Inspection on 11/07/07 for Paradise Lodge

This inspection was carried out on 11th July 2007.

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

Paradise Lodge 15/08/06

Paradise Lodge 12/01/06

Paradise Lodge 25/08/05

Paradise Lodge 30/03/05

Paradise Lodge 14/10/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Beau Sejour

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

CARE HOME ADULTS 18-65 Paradise Lodge 28 Paradise Road Writtle Chelmsford Essex CM1 3HP Lead Inspector Sarah Hannington Unannounced Inspection 11th July 2007 11:00 Paradise Lodge DS0000057520.V345627.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 Paradise Lodge DS0000057520.V345627.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. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paradise Lodge Address 28 Paradise Road Writtle Chelmsford Essex CM1 3HP 01245 422901 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) paradiselodge@hotmail.co.uk Paradise Lodge Care Home Ltd Mr Vickram Damhar Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 5 persons) Date of last inspection Brief Description of the Service: Paradise Lodge opened in 1995 and provides care for five service users of both genders who have learning disabilities, minor levels of physical disabilities and associated mild to moderate mental health problems. Paradise Lodge is a detached dormer bungalow situated in a residential area close to the centre of Writtle. The property is fully in keeping with other properties around it. There is one communal lounge situated at the rear of the property, with an adjoining conservatory providing additional space and access into the garden. All bedrooms are single occupancy with three on the ground floor and two on the first floor. Dining facilities are available in the large kitchen. The rear garden is fully accessible, enclosed, and was well maintained. Visitor car parking is available on the front driveway with additional parking on the street outside. A bus service stops a short walk from the home at the end of the road. This provides a public transport link with Chelmsford town centre approximately 2 miles away. Regular community access is mainly provided to residents by the use of a vehicle based at the home. The minimum fee starts at £1,150 and is based on individual need. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took three hours to complete. During the Inspection the manager was present throughout. A tour of the home took place. Residents were spoken with during this inspection. The visit mainly focused on all Key standards. There were no requirements or recommendations from the last inspection report. Random samples of records, policies and procedures were inspected. What the service does well: What has improved since the last inspection? What they could do better: To develop user friendly formats of personal and general documentation. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 6 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. Paradise Lodge DS0000057520.V345627.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 Paradise Lodge DS0000057520.V345627.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good systems in place to ensure clients consultation. Initial assessments are in place. The home is good at assessing individual needs prior to admission. EVIDENCE: Prior to any admission a number of meetings, visits and general gathering of information is collated. This allows the home to assess if they can meet that individual’s needs. Similarly visits by residents and their families, statement of purpose and service users guide enable them to make a choice that the home can provide a service that they need and want. Care plans are based on initial assessments from the placing authority and the homes own pre-assessment of need. Once in placement care plans are adjusted and change according to the changing needs of each individual. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has demonstrated that a person centred care plan process for all service users is in place and that a good system of risk assessing is in place. EVIDENCE: Within the returned Quality Assurance Surveys sent out by the home, residents had complimented the home in being able to meet their needs. The residents spoken with think highly of the staff team and have expressed that they feel they are encouraged to live a full and active life as much as possible. New Care Plans and risk assessments have been developed and improved upon and have been put into place. Care Plans evidenced that the home ensures that residents are consulted with as much as possible. Advocates, families and other professionals are used within this process usually at the six monthly review meeting. Within the home is a folder called How we support you. This highlights all areas of the care plan. Additionally this signing and agreement to care plans is Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 10 done with the support of an independent professional such as Community Nurse or the individuals advocate. This is good practice. Risk assessments are to a good standard. They not only lower risk, but also allow residents to take reasonable risks to support them in living a full and purposeful life. Financial policy and procedures are to a good standard and finances are accounted for efficiently. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All clients have a varied choice of activities, leisure interests and are encouraged to find meaningful work. The home encourages service users involvement within the community. EVIDENCE: Advocacy and an Inclusion worker are engaged by the home to support residents in exploring interests, educational needs and employment. Additionally, coordinators regarding relationship and sexuality are working alongside residents to offer advice and information. Residents spoken with during the last and on this inspection feel that staff are very proactive in supporting them to take up appropriate and meaningful activities within the home, finding employment and accessing the community. Residents have meetings and yearly reviews carried out. Views, opinions and issues raised through these forums and through the Quality Assurance Monitoring surveys the home sends out are collated and form the home’s Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 12 business plan in terms of actions plans for improvements. Additionally, residents’ interview and set questions for potential new staff. They also plan part of the induction process and identify training needs. This is excellent practice. The home has good practice in involving residents in every aspect of planning menus. Firstly there is a weekly meeting to discuss the following weeks menu. Then residents shop, prepare and cook meals. Menus are reflective of resident choice, are nutritious and residents spoken with are happy and feel the choice of meals and quality are to a good standard. In the near future the home is looking towards appointing a dietician to advise and give information to individuals regarding healthy eating and nutrition. