CARE HOME ADULTS 18-65
Park Lodge 17 Stoney Street Burnley Lancashire BB11 3PT Lead Inspector
Mrs Marie Dickinson Unannounced Inspection 20th June 2007 10:00 Park Lodge DS0000009533.V335266.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 Park Lodge DS0000009533.V335266.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. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Park Lodge Address 17 Stoney Street Burnley Lancashire BB11 3PT 01282 458051 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) Mr Joseph Serge Zephir Mrs Linda Joyce Zephir Mrs Sarah Casey Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The care home must at all times, employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. The home is registered to accommodate 2 adults with a learning disability. 22nd February 2006 2. Date of last inspection Brief Description of the Service: Park Lodge Stoney Street is a small terraced property.it is near to Burnley town centre. It is owned by Mr and Mrs Zephir and managed by Sarah Casey the registered manager. Two service users live at the home. They have their own bedroom and share a bathroom, lounge/dining room and kitchen. The service users manage the home with the help of trained staff. Information about the service is available from the home. Charges range from £336 minimum to £355 per week. There are no additional costs. The residents can purchase optional extras such as hairdressing, social activities, and magazines individually. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place on the 28th June 2007. The inspection involved getting information from a pre inspection questionnaire returned to the Commission prior to the inspection, staff records, care records and policies and procedures. It also involved talking to people living at the home, a staff member on duty, and the manager. People who use this service and a relative also gave their view of the services provided in written comments sent direct to the Commission. Three responses were returned to the Commission from residents and a relative who gave their personal view of the overall service and facilities provided. The inspection included a tour of the home. The home was assessed against the National Minimum Standards for Younger Adults. What the service does well:
Before any one moved in, careful preparation is made such as looking at the type of help people needed, planned visits, and staying for a short while. Staff at the home, relatives, and other people involved helped people do this. When a decision to stay and live at the home is made a contract is given, telling the person about their rights and cost of their stay. Residents benefited from excellent care planning. These showed how they were involved in making decisions about their everyday lives. Good communication methods were used in helping people understand as much as possible, such as picture reference. People knew information about them was kept confidential. One comment from a relative read ‘. ‘Our sons needs are always catered for in every respect. We are always informed of any changes’. Activities were varied and personal to everyone, which meant people lived their lives to the full. Relatives agreed with this and residents living in the home said they usually did something different every day. For example they knew when they cooked a meal, cleaned their bedroom, and what day they went to work and clubs. Staff helped them where needed. Comments from relatives in the scheme gave a positive view of life in the home for example ‘‘Independence is encouraged and promoted with service users’ and ‘plenty of activities organised for service users ie. Work, parties, clubs, outings etc.’ ‘Service users take part in personal routines, help tea preparations’, ‘social occasions and outings good’, ‘and ‘I think the care service supports and encourage people to achieve their potential.’ ‘It encourages clients to take part in lots of activities outside the home. It provides excellent holidays both home and abroad’.
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 6 Residents said they had enjoyed their holiday at Prestayn Sands. They had played crazy golf and gone Go-Karting. They also enjoyed watching football and going into town. The level and type of training given to staff helped make sure they had the right skills to care for people and provide the necessary support people needed in any given situation. Staff were also skilled to help people unable to communicate their needs. Family links were encouraged and they were made very welcome in the home. Residents held a record of important dates such as birthdays to help them remember to send greeting cards or purchase a gift if they chose. Relatives said they were kept informed of progress their relative made. Records in the home showed they attended reviews. Meal times in the home were what the residents wanted. They shopped for food, planned and prepared meals and cooked their favourites. The high standard of peoples healthcare plan helped them to receive the correct support from medical professionals. People were registered with a General Practitioner and had regular routine health screening. Medication was managed safely. The complaints procedure and the way the home was managed made it very easy for residents to raise any issues or concerns they had. People are regularly reminded at meetings and reviews of their right to make a complaint. Staff were trained in adult protection, and residents shown how to protect themselves from abuse, neglect and self harm. They also had their own policies and procedures, information about their rights and their own house rules they agreed on. The home was an ideal place where people lived in small numbers in the community, and provide a real ‘home from home’. The home was very nicely decorated. Furniture provided for residents was of a good quality. Everyone who sent comments to the Commission considered the home to be clean and tidy’, and ‘nice’. Resident’s views were taken into account regarding their accommodation such as furniture and colour schemes. Residents said they liked living at Park Lodge. It was their ‘home’. Recruitment practices were excellent as residents took part in the process. Relatives and residents considered there was always sufficient staff employed to meet with their needs. Staff were trained properly and had the right skills and experience to look after people. Supervision and appraisal of staff also involved residents. Carers treated people with respect and relatives comments included, ’I am quite happy with the care he gets’. And ‘I have full confidence in both managerial staff and carers and place a great deal of trust in the care of my son’. ‘The competence of staff is excellent’ Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 7 Staff training took into account special needs such as abuse of vulnerable adults, health and safety and principles of care and care planning. The training given to new staff by residents was excellent and covered all aspects of care needs from their view, such as ‘the right to shop for their own food, the right to pay for their care, the right to clean their own bedroom’ and the important principle of ‘staff are not in charge, we are working together.’ Management responsibilities were clear and the home was very well managed. It was run in the interests of the people living there and the staff and promoted equal opportunities for everyone. Every effort was made to give people good opportunities to have their say in how the home was managed such as management, staff, and residents meetings, all linked together. The views of relatives and other visitors to the home were also sought. Results of all surveys carried out were made public and the business plan covered all aspects such as staffing, training, and refurbishment. Residents were involved in keeping safe. They had regular fire drills and knew what to do should this occur. The home had a good range of policies and procedures and practice aimed at keeping everyone safe. Staff were given essential health and safety training in topics such as first aid and fire prevention. 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. The summary of this inspection report can be made available in other formats on request. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 8 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 Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 9 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): 1,2,3,4,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit and have a short stay were given to people that helped them decide if the facilities and services could meet needs and preferences. Contracts issued, informed them about the terms and conditions of living at the home. Assessments were completed properly which helped plan personalised care. EVIDENCE: There had been no new admission to the home since the last inspection. Information about the home was available. As the home accommodates two people any new admission involved careful preparation such as full assessments and planned introductory visits and short stay. It is important both people can live together. Records belonging to existing residents showed that a complete assessment had been made by a social worker involved in helping people move, and by the manager of the home. Both assessments were detailed and highlighted all areas of need for the person. Family had also been involved. This helped to make sure the right care could be provided, what the person wanted, if the Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 10 facilities of the home was right, the staffing levels and skills enough, and what the other person living at the home thought. People who are ‘friends’ are usual candidates for living together. A short stay is offered followed by a review when everyone involved meets together to discuss if living at the home is satisfactory and the care given is suitable. The other resident is invited to say what they think. Both people living in the home was given a contract they could understand outlining the terms and conditions of residence. Staff who cared for them had been carefully recruited and trained to care for people with a learning disability. There was written evidence they worked closely with other professional people, such as psychologists and dieticians in meeting people’s needs. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 11 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): 6,7,8,9,10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Good person centred care planning meant residents had their assessed and changing needs met in a way that was suitable to them. Thorough risk assessments and management strategies potentially reduced the risk of harm to residents. People were consulted and given information which assisted them to be involved in day to day routines and know confidential information was handled right. EVIDENCE: The standard of peoples’ care records was very good. Both people had been living in the home for a while and assessments of needs were current and relevant. Assessments linked well to care plans. There were clear directions for staff as to the type and amount of support people needed. The method of care planning used was person centred planning. This meant it was based on residents having rights, choice, independence, and inclusion. The
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 12 information in the care plan was easy to understand and was illustrated. Other information was recorded linked to ‘special’ personal care. This could include for example nails, make up and appearance with clothing. One relative who sent comments to Commission said, ‘They meet my daughters needs very well. They encourage and prompt her to do things for herself. She will never be totally independent but has done very well given her mental and learning difficulties.’ It was the practice of the home to support responsible risk taking and policies and procedures promoted this approach. Risk assessments and management strategies were available for staff to work to. Methods to reduce or manage the risk were completed and thorough in all areas of what staff must do to support people. Policy statements indicate for example, ‘it is an intrinsic right of every individual to be allowed to take responsible risk’. Residents benefited from being involved in writing their own care plans. Each person had a member of staff referred to as a key worker to help her with special activities such as keeping in contact with their family and personal care. Residents in the home said the carers helped them’. They also said their carer took them to medical appointments, holidays and shopping. They helped them with budgeting skills. Care plans were reviewed regularly showing progress and changes needed in meeting needs or achieving goals. These were easy to follow. They showed who would do what to reach the desired outcome. Everyone held a copy of their own care plan and understood what they were about. Good communicating methods were used such as large print in plain English, signing, picture reference, and symbols. In meeting diverse needs difficulties people experience such as money value, staff worked with them to make sure they were not at risk. They were also supported to send invitations to people to attend their reviews such as family. Records show family often attend care reviews. The key principles identified in the home show people using the service are in control of their lives and can direct the service. There was evidence people were involved in staff and management meetings. They took turns to be represented to say what they wanted at these meetings. They also had their own policies and procedures and ‘house rules’ they had agreed on, such as ‘we are kind and respectful to each other’. All care plans people held, had an agreement for sharing of information and a confidentiality policy for their reference. Confidentiality was included in induction training and in the staff handbook for reference. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 13 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): 11,12,13,14,15,16,17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The scope of opportunities for personal development, family contact, and social activities was excellent which meant residents were treated with respect and lived a fulfilling lifestyle in the home and in the wider community. EVIDENCE: Both residents were at home during the day when the inspection took place. The philosophy of the home to enable people to live full independent lives, and be involved in the community was central to the home’s aims and objectives. Staff had guidelines to follow to help people achieve this for example how to be discreet when accompanying residents shopping. Part of care planning was to help people identify what their own goals are, and what they want and need to do. For review meetings people are supported to send out invitations to people they consider able to help them achieve goals.
