Inspection on 15/08/06 for Paradise Lodge

This inspection was carried out on 15th August 2006.

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 11/07/07

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 Axam Key Unannounced Inspection 15th August 2006 10:20 Paradise Lodge DS0000057520.V309266.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.V309266.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.V309266.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.com Paradise Lodge (Care Home Limited) Mr Vyramuthu Rattinam Loganathan Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Paradise Lodge DS0000057520.V309266.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) 12th January 2006 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.V309266.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Key inspection site visit took place over a period of 4 hours. During the Inspection the two managers of the home – Mr Vyramuthu and Mr Vickram Damhar, were present throughout the inspection process. A tour of the home took place. Staff and service users were spoken with during this inspection. All residents confirmed that they were satisfied with the care and support they received. The visit mainly focused on all Key standards and all of the requirements 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: 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 DS0000057520.V309266.R01.S.doc Version 5.2 Page 6 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.V309266.R01.S.doc Version 5.2 Page 7 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 the following standard(s): 2 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. Initial assessments were in place and the homes systems for assessing individual needs prior and once admission has taken place are to a good standard. EVIDENCE: All initial assessments were in place from the placing authority prior to a service user moving in and the manager of the home completed pre-admission assessments of needs. Once in placement the home monitored, observed and recorded needs, behaviour and aspirations of individual residents. Care plans are based on these assessments. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 8 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 the following standard(s): 6,7 & 9 Quality in this area is adequate. This Judgement has been made using available evidence including a visit to this service. The manager needs to make sure care plans include review dates and service users signatures to evidence they have been consulted as part of this process. EVIDENCE: The home carries out person centred planning and this is in consultation with the individual resident, family, advocate and other professionals. The plan is made available in a format of choice of the service user. At this present time care plans and information in service user files are being re-organised and includes individuals needs, views, likes and dislikes these are presently being completed for all residents. Staff spoken with and through observation evidenced that they are very good at taking on service user views, wishes and show that they listen and promote the values of respect, dignity and clients rights. In general service user care plans sampled did not include a signature or that a review date was set. Service users spoken with on the day of inspection were very clear and positive about being able to live their lives as independently as possible and that staff are very good at supporting this. Three out of five service users have advocates and all service users were aware of the key worker system and who their key worker was. Service users Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 9 informed me that they are consulted with and that meeting regularly go ahead as part of the information sharing process. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16 & 17 Quality in this area is excellent. This Judgement has been made using available evidence including a visit to this service. The team and manager evidenced a dedicated and consistent approach, non-judgemental attitudes and high standard of professionalism is in practice. EVIDENCE: Overall service users spoken with during the inspection evidenced that staff were very proactive in supporting them to take up appropriate and meaningful activities within the home and whilst out using the community. On the day of inspection it was evidenced that staff were accompanying individuals to use the community and carry out activities, which service user’s had requested. One particular service user spoken with felt that the homes staff supported him to maintain some form of positive outlook concerning his family contact, even though this had complications surrounding the individual’s circumstances. Again paperwork looked at surrounding this individual, evidenced that staff in general gave a high quality service and support. During Inspection lunchtime was observed and it was noted that the service users were encouraged to have a choice of foods available that day. Menus looked nutritious and reflected residents tastes. On the day of inspection service users were asked about the Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 11 food provided and were very complementary about the food provided and how staff supported them to be involved in the preparation and buying of foods. Food smelt and looked appealing and was presented nicely. Meal times were unrushed and had a relaxed atmosphere. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 18,19 & 20 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. The homes policies, procedures and discussion with service users, staff, evidenced good practice is in place. EVIDENCE: Service users are given a choice of how they would like to be supported concerning personal care and this is recorded in their care plans. Promotion of independence and learning/retaining skills was evident. All service users have access to a GP and dental practice either local or of the individuals choice. Specialist services are catered for if necessary and of beneficial to the individual. Good paperwork was evidenced which shows strong links and good partnerships with the local PCT team. Recording of health care appointments, decisions and meeting were in place. 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. Training records indicated that all staff had medication training and if any medication errors had happened with individual staff, that these incidents were recorded and staff monitored and supported to improve on practice. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 22 & 23 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. The home has a complaints policy and the service user guide highlights the complaints procedure. The homes policy and procedures and training of staff appear to protect residents from abuse. EVIDENCE: The home has a good complaints procedure in place. All complaints are kept, maintained and outcomes recorded. A service user complaints procedure is available in a format of their communication choice, Service users spoken with were clear about how to make a complaint and felt confident that if they were to make a complaint it would be dealt with effectively. Paperwork inspected, staff and service users spoken with evidenced that the health and safety of both services users and staff were paramount and an intrinsic part of the philosophy of care carried out at paradise lodge. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 24 & 30 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. On the whole the outside environment is pleasant, attractive and provides appropriate and practical usage for the service users of Paradise Lodge. The home environment provides a clean, comfortable and safe environment in which to live in. EVIDENCE: Three bedrooms and all communal areas were looked at as part of the inspection. Bedrooms looked at were personalised and one service user had sky installed in his bedroom and this was carried out at the owner’s own expense. The home has a separate ‘free of charge phone’ that allows service users privacy when making or receiving calls. Some service users have their own mobile phones. On the day of inspection the home was observed to be clean, tidy and odour free. Overall the home environment present no health and safety issues, the environment was homely comfortable and practical for the use of service users at Paradise Lodge. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this area is adequate. This Judgement has been made using available evidence including a visit to this service. The staff team are a mixture of qualified nurses, NVQ qualified and staff presently training on the NVQ. EVIDENCE: Paradise Lodge has over 50 of its staff either presently on or have finished their NVQ training. Additionally although not providing nursing care, four staff are qualified nurses. The home’s induction pack is to a good standard and new staff also receive support by shadowing more experienced staff before carrying out duties on their own. Regular training, supervision and staff meeting go ahead and staff spoken with on the day of inspection confirmed this. Staff records were also inspected and records evidenced training had been carried out and future training had been arranged. Paperwork for staff recruitment was looked and overall was to an adequate standard, however gaps in work history for new staff need to be pursued, clarified and recorded. The owner and management need to look at their policies around these issues. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this area is excellent. This Judgement has been made using available evidence including a visit to this service. Looking at paperwork and through discussion with individual residents and staff evidenced good teamwork and clear leadership skills from the management in situations that are both sensitive and complicated. EVIDENCE: The manager has clearly made a positive impact on the running of the home. Staff and relatives of service users appear contented with the home under his leadership. The manager has good experience and is a RMHN and has a diploma qualification in management studies. The home provides a good standard of experienced staff, that either hold a nursing or NVQ qualification. Regular support of staff is continuous and service users views underpin the philosophy of the home. Policy and procedures that are put into place reflect the service user group that the home caters for. There is a good standard of induction programme for new staff and of monitoring individual’s practice. Training is on going and staff are encouraged and offered mandatory Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 17 professional and service users ‘specific’ courses to develop their knowledge and skills. The Quality Assurance monitoring which gathers views of all interested parties is yet to come to fruition. The home is required to carry this out and to collate information, draw up an action plan and make a report of these findings available to all interested people with a copy sent to the CSCI. Health, safety and welfare of service users and staff have been made a priority. All health and safety checks inspected were up to date. Service users are benefiting from a strong management team and the level of service is of good quality. Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 18 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 3 23 3 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 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 X X 4 X Paradise Lodge DS0000057520.V309266.R01.S.doc Version 5.2 Page 19 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.V309266.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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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