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 13 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): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare support is well managed and good written information was evidenced. General documentation within the home is being maintained to good standard. Good medication systems and practice are in place. EVIDENCE: Overall health checks are carried out annually and then throughout the year the home monitors, records any concerns and works in partnership with other professionals to ensure the health, safety and welfare of all residents at Paradise Lodge. Support Plans around self-care promote independence and are to a good standard. Self Care support plans include how the resident wishes to be supported and highlights areas that need regular monitoring by staff. Residents have a choice over staff that supports them with self-care. Health Care plans evidence that residents are fully supported in this area. The home has good professional links with the local PCT team. A number of specialist professionals are involved within individuals care if necessary. GPs, Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 14 community/ district nurses, chiropodist and many other health care providers are involved within the health care package of the residents at Paradise Lodge. Regular meetings, reviews, consultation and information sharing goes ahead with the individual and the multi-disciplinary team. On each shift a member of staff is designated to carry out the recording and administration of medications. Staff who administer medication are trained and regularly updated to any changes. Training records indicated that all staff had medication training. A monitored medication dosage system is in place for service users. Medication is stored in a lockable cabinet and the administration records were being maintained in accordance with agreed procedures. Record sheets had been correctly recorded and signed for. Paradise Lodge DS0000057520.V345627.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): 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a good complaints procedure. The homes policy, procedures and training protects residents from abuse. EVIDENCE: There have been no complaints made to the home or anything reported to the CSCI office since the last inspection. All staff have attended Safeguarding (protection of vulnerable adults) training and when spoken with showed that awareness around these issues was to a good standard of understanding and knowledge. The home has a good complaints procedure in place. All complaints are recorded, maintained and outcomes recorded. A service user complaints procedure is available in a format of their communication choice. Residents spoken with are aware of their rights, what constituted abuse and what to do if they wanted to make a complaint. Paradise Lodge DS0000057520.V345627.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): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home environment is good and provides a clean, comfortable and safe environment in which to live. EVIDENCE: Overall the inside and outside of the home present no health and safety issues for the residents of Paradise Lodge. The home is odour free, clean, homely and meets the needs of the client group. Individual rooms are personalised and well maintained. Management are proactive in listening to individuals and group needs around improvements to the environment. The home installed a modern bathroom suite and further consultation with residents for improvements to the communal areas is being sought. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 17 A new way of recording, monitoring and tracking of maintenance has been developed and put into place. Regular Health and Safety checks of the environment are in place. Paradise Lodge DS0000057520.V345627.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): 32,34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The number of staff on duty, their experience and skill was able to meet the needs of residents and to a good standard. Good recruitment policy, procedures and records are in place. EVIDENCE: Recruitment procedures are to a good standard and all staff are POVA First checked. New staff have a good comprehensive induction process, which covers all of the core training required. Paradise Lodge has over 50 of its staff that have completed their NVQ 2 and 3 training. A member of staff has recently finished their RMA (registered managers award). Staff receive support through formal an informal one-to-one supervisions, training, annual appraisals and staff meetings. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 19 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): 37, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Management systems are good and the home is run in the best interests of residents. The health, welfare and safety of both the clients and staff are promoted and protected. There is a good quality assurance monitoring process implemented, however a better recording system of the results needs to be developed. All certificates required by regulation were available and seen to be satisfactory. EVIDENCE: The manager is knowledgeable, has good experience of the client group he works with and is highly organised and efficient in his role. There is clear accountability of roles amongst the team and a strong management support system in place. The policy, procedures, support for both residents and staff maintains that their health, safety and welfare is protected. The manager leads by example and encourages the staff team to practice in terms of a client rights and empowerment. The home’s practice is continually changing and Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 20 adapting according to individual and group need which in turn moulds the service provided.The manager is currently studying for the RMA (Registered Managers Award) The homes Quality Assurance, which is to a good standard and residents meetings partly mould the homes business plan. Overall the home provides a very person centred based service which promotes and encouarges independence of the individual. Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 21 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 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 4 X X 4 X Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Paradise Lodge DS0000057520.V345627.R01.S.doc Version 5.2 Page 24 - 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!