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 14 This can be College tutors, or day centre staff, and key worker, medical professionals, and any other person who has an interest in their well-being. Goals set were achievable, with everyone involved knowing what their role was. For example budgeting support. Staff role was to support residents understand money value and make sure they had sufficient funds to purchase the things that they wanted. People in the home discussed the type of activities they did. They had illustrated weekly planners to help them remember what to do and where to go. They usually did something different every day. For example they knew when they cooked a meal, cleaned their bedroom, and what day they went to work and clubs. Staff helped them where needed. Comments from relatives in the scheme gave a positive view of life in the home for example ‘‘Independence is encouraged and promoted with service users’ and ‘plenty of activities organised for service users i.e. Work, parties, clubs, outings etc.’ ‘Service users take part in personal routines, help tea preparations’, ‘social occasions and outings good’. One relative wrote ‘they meet my daughters needs very well. They encourage and prompt her to do things for herself. She will never be totally independent but has done very well given her mental and learning difficulties. Induction training of new staff by residents included basic principles of care. Topics centred round their rights such as choice. ‘I choose to go to town, my own friends, my clothes, my food.’ If someone had any difficulty in making choices, staff support is offered. Residents pleased themselves what activity they joined in. One resident had part time employment. Residents made full use of community facilities. They went to town regularly. They had outings, holidays and went to concerts. They had been to Prestatyn Sands. They had a good time with their friends. Joining in the mobility scheme in the home had the benefit of being transported to various places. However as part of people’s development they are supported to use public transport. Routines were very flexible and individual. Written comments from relatives regarding the Park houses scheme included, ‘Treats people living there as individuals and plans their activities with them.’ ‘We get a detailed calendar of events and activities. There is time to talk to staff on visits attend care plans and the staff are always helpful’. ‘home life is excellent, all needs are met.’ And ‘care plans improve quality of life, we know what targets are to be achieved’ and ‘do the best for all clients in all areas’. Residents also considered they had a fulfilling lifestyle with plenty of activities arranged for them to enjoy. Family links are encouraged and personal files listed names of family and friends and their birthdays. This helped people remember to send greeting cards and purchase gifts if they chose. A relative who sent written comments considered the home to make family contact easy, as ‘her daughter would not
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 15 do so unless supported.’ Relatives are given a detailed calendar of events and activities. They are formally invited to social events. The visiting policy enabled residents to have visitors at any time they wished. They have had the occasional ‘party’ for their friends. Induction training given by residents for new staff includes respect, privacy, and dignity. Everyone had an opportunity to tell management on how staff treated them, when they completed an easy to follow questionnaire deigned to comment on staff in general. All those who sent written comments about the staff considered ‘staff treated them well all the time’. Both residents planned their own menus, went shopping, and took turns to cook. They cooked their favourites and staff helped them as agreed in care planning. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 16 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): 18,19,20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individual preferred routines likes and dislikes allowed people to enjoy personal care in a dignified way. Their healthcare was monitored very well and medication policies and staff training promoted best practice, and reduced the risk of errors being made. EVIDENCE: How people wanted to be supported in their care was recorded for example ‘able to wash independently, but may require verbal prompts in the first instance to run the water.’ Staff helping with these tasks had sufficient instructions to help people according to their need and what people liked or disliked recorded on assessment and reviews. Those residents in the scheme, who trained new staff with induction, covered the basic principles of care, showing staff how they expected them to give support. New staff were left in no doubt this was an important issue for them. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 17 All staff were trained to care for people with a learning disability and in other topics relevant to their work. Information sent to the commission showed staff had been trained in for example epilepsy, autism, makaton, challenging behaviour, and person centred care planning. Healthcare needs had been properly assessed and were included in each person care plan. Daily records showed how healthcare was closely monitored. Appointments for routine health screening were made and staff support offered where needed. There was also evidence of other professionals being involved in resident’s healthcare needs. Healthcare plans were also written for people to understand. Each area of need was considered, showing the necessary action to be taken to help such as support needed for ‘visits to the dentist’, . People were registered with a General Practitioner. Records of medication was kept for each individual that included information staff should be aware of if someone was not well. Residents could self medicate following an assessment to make sure this would be safe. Medication storage was secure. Medication administration records were up to date, and all staff responsible for this task had been trained. