both the residents had been supported to have an annual care plan review meeting with their care manager. Both these reviews had identified actions that needed to take place but it appeared that some of these actions had not been completed. For example for one resident the home had been asked to ensure that this persons medication was reviewed. There was however no record of the resident, being supported to attend a GP appointment for this to take place. We read the risk assessments for the people who live in the home. It was evident that since the last inspection the risk assessments had been reviewed and typed using a format that was easy to follow. It was however noted that for one resident who has a high risk of loosing weight, this risk was not included in their risk assessment. Each person living in the home had individual behavioural guidelines and these were clearly written and gave appropriate guidance. We observed the people living in the home and their interaction with the staff. It was positive to note that they were being facilitated to make choices including when they wished to get up or move around the home. From talking to the staff it was evident that they were very aware of each residents nonverbal communication and when they appeared distressed or tired. This enabled them to respond quickly to meet their individual needs. Palmers Lodge DS0000031152.V374848.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): This is what people staying in this care home experience: People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to develop their daily living skills and are also enabled to follow their own routine. There is still, room for improvement in supporting the residents to enjoy a stimulating lifestyle. EVIDENCE: “We liaise with the day centre staff on a daily basis to compare notes on every day support”. (Extract from the AQAA prepared by the home) “One of the residents really enjoys a short walk and going out for a drink rather than a meal”. (Quote from staff) Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 13 From talking to staff and reviewing the professional support plans we were able to understand that, the people living in the home were being supported to develop their independent living skills in line with their individual needs. For example one person, has made significant progress in feeding themselves. We spoke to the staff and looked at the activity records to get an understanding about the activities that are taking place. The manager explained that the residents go to a specialist day centre five days a week. The home has its own vehicle but only the manager is a driver at the moment. The staff did however say that they support the residents to make use of public transport. The records of leisure activities showed that the people living in the home were accessing the community. For example they usually go to an evening social club once a week. There has also been one weekend trip to Syon House in the last four weeks. For one resident the only other weekend activity outside the home in the last four weeks had been a short local walk. The manager said the resident does not like going out in poor weather but there is still scope to go out more frequently and to use alternative transport such as taxis and public transport. In terms of holidays the manager explained that different holiday options are being explored but nothing is yet booked. We observed that for the two people who are living in the home who are AfroCaribbean that care had been given to ensure that their hair and skin care was culturally appropriate. The manager explained that one resident has been visited by relatives since the last inspection and the other relative is kept up to date with phone calls from the home. The staff are trying to facilitate contact with relatives. From talking to the staff it was clear that they try to support each resident to have a routine of their choice particularly when they are not going out to the day centre. For example the staff said that one resident likes to go to bed for a nap between returning to the home after the day centre and their evening meal. We saw the menu used in the home and this offered a nutritional and varied menu. We also saw that there was fruit and vegetables available in the home. The manager explained that the menu had been slightly amended since the last inspection to include more culturally appropriate meals. The people living in the home have an individual record of the food they eat. One resident has food supplements to help them maintain their weight. Once a week the residents have a takeaway meal. Palmers Lodge DS0000031152.V374848.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are supported in a manner that protects their privacy and dignity. Each person is supported to access professional healthcare input based on their individual needs. EVIDENCE: “We liaise well with the GP, day centre and other healthcare professionals such as the dentist and optician”. (Extract from the AQAA completed by the home) “One resident has a shower during the week, but enjoys a leisurely bath at the weekend and feeling the bubbles”. (Quote from a member of staff) We observed during the inspection that the staff were supporting the people living in the home to receive personal care in a manner that preserved their privacy and dignity. It was observed that the residents were appropriately Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 15 dressed in clothing appropriate for their age. The care staff said that the residents had enough clothing. We looked at the healthcare records for the people living in the home. They had all been supported to access a range of healthcare professionals including the GP, dentist, optician and other appointments according to their individual needs. The psychiatrist has an appointment to see them at the home shortly. The residents are having their weight checked on a weekly basis. We looked at the medication, administration records and staff training records. The home is in the process of changing to Boots for its pharmacy input. The medication is stored in a cooled medication cupboard and a medication fridge is also available. The medication administration records were accurate and showed clearly when medication is received and administered and were completed correctly. The training records were inspected and refresher medication training has taken place. