Inspection on 15/04/09 for Park Lodge (45)

This inspection was carried out on 15th April 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Park Lodge (45) 08/05/07

Park Lodge (45) 31/07/06

Park Lodge (45) 20/02/06

Park Lodge (45) 10/10/05

Park Lodge (45) 22/02/05

Park Lodge (45) 12/11/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Park Lodge (45) 45 Carshalton Park Road Carshalton Surrey SM5 3SP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: James Pitts     Date: 1 5 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Park Lodge (45) 45 Carshalton Park Road Carshalton Surrey SM5 3SP 02086694252 F/P02086694252 hoozeer@beeb.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Tracescent Limited care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Park Lodge is a care home for younger adults with learning disabilities. It is situated on the Carshalton Road between Wallington and Carshalton and is on a bus route. The home is a traditional brick built detached house. It comprises eight single bedrooms. There is a lounge, an open plan kitchen/dining room, a conservatory and other facilities including toilets, 1 bathroom, 2 showers rooms, a laundry room and a small office. 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Since the key standards inspection in May 2007, the home was subject to an annual service review in 2008. This visit took place in mid April at a time when the people who use this service were on holiday from their colleges and other centre based activities for the Easter period. There were five people at home during the inspection and two spoke in some detail about what they had been doing whilst away from college, as well as commenting about their view of the home. Some of the people who live here are not able to hold voice conversations but all can make at least some of their needs known in other ways. The staff member on duty was observed interacting with those who use the service appropriately. The registered person, but not the registered manager was also involved in providing assistance during this visit. Care Homes for Adults (18-65 years) Page 6 of 27 Six of the people who live here also sent questionnaires to the Commission before this visit took place. All of the comments that were made once again show that these people are happy living at the home and like the care staff who support them. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service continues to properly consider referrals and admissions on the rare occasion that these occur. Evidence: he people who use this service, and other stakeholders, are told what the home does and how it will do it, and the guide for service users is presented in a clear way so that people can understand it. The service users can still remain confident that the home will only care for people that the staff are trained and able to care for. The home is meant to provide long term accommodation for all of the people who live here. For this reason it will be unusual for new service users to be admitted on any frequent basis. The home has had no new service users admitted for quite some time and currently has no vacancies. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service can continue to feel confident that staff generally know what they need. they can also be assured that the staff will try their best to make sure that each person who lives at the home is allowed to live the sort of life that they choose. The care planning process still requires improvements as to not do so could undermine the other good work that is done. Evidence: We looked at a total of four service user care plans in detail during this visit. The care plans improved as the result of previous inspections. The care plans do still, however, need to be expanded upon further to encompass more detail about the day to day living experiences and personal development opportunities that are offered to the service users as was required at the previous key standards inspection in 2007. It is disappointing to note that no further progress has been made on this and the previous requirement remains unmet. The current care plans are, however, still reviewed regularly. The reviews include consultation with service users about their preferences and what can be done to help them to live their chosen way of life within acceptable Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: boundaries. The service users and staff still get together for a house meeting, usually each month. At this meeting everyone should talk about what it is like to live at the home and about anything that has changed or needs to get better. This meeting is somewhere that everyone can also say how they are feeling about living together and to ask for the things that they want. At the previous two key standards inspections it was seen that the minutes of these meetings could get better at reflecting the things that service users say and what choices they are offered about the things that change in the home. It is disappointing to note that no further improvements have been made since this was recommended at the key standards inspection in 2007. The home should still show how service users are consulted about plans for the future of the home and how they respond to service users requests. The home writes a risk assessment for each of the service users. A risk assessment tells the staff how to make sure that each person is kept safe from anything that might harm them. The staff are still very good at doing this about very particular needs for each of the people who live here and these risk assessments also encompass more general areas of safety, for example if it is safe for particular person to go out alone. The staff are still very good at making sure that nobody is told anything about any of the service users unless the person is allowed to know. The staff are also very good at making sure that they tell the right people about things that are happening to the people who live here. The home has a confidentiality policy that tells staff about how to make sure that they keep to this. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service can continue to feel confident that the opportunity for each to develop and maintain personal and family relations is offered and actively supported by the staff team. Evidence: The people who come to live here stay for a very long time. Each service user is supported by the staff to be as independent as possible and to make as many choices as they can. All of the service users are engaged in activities each week that range from attendance at day centres and classes at college or other activities. They also go shopping and to make use of other things in the community such as the cinema or the pub and other places of interest. The staff are very good at helping each service user to keep in contact with their families and friends, and the comments that were made by some people during this inspection support this. Family and Friends continue to be made very welcome when they visit the home. There are not many rules at this home. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: The most important one is that no one is allowed to smoke in the house. All of the people who live here are allowed to use the entire house, except other peoples bedrooms or the office if a meeting is happening. The menus, backed up by comments that have been made by service users, show that the people who live here are involved in choosing what meals they prefer. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can feel confident that they will get the right support to take care of their physical and health care needs, although more written detail of the care needs could be provided. Anyone who needs to take medicine regularly to help them stay well will get the proper support from staff to make sure that this happens. Evidence: Each service user has a care plan that tells the staff to some degree about the way that each service users wants to be cared for and supported and about what each person likes or does not like. (please refer to the comments that are made under Individual needs and choices in this report with reference to how these could be improved) All of the people who live at the home usually go to see a local GP if they are not feeling well. The service users can see any local GP but most see the same one that the staff know very well and get along with. The staff are still very good at writing down anything that happens if anyone becomes unwell. If any of the service users have an illness or something else is wrong with them then the staff do know what this is and how to help them to get the treatment that they need. Health action plans are Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: written with the help of local community nurses, and these are now being updated for the current year. This is a very good way of helping to make sure that everyone who lives here can remain healthy. Staff have been trained in how to respond in the event of anyone suffers from an epileptic seizure. All of the service users need to take medicine every day and the staff are very good at making sure that this happens so that they can stay well. The fact that staff have to control these medicines has been previously agreed with the service users placing authorities, and with individual service users where they are meaningfully able to provide consent. The staff are also good at making sure that no one can get hold of any medicine that they should not have and so they keep medicines locked away. The home has a local agreement for a pharmacist to provide regular advice about the handling and administration of medicines. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service can continue to feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. Evidence: The service users are given clear information about how to complain and what happens when they make a complaint. No complaints have been made to the home or to the Commission since the previous key standards inspection. Notes are made of compliments to the service that are received and these are usually from family members of the people who live here. The staff team are good at making sure that all of the service users are protected from abuse (this means that the staff at the home do everything that they can to stop any of the service users from being hurt by someone else). There is also clear written information for staff about what to do if they think that a service user is being hurt or abused by another person. The staff know what they then have to do to keep people safe. None of the service users have said that they are being hurt by anyone else. No concerns have been raised by anyone else who has contact with the home. It is also once again positive to note that new staff are sent on a protection of vulnerable adults training session as a part of their induction at the home. It would now be advisable to seek update training for the longer service members of the staff team. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service can remain confident that they are living in a well maintained and clean home. Evidence: The house continues to be kept very clean, and remains a warm and comfortable environment for the people who live here. The people who use this service are permitted to, and do, personalise their own bedrooms with staff support if required. Care Homes for Adults (18-65 years) Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service can feel confident that there is a largely qualified staff team to meet their needs and that these staff are safe people to support them. However, the quality of the support that is offered by the staff team could be compromised if staff are still not in receipt of proper ongoing training or are not supervised in an adequate way. Evidence: There has been one new staff member come to work at the home since the previous inspection. This person did have the proper background checks completed and the home continues to insist that references from previous employers or other organisations are confirmed. (This may be done by the organisation stamping the reference questionnaire with their official stamp or by writing a covering letter on headed paper to the home along with the reference that is sent). The law says that half of the staff must have a proper qualification to work with adults who need support