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 18 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): 22,23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The complaints procedure and way the home was managed made it very easy for residents to raise any issues or concerns they had. Good practice in employment, formal training for staff in adult protection, and residents shown how to protect themselves in and outside the home, meant they were protected from abuse, neglect, and self-harm. EVIDENCE: Comment cards received at the Commission from residents showed they were very satisfied with how they were treated. Staff listened and acted on what they said. They both knew who they would speak to if they were not happy and had any concerns. Those responsible for training their new carers for their induction emphasised the importance of listening to them, and treating them as individuals who need support to live everyday life. At various meetings residents can raise any issue they may have, and are also actively involved in staff appraisals. The complaints procedure was illustrated and written in simple plain English and was easy to understand. The relative who gave written comments indicated she was given the procedure. A complaint form is given at every annual planning meeting to remind people of their right to make a complaint or raise any concerns they may have.
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 19 People in the home are instructed ‘how to keep safe’ when they are admitted. They are told what abuse is in easy to understand language with illustrations. They are made aware of what abuse is, and safeguards in place for their protection. These policies and procedures regarding Safeguarding Adults are also available to staff and gave them clear guidance about what action should be taken in such an event. All staff had been trained in safeguarding vulnerable adults and protection issues. Access to external agencies or advocacy services is actively promoted. Staff were also trained to respond correctly to physical and verbal aggression, and to fully understand the use of physical intervention as a last resort. Good recruitment practices in the home helped safeguard people living there and staff had signed a declaration excluding them from benefiting financially from them. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 20 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): 24,25,28,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided a clean, well-maintained, comfortable environment for people living there. EVIDENCE: Park Lodge Stoney Street is a small terraced house situated near to the town centre of Burnley. The home has a lounge/dining room, kitchen, and bathroom. The home was decorated to a very good standard and furnishings and fittings were ‘homelike’ in style and of a good quality. There was a small yard at the back. It is an ideal residence for two people to live in the community, and provide a real sense of ‘home from home’. The home was very well maintained, with obvious continuing investment made to keep high living standards for residents. Both residents sent written comments for the inspection showing they considered their home to be always fresh and clean and said ‘I like my home’, and ‘I like living at Stoney Street’.
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 21 Resident’s views were taken into account regarding the choice of furniture and colour schemes. They said the lounge carpet had recently been cleaned. Residents used all parts of the house. On inspection the home was very clean and both were very much ‘at home’. Residents were proud of their home and the way they kept it clean. Bedrooms were personalised and had everything residents wanted and needed provided. Residents had their own keys to lock their rooms and keep them private. Observations made during inspection showed the overall standard of hygiene in the home was very high, which the residents must take credit for. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 22 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): 32,34,35,36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Excellent recruitment practice involving residents helped select people who were suitable to care for people living in the home. Staff employed were trained, skilled and in sufficient numbers to support the people who use the service. EVIDENCE: Written comments from residents’ appraisal of staff in the scheme included ‘I can discuss problems with her’, ‘she is friendly’, kind and respectful when giving personal care’. And ‘I am really happy with her’. Information received at the Commission indicated that a high percentage (100 ) of staff was trained in National Vocational Qualification in Care (NVQ) level 2 and above. A wide range of other training was provided and included, Induction/foundation; Good to great, first aid, moving and handling, health and safety, safer food, food hygiene, challenging behaviour, abuse, care planning, makaton; Nomad medication, learning disability, principles in care, infection control, business planning and epilepsy and autism.
