Inspection on 12/01/06 for Paradise Lodge

This inspection was carried out on 12th January 2006.

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 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 11/07/07

Paradise Lodge 15/08/06

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 Alan Thompson Final Report Uannounced 25th August 2005 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. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Paradise Lodge Address 28 Paradise Road, Writtle, Chelmsford, Essex CM1 3HP 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) Category(ies) of registration, with number of places 01245 422901 Paradise Lodge (Care Home Ltd) Mr Vyramuthu Rattinam Loganathan Care Home 5 Learning disability (5) Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 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 30th March 2005 Brief Description of the Service: Paradise Lodge is a detached dormer bungalow situated in a residential area close to the centre of Writtle, and all local amenities. A bus service stops a short walk from the home at the end of the road. Visitor car parking is available on the front driveway, additional parking is available on the street outside. The home has a good size well maintained rear garden which is fully accessible to residents. The communal lounge is situated at the rear of the property, with a 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 adjoining the kitchen. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 1100 hours on Thursday 25th August 2005. This was the first inspection of this home in the inspection year 2005/6. The content of this report reflects the inspector’s findings on the day of the inspection, and from taking account of the findings from previous inspections of the home. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Paradise Lodge provides accommodation for five adults who have a learning disability. Three residents were spoken with during this inspection. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All residents confirmed that they were satisfied with the care and support they received. They also said they were satisfied with the accommodation and food offered. What the service does well: What has improved since the last inspection? What they could do better: There were no identified areas for improvement relating to the standards covered at this inspection. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 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. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 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 Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 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) 2, 4 The assessment format used for new residents was adequate for ensuring that initial perceived needs and aspirations were identified upon admission. EVIDENCE: The home had a copy of the placing authority assessment for residents. In addition an-house pre-admission assessment of need is undertaken by the manager and deputy manager or other designated staff member. The format used was available for inspection and included background information, next of kin details and GP. Areas of need assessed included: mobility, personal hygiene, general health, diet, occupation, leisure, reading, writing, maths, finances, domestic skills, communication, general behaviour, current identified needs, particular likes and dislikes and any other significant issues such as epilepsy. Care plans were compiled taking account of this assessment. Prospective new residents are always invited to visit Paradise Lodge before undertaking a three month trial placement. Visits may including staying for meals and overnight to try to ensure that there is full opportunity to experience day to day routines in the home. The resident’s relatives and named nurse/care manager are all involved in the review process as to the appropriateness of permanent placement. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 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 Residents are supported in progressing towards improving independence, whilst taking account of perceived and identified risks. Care plans in place set out the resident’s daily and longer term needs and goals, with the actions required towards meeting these. EVIDENCE: All residents had an individual support care plan. These included a personal profile with background information, next of kin GP etc. There was an identified activity chart and written assessed needs under headings of: diet, financial, shopping support, communication, health, medication, personal support, likes & dislikes, sleep pattern, spiritual and cultural needs. The perceived daily support required from staff was recorded showing the identified need with separate short term and long term goals and implementation guidelines for staff to follow. There was guidance for staff on dealing with and responding to epileptic seizures, and staff had received recent training on this subject from a community nurse. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 10 Also included in care plan files were environment risk assessments, individual specific risk assessment relating to known behaviours and a whole life risk assessment. CPA review notes were also seen. Full reviews take place annually with a minimum six monthly interim review. Where necessary care plans were kept under constant review and updated on an on-going basis in line with the CPA process. Care plans seen included details of any agreed restrictions on activities. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 15 Residents were supported in being an active part of the community. Regular opportunities were provided for residents to maintain contact with friends and family. EVIDENCE: There were individual activities programmes on support care plans. Reasons for staff support given to residents when accessing the community were included. Additional daily activities were decided on with residents each day. On the day of this inspection one had been to the local shops independently, and another was attending bowling and line dancing sessions. The home had a seven seat vehicle to enable full access to local and wider community facilities. A new daily activities record was being maintained. Some examples of activities taken part in were: social clubs, pubs, meals out, going to church, walks, bowling, cinema (residents were members of an association which enabled free cinema admission to a carer), sports, home visits, park visits, drives out and swimming. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 12 All residents had planned holidays scheduled, one was going to Disneyland Paris, another to Spain and the remaining two to Centre Parcs in Suffolk. All holidays were with 1-1 or 2-1 staff support and were chosen by residents themselves. Some funding support had been successfully obtained by a member of staff from the local branch of a national charity. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Residents were included in planning the level of support provided them EVIDENCE: The manager confirmed that staff are expected and required to provide appropriate support to residents. He agreed that the current resident group will quickly express their views on the appropriateness/inappropriateness of support offered them if they are not totally satisfied. Residents confirmed that they were satisfied with the way staff supported them. They also confirmed that they do chose what they wear each day but get staff views if they wish. Close personal support is always provided in private. Guidance is continuously offered on a daily basis to all residents regarding personal hygiene. Discussions with staff and residents indicated that there is flexibility regarding rising and retiring times, as with meal times, subject to previously agreed routines and restrictions for individuals. Residents files and care plans evidenced full consideration towards their preferences on routines likes and dislikes regarding daily living. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The home’s adult protection policies, procedures and practices were aimed at ensuring residents welfare. EVIDENCE: Evidence was provided to confirm that update staff training on POVA guidelines and procedures had taken place since the last inspection. This met the recommendation made in the last report. The home had the latest Dept of Health written guidelines on POVA procedures and information from the Essex Vulnerable Adults Protection Committee on reporting and recording procedures regarding suspected or alleged abuse. The home’s in-house polices and procedures under this heading were detailed and met the standard. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 15 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) 24, 26, 27, 28, 30 Furnishings in the home looked comfortable and areas of the premises seen were acceptably maintained. Private accommodation was comfortable and suited to needs and preferences. The premises appeared safe, were accessible, and had sufficient (according to these standards) numbers of toilets and bathrooms. The home was clean and considered to be hygienic. EVIDENCE: The house was furnished and well decorated in a homely comfortable style. Over the past 12 months general redecoration and some refurbishment had taken place. The ground floor shower room had been completely refurbished, the ground floor bathroom had been redecorated and new floor tiles had been laid. The first floor bathroom had been redecorated and new flooring had been laid. Four bedrooms had been redecorated and new carpets had been laid. One bedroom had all new furniture. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 16 The lounge had been redecorated and a new 42” screen TV installed. The conservatory had been recarpeted. The laundry room had been redecorated and new flooring laid. The staff wc had a new wc unit and new flooring. All residents’ bedrooms also had new curtains. Externally the rear garden had been cleared and there was improved access to the side of the home. All of these improvements had taken place since the home changed ownership in 2004. Three bedrooms in the home were inspected and were seen to be individually furnished to residents tastes and requirements. The proprietor confirmed that decoration and colour schemes are chosen by the resident with support from staff. Rooms included hifi’s, t.v’s and other items of personal possessions. Rooms also contained television points. Residents said that they satisfied with the layout and provision of furnishings and fittings within their rooms. They had access to their rooms at all times, thus privacy was ensured when required. The new owners had installed a separate free of charge phone in the dining area for residents to use to make private calls. One resident had his own mobile telephone. Bathroom facilities and toilet facilities are provided on both floors of the home. On the ground floor there is a bathroom and wc and a separate shower room with wc. On the first floor there is a further shower room with wc. These rooms were lockable and located close to communal areas and bedrooms. Kitchen and laundry facilities were fully appropriate for the resident group and on a domestic scale. Communal space available in the home exceeds the recommended 4.1 sq. m per resident, private rooms met space recommendations. The last visit by the fire service was in October 2004. Environmental health had not visited since the change of ownership. On the day of the inspection the premises were considered to be clean hygienic and were free from any offensive odours. Access to the laundry room was off the ground floor hallway corridor with access completely separate from that to the kitchen and dining room areas or any communal lounge space. The laundry floor was covered with impermeable vinyl. Work surfaces and walls were considered readily cleanable. The home had written policies and procedure on the control of infection and staff training had taken place on this subject. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 Staffing numbers, skills and experience provided appropriate support to residents. Recruitment practices and procedures in the home were aimed at ensuring the protection of residents. EVIDENCE: Staff meetings had taken place at six weekly intervals, minutes had been kept and were inspected. Issues discussed included staff issues, training, medication, activities, house issues, policies & procedures, individual resident issues. Staff rotas were seen and evidenced that minimum daytime staffing was still two on duty. Night time staffing was one on waking duty with one on-call support. Handovers take place between shifts. A domestic assistant works three days each week. Staff files evidenced that two references had been obtained, CRB checks processed, application forms completed, medical questionnaires completed, training records and proof of ID copied with a photograph. All new staff were employed on a six month probation period, induction training records from the first day or work up to six months had been kept. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 41, 42 Quality assurance and review processes ensured residents views were included in service provision and development. Records required by regulation had been maintained. The health and safety of residents and staff was generally assured. EVIDENCE: Since the last inspection the home’s new quality assurance questionnaire has been implemented. This covered questions on: facilities, support provided, staff attitudes, activities and food. Views had been sought from residents and relatives. A quality evaluation form had been completed from the results of the survey. This identified what had been done well, what would be improved, residents views, relatives/advocates views, team views, with outcomes and any actions required, by when and by whom. This fully met the requirement made in the last report. A new complaints compliments book was also available for daily comments from residents and relatives. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 19 Random samples of records required to be kept were inspected. These included: care plans, assessments, complaints, visitor records, fire drills, nutrition, recruitment, regulation 37 notices, staff rota and accidents. All were satisfactory. A discussion took place regarding the timescales for recording fire drills. Service records/certificates were seen confirming that checks had taken place within recommended timescales on: fire equipment, fire alarms, portable electrical appliances, gas supply and electrical installation supply. Hot water supply in the home is regulated at a temperature of or near to 43 degrees celsius, (not tested), although records maintained by the home were seen. There was a premises risk assessment in place which included fire, first aid, infection control, COSHH, boilers, elctrical, general premises, security, windows and safety. Staff had been trained in first aid, infection control, fire, food hygiene, health & safety. Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Paradise Lodge Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 3 x I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard None Good Practice Recommendations Paradise Lodge I56 I05 S57520 Paradise Lodge V236916 UI 25.08.05 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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