in a care home. The name of this qualification is NVQ 2. It was confirmed again at this inspection that over half of the staff team have this qualification with others either still completing the qualification or to start doing it. The service continues to carry out checks to make sure that the people who work here Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: are safe people to work with the people who use the service. These checks include things like asking the police if a new member of staff has ever been found guilty of a crime, and asking people who used to employ them if their work was good and if they are the right sort of person to work with the service users and to support them. The home keeps records that say what training courses staff have done, and when they did them. Each year staff have an appraisal that tells them and the home how well they are doing their job. After the appraisal each member of staff is then has a personal development plan which they write with their manager. A personal development plan says thing like what the member of staff does well, what they need to improve upon and what training they need. Although in three of the four staff records that were examined appraisals had occurred, in a fourth none had been done. Additionally none of the staff have a current training or development plan which must be remedied. Staff supervision (this is a time that each member of staff spends talking about how they are getting along in their work) is done by the manager. Staff are supposed to meet with their manager at least 6 times a year by law. The home can again show that this is happening at the required frequency. The style of supervision and the things that are discussed were again seen to still be in need of improvement, as in many cases one topic is discussed and even then it is not always one of professional care. For example the use of the pay phone was a topic for almost all staff at consecutive supervisions. It was recommended at the three previous inspections that the manager attend a training course about supervising staff in a care home setting. It is not acceptable that, despite previous unmet requirements, no further progress has since been made and this must now be acted upon without further unnecessary delay. Care Homes for Adults (18-65 years) Page 20 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service cannot feel confident that they are living in a home that is doing all that should be done to fully consider the need for future developments. The service users can, however, feel confident that the necessary health and safety checks are being properly carried out. Evidence: The registered persons, one of whom is also the manager of the home, have a number of years experience in running care services. The home was told at the annual inspection in 2005 that they must introduce service user satisfaction surveys and an annual development plan that is open to the service users. The service users surveys that have been done were completed in October & November 2005 and a quality assurance system and an annual development plan were seen to be in place at the time of the inspection in 2007, but were needing to be updated at that time. This was done later in 2007, however, it is now more than overdue once more. As this requirement has arisen again it will be deemed to not have been achieved from the previous inspection. Additionally there had been a clear Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: attempt to mislead by overwriting the 2007 survey date with 2008 which can be considered as an attempt to falsify records. This is wholly unacceptable and the registered person was informed during this inspection visit that if any further alterations of records in this way is seen again then they may be liable to immediate enforcement action without further discussion. An examination of the required health and safety records showed that these are all up to date. The London Fire Brigade carried out their most recent routine inspection visit to the home on 7 December 2005. The report that resulted from that visit stated that the premises were found to be satisfactory. The home is generally good at making sure that the people who live and work here are kept safe from fire and other hazards. Care Homes for Adults (18-65 years) Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 15 (2) (b) The care plans should now 08/05/2007 be expanded upon further to encompass more detail about the day to day living experiences and personal development opportunities that should be offered to the service users. (Previous timescale of 16/10/06 not met) 2 36 18 (2) The style of supervision and 08/05/2007 the things that are discussed were again seen to still be in need of improvement. It was recommended at the previous inspection that the manager attend a training course about supervising staff in a care home setting. Since that time no progress has been made and this must now be acted upon. (Previous timescale of 16/10/06 not met) 3 39 24 (3) Both the service users / stakeholders satisfaction questionnaires and the annual development plan must be updated to cover the current year. 08/07/2007 Care Homes for Adults (18-65 years) Page 23 of 27 Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 5 5 The current range of fees must be supplied to service users and the Commission. To show transparency in the cost of the service. 27/05/2009 2 35 18 The registered person must ensure that all staff receive appropriately planned and ongoing training about the work in which they are engaged. To ensure that the well being of the people who use this service is safeguarded and promoted by means of having a knowledgeable and trained staff team. 24/06/2009 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 It would now be advisable to seek update training about the protection of vulnerable adults for the longer serving members of the staff team. Care Homes for Adults (18-65 years) Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 2 33 The registered person should ensure that all members of the staff team have an annual appraisal of their performance. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!