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 23 Staff rotas also showed staff being available at all times. Comments received from residents and from relatives indicated sufficient staff were available to support people’s individualised needs, activities and aspirations. The recruitment practice was excellent as it involved residents at all stages. This included taking turns to interview people with management and completing a job assessment form after the interview, irrespective of disability. Questions for example included, ‘Shall we employ this person? Would you like this person to work in your home? Do you think the other people living here would like this person? For those people unable to express themselves verbally, their preferred method of communication was used. There had been two new staff appointed in the scheme since the last inspection. Staff files showed that essential checks had been made before people were offered a job. They were given a contract and job description. Relatives had confidence the home would recruit the right people, Written comments from relatives also showed they were of the opinion staff had the right skills and experience to look after people properly. Comments regarding the scheme included ‘’I am quite happy with the care he gets’. And ‘I have full confidence in both managerial staff and carers and place a great deal of trust in the care of my son’. ‘The competence of staff is excellent’. All new staff were given induction training by residents in addition to a full induction by the manager. Staff employed viewed resident induction training very good. ‘The course was very beneficial and interesting to learn about what service users think so it can be put into practice’. Certificates of training were kept on file with staff training records. Staff were given regular supervision that included topics such as interaction with service users, service users care plans, person presentation, health and safety, training issues, staff meetings, reporting and record keeping, good practice and any other issues. An action plan following supervision was then completed. Residents took part in staff performance evaluation. Regular staff meetings took place with agendas written, and minutes taken. Staff considered working in the home, ‘management and staff have a good team spirit which in turn reflects the high standards which have been achieved. The future is for us all to maintain those very high standards.’ And, ‘good training opportunities’, ‘lots of support provided by the manager and providers’. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 24 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): 37,39,41,42,43. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management of the home promoted equal opportunities for everyone, which meant the home was run in the best interests of people living there and protected their health, safety, and welfare. This helped towards people’s quality of life experience in the home and community being good. EVIDENCE: The registered manager is qualified in management and care, and has many years experience in managing a care home. Information received at the Commission show the scope of her responsibilities includes for example ‘overall responsibility for staff employment, policies and procedures, health and safety, provisions, furnishings and refurbishment, standards, service user welfare, appraisal of all staff, supervision of senior staff, staff training, wages, accounts
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 25 and motor vehicles, induction and foundation training and finance.’ Home leaders support her in this role, and have their own delegated responsibilities. The management approach allowed for residents to have opportunities to tell the owners, manager and staff how they would like the home to run, the care they receive and facilities they enjoy. They were consulted regularly about this and attended staff and management meetings. People in the scheme took turns to attend these meetings to put forward ideas and views of how the home should be run. To do this staff helped them put their ideas for better care and working practice on an agenda and put them forward during meetings. Together these ideas were discussed and changes agreed. Residents said their views were listened to. Another method used was anonymous questionnaires. These were given to residents and other people such as relatives. The views of those who completed these regarding the care and facilities were published and made available for people to look at. Written comments received in the scheme included, ‘relationship between the management and carers excellent’. The manager was involved with the providers in business planning and review. The current business plan looked at the objectives of the home and what was hoped to achieve in the year. Finances were outlined, and staffing, training, marketing, and refurbishment also considered and provided for. Staff were expected to read the business plan and the stated objectives for the coming year. Insurance cover was in place to meet any loss or legal liabilities. The home made sure everyone who could manage their own money as far as they were able. Proper records were kept and audited at regular intervals. Record keeping was very good, and confidential records were stored securely. Staff were made aware of the requirements of the Data Protection Act, and compliance was included in their terms and conditions of employment. Staff had the opportunity to discuss work issues with the owners and manager on a day-to-day basis and in supervision. Residents were supported to take part in staff supervision. Their comments were taken seriously and used as a means for staff to develop their skills in care. This was recorded in easy to use picture illustrated forms, designed for everyone to understand. Staff said they had support with training. Written comments on from residents in their review of care included ‘I like living here’ and ‘I’m ok.’ Relationships between staff and those living there were observed as positive. Staff spoke about people with respect. The home has investors in people award. Professional people describe the team at Park House as ‘professional and caring’, and ‘the service promotes independence’. Throughout the inspection of management of the home, there was evidence in equal opportunities for all. For example, residents involved in
Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 26 recruitment of staff, and living a valued life in the wider community. Residents were also supported to attend East Lancashire service users network meeting run by Lancashire County Council. This is held about three times a year. To make sure staff follow the policies and procedures of the home, as outlined in their staff handbook, these are discussed during supervision. Action was taken to help staff understand them by formal training provided, such as caring for people with a learning disability. Safe working practices in the home were evident. Both residents had regular fire drills and each person was risk assessed to make sure they were kept safe in the event of a fire. The home had a good range of policies and procedures and practice aimed at keeping everyone safe. Staff were given essential health and safety training in topics such as first aid and fire prevention. Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 27 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 3 2 3 3 3 4 3 5 3 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 4 25 4 26 X 27 X 28 3 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 3 LIFESTYLES Standard No Score 11 4 12 4 13 3 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 4 X 4 4 4 Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 28 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 Park Lodge DS0000009533.V335266.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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