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home have access to an appropriate complaints procedure. Procedures and training on safeguarding vulnerable adults are in place to protect the residents. Residents personal monies may have been mismanaged by the company. EVIDENCE: “There has not been any complaint, any abuse or bad practice of any type”. (Extract from the AQAA prepared by the home) The AQAA stated that there have been no written complaints since the last inspection. The organisation has two complaints procedures, one designed for the service users and the other for relatives and care professionals. Both these documents have been inspected previously. There have been no adult protection issues since the last inspection. We looked at the staff training records and these show that all the staff have received safeguarding vulnerable adult training. The staff spoken to showed a good understanding of how to recognise and respond to abuse. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 17 We checked the personal finances for both residents including their cash record, cash and receipts. Both these people have their finances managed through the company head office. In the home there is an individual finance record for each person and his or her cash is held in a lockable tin. All expenditure is recorded and receipts are available. The manager also had a record of each persons balance held at head office. This record gave concern as one resident appeared to be overdrawn and the other resident had a reducing balance and yet expenditure was very modest. The manager explained that he was not clear on what benefits each of the residents should be receiving. The manager has been trying to get each resident his or her own account and had submitted an application to the post office. A record of this application was available in the home. After the inspection we spoke to social services regarding the residents finances so they could investigate the matter further. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical environment in the home is homely, comfortable and clean. Replacement furniture and other equipment is not provided in a timely manner by the company. EVIDENCE: “In the last 12 months a new extractor has been fitted in the kitchen, the radiator covers have been redone, storage in the basement has been moved to the shed to avoid a fire risk and seals and self-closers on the fire door have been redone and a heat detector installed in the laundry”. (Extract from AQAA prepared by the home) We did a tour of the premises. The house is built over three floors and each person living in the home has their own bedroom. The shared lounge, dining Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 19 area and sensory area are all located on the ground floor. The garden can be accessed through the dining area. The house was observed to be clean and there were no unpleasant odours. The staff have worked to make the environment more homely. The cupboards in one residents bedroom still need to be replaced and the tumble drier was broken. The manager said that the directors have not approved the new cupboards. He also said that for the tumble drier to be replaced he has to submit three quotes and it takes a long time for approval to be given. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 20 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are consistently enough staff available to meet the needs of the people living in the home. The staff receive relevant training and are supported by regular supervision sessions. This enables them to work to a high standard and deliver good care. EVIDENCE: “We ensure there are always sufficient numbers of staff to support service users. We ensure the staff attend all the mandatory training and other specific training they may require such as autism, sensory impairments, managing challenging behaviours and others as needed”. (Extract from the AQAA prepared by the home) “We have attended four lots of training in the last two months and have training booked with social services”. (Quote from a staff member) Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 21 We checked the rota for the home and this showed that there is a team of nine staff working in the service. The staffing structure consists of the manager and a team of carers. During the day there are two staff on duty when the residents are home and at night there is one waking member of staff. The manager is shown as being supernumerary on the rota. Since the last inspection there have been no new staff although one person who was transferred to work in another home owned by the company has returned to work at Palmers Lodge. The recruitment checks for this member of staff were inspected and were all in place. The manager explained that staff team meetings usually take place on a monthly basis, although there has been a gap of four months since the last meeting. The staff spoken to did say they felt well informed about the home. It is recommended that meetings take place more regularly. The AQAA prepared by the home stated that four staff had completed an NVQ and three staff were studying towards an NVQ. We looked at the ID for three staff and one did not have evidence of current permission to work in the UK. The manager explained that he had spoken to the staff member about this matter and that they are trying to get the matter resolved. The manager had an updated summary of all the staff training details. He had arranged for staff to apply for courses arranged by Haringey Social Services. The staff said they had received training and that this was a good standard and very useful for their work. We looked at the supervision records. All the staff had received regular individual supervision. The format used for supervision is appropriate and includes a record of any action agreed. The manager explained that his line manager uses the regulation 26 format as a basis for his supervision. Whilst this is a good means of identifying action that needs to take place in the home, it does not provide a format to discuss performance issues and development needs. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 22 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A permanent manager who can provide effective leadership and support has completed the registration process. Not all the health and safety measures are in place to safeguard the people living in the home. EVIDENCE: “The manager makes you feel able to talk about anything that is needed in the home”. (Quote from a member of staff) Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 23 Since the last inspection the manager has made progress in improving the service. He has completed the registration process and is waiting for the registration certificate. The manager has completed the Registered Managers Award. The manager explained that he had sent quality assurance questionnaires to relatives, care professionals and the day centres as part of the homes annual quality assurance exercise. A response was seen from one of the day centres giving a suggestion about meeting the resident’s sensory needs. The manager explained that he needed to speak to them and find out what specific ideas they have. The Regulation 26 visits to the home had taken place regularly since January 2009. In terms of fire safety we looked at the fire safety risk assessment and this was now complete. The service has an emergency plan. The fire alarm had been serviced but the fire extinguishers were outstanding. The fire alarm records show the alarm is checked weekly and the manager said drills take place at the same time. Fire safety training has been completed for most of the staff and refresher training has taken place this year for some staff. The AQAA showed that most of the health and safety maintenance checks had taken place although the portable electrical appliances, is outstanding. The manager explained that the usual contractor did not want to come and do the work saying he had not been paid after doing the job in another home owned by the same company. The manager has been asked to submit three quotes for the work. This stringent financial control and the length of time it takes for these matters to be addressed raises concerns about the financial viability of the company and therefore a copy of the audited accounts will be requested. The staff training records show that the staff have completed most of the health and safety training including food hygiene, moving and handling, first aid and infection control and have access to refresher training through social services. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 3 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 4 3 3 x LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 2 2 Version 5.2 Page 25 Palmers Lodge DS0000031152.V374848.R01.S.doc Are there any outstanding requirements from the last inspection? YES 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 YA1 Regulation 4 Requirement The registered person must ensure the statement of purpose is updated to include all the current details of the service. The registered person must ensure the residents care plan is up to date and includes any actions agreed at their review meeting. These actions must be carried out to meet the needs of the resident. The registered person must ensure the residents are not put at risk of financial abuse by ensuring their monies are being managed properly and that they are receiving the correct benefits. They must work with social services to address this matter and ensure it is resolved. The registered person must ensure the cupboards are replaced in one resident’s bedroom. This requirement is restated from two previous inspections. The registered person must ensure that the broken tumble drier is replaced and that all broken equipment is replaced in DS0000031152.V374848.R01.S.doc Timescale for action 31/05/09 2. YA6 15 31/05/09 3. YA23 13 15/06/09 4. YA24 23 15/06/09 5. YA30 23 30/04/09 Palmers Lodge Version 5.2 Page 26 a timely manner. 6. YA42 13 The registered person must maintain health and safety in the home by having the portable electrical appliances and fire extinguishers serviced. The registered person must provide the Commission with a copy of the most recent audited accounts to demonstrate the financial viability of the company. 15/05/09 7. YA43 25 30/04/09 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. 3. 4. 5. 6. Refer to Standard YA9 YA14 YA33 YA34 YA36 YA39 Good Practice Recommendations The registered person should update the risk assessment for one resident to ensure all their risks are appropriately addressed. The registered person should ensure the residents have access to regular leisure activities outside the home and have a holiday. The registered person should arrange regular staff team meetings to share information about the service. The registered person should seek appropriate advice about the continued employment of a member of staff working without current permission. The registered person should ensure the managers supervision also includes an opportunity to discuss his performance and development needs. The registered person should follow up the suggestion made by the day centre about how the home can be further improved to meet the needs of the residents. Palmers Lodge DS0000031152.V374848.R01.S.doc Version 5.2 Page 27 Care Quality Commission London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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