Inspection on 08/05/07 for Park Lodge (45)

This inspection was carried out on 8th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park Lodge (45) 15/04/09

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 09/07/2008.

CARE HOME ADULTS 18-65 Park Lodge (45) 45 Carshalton Park Road Carshalton Surrey SM5 3SP Lead Inspector James Pitts Key Unannounced Inspection 8th May 2007 10:11a Park Lodge (45) DS0000007148.V337712.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 (45) DS0000007148.V337712.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 (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Lodge (45) Address 45 Carshalton Park Road Carshalton Surrey SM5 3SP 020 8669 4252 F/P 020 8669 4252 hoozeer@beeb.net 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) Tracescent Limited Mrs Bibi Mahazabine Hoozeer Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow one specified service user in the Mental Disorder and Learning Disability service user categories to be accommodated on condition that the risk assessment for the service user is renewed at regular intervals, or sooner should the need arise. Should the service user’s care needs become such that the home is no longer able to properly meet these or their needs cause detriment to the care of other service users, the home must request that the service user be moved to a suitable alternative placement. 31st July 2006 Date of last inspection Brief Description of the Service: 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. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the key standards inspection in July 2006, the home was also visited in October of last year to check upon improvements that had been made. Two of the previous six requirements had been achieved, and a further two have also been achieved since. It is, however, disappointing that care plans and staff supervision still need further improvement. This visit was first due to take place at the end of April, however, as the service users were on their way out for the afternoon a further visit was arranged. This visit took place during the daytime and there were four service users at home, and others were out engaging in activities. Some of the service users who live here are not able to hold voice conversations but all can make at least some of their needs known in other ways. One of the service users spoke about what they were doing during the day and staff were observed interacting with other service users appropriately. The proprietors, one of whom is also the manager, were also were also involved in providing assistance during this visit. Five of the people who live here also sent questionnaires to the Commission before this visit took place. Most of the comments that were made show that these people are happy living at the home and like the care staff. People were also confidant about who they can go to if they wish to talk about any concerns or to make a complaint. Areas of improvement that were suggested were to go out to eat at the weekends as used to happen and a service user who would like particular friends to visit. These are areas that the home should give serious consideration to. What the service does well: The home continues to show effective continuing improvements with ensuring that service users are supported appropriately in all aspects of their day-to-day living. This includes providing the necessary support to service users that will enable them to be a part of the wider community and to have aspirations, expectations and goals. There is a positive commitment to encourage and support service users to maintain family relationships and friendships. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 6 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 (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall rating of the two standards that were examined is good. Service users and other people 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 continue to feel confident that the home will only care for people that the staff are trained and able to care for. EVIDENCE: Service users and other people 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 feel 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. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service users can feel confident that staff generally know what they need. Service users 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. EVIDENCE: A total of four service user care plans were looked at 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 should be offered to the service users. The care plans are, however, reviewed regularly. The care plans and 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 boundaries. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 10 The service users and staff 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 inspection 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. Since that time there has been some improvement to the way in which the minutes reflect what service users have said and more in depth comment about service users participation is now recorded. However, 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 of the service users is kept safe from anything that might harm them. The staff are 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 service users to go out alone. The risk assessments are all up to date as was required at the previous key inspection. 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. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users can continue to feel confident that the opportunity for each to develop and maintain personal and family relations is also offered and actively supported by the staff team. EVIDENCE: The people who come to live here stay for a very long time. The service users are supported by the staff to be as independent as possible and to make as many choices as they can. The staff are good at helping each of the service users to learn new things and to obtain new skills. All of the service users are engaged in activities each week which range from attendance at day centres, to classes at college or other activities. They also go shopping and to make use of other things in the community such as the cinema, the pub and other places of interest. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 12 The staff are very good at helping each service user to keep in contact with their families and friends. Family and Friends continue to be made very welcome when they visit the home. There are not many rules at this home. 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 people’s bedrooms or the office if a meeting is happening. The menus, backed up by comments that have been made by service users in house meetings and comments that were sent to the Commission, show that the people who live here are involved in choosing what meals they prefer. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available 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 healthcare needs. 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, although these could be more detailed, 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) 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 Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 14 the staff do know what this is and how to help them to get the treatment that they need. Health action plans are written with the help of local community nurses, and these are now up to date as was previously required. This is a very good way of helping to make sure that everyone who lives here can remain healthy. It should also again be noted that the staff have been trained in how to respond if one of the service users suffers from a particularly bad 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, although an updated copy should be obtained. At the previous inspection it was suggested that when staff return unused medicines to the pharmacy it would be advisable to ask the pharmacist to use their own stamp to show that the medication was received. This is now happening. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service users 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 inspection. The home also records compliments in this same record that they receive from relatives and friends of the service users. 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. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 16 Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users can feel confident that they are living in a well maintained and clean home. EVIDENCE: The house is kept very clean, is a warm and comfortable environment and is free of any unpleasant odours. Service users are permitted to, and do, personalise their own bedrooms with staff support if required. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users can feel confident that there is a well trained 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 supervised in an adequate way. EVIDENCE: There have been two new staff come to work at the home since the previous inspection. Each of these staff have had the proper background checks completed and the home now 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 Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 19 team have this qualification with others either still completing the qualification or to start doing it. The home carries out checks to make sure that the people who work here are safe people to work with the service users. 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. 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. It was recommended at the two previous inspections that the manager attend a training course about supervising staff in a care home setting. It is not acceptable that no further progress has since been made and this must now be acted upon without further unnecessary delay. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users can continue to feel confident that they are living in a home that is doing still more to fully consider the need for future developments. The service users can also feel confident that the necessary health and safety checks are being properly carried out. EVIDENCE: The proprietors, 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 (standard 39.6) and an annual development plan (standard 39.2) that is open to the service users. The service users surveys that have been done were completed in October & November 2005 Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 21 and there is now a quality assurance system and an annual development plan in place. However, both the service users / stakeholders satisfaction questionnaires and the annual development plan must be updated to cover the current year. The following health and safety checks have been carried out within the last year: Fire Alarm System: 30/04/07 Fire Extinguishers: 03/05/06 (now needs updating as just expired) Gas Safety Check: 12/09/06 Portable appliances: 29/11/06 Legionellosis: 09/03/06 (proprietor stated this has been done recently but the report is still awaited) The London Fire Brigade carried out a routine inspection visit to the home on 07/12/05. The report that resulted from that visit stated, “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. A hot water check is carried out weekly, although it was required at the previous inspection that these checks include all hot water outlets and not just a small number of them. This is still being done and a record of these checks was seen at this inspection that showed that hot water is being kept within a safe temperature range. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 22 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 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 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 x Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 (2) (b) Requirement The care plans should now 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) Timescale for action 08/05/07 2. YA36 18 (2) 08/05/07 The style of supervision and 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) Both the service users / stakeholders satisfaction questionnaires and the annual development plan must be updated to cover the current year. 08/07/07 3. YA39 24 (3) Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA8 Good Practice Recommendations 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. Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Park Lodge (45) DS0000007148.V337712.R01.S.doc Version 5.2 Page 26 - 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. 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