Inspection on 08/03/07 for Park Lodge

This inspection was carried out on 8th March 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 10/01/08

Park Lodge 09/11/05

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Park Lodge Park Avenue Roker Sunderland Lead Inspector Gillian McCabe Key Unannounced Inspection 8 and 9th March 2007 1:30 th Park Lodge DS0000063966.V299135.R02.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 DS0000063966.V299135.R02.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 DS0000063966.V299135.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Lodge Address Park Avenue Roker Sunderland 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) 0191 5490321 Autism North Limited Michael Winter Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th November 2005 Brief Description of the Service: Park Lodge is a very large detached domestic house, which was built during the turn of the 20th century. Park Lodge was opened in May 2005 and prior to that Autism North had completed considerable refurbishment works to the building. Park Lodge, which was registered in May 2005, provides personal care for young people and young adults who have Learning Difficulties. The current age range is from 17 - 25 years. All of the current residents pay fees of £2096 per week; however the amount the person pays will depend upon the financial assessment completed by social services. Each person’s social services department pays the majority of the weekly fee. The home has three floors. The eight en-suite bedrooms, lounges, dining room, large kitchen and laundry are located on the first two floors. A sloped drive leads to the main entrance to the home and a yard is at the rear. The building is spacious with two lounges and sitting areas for the people who live here to choose from. It also has access for the person who has a physical disability. The adjacent house is also owned by the same organisation and offers a similar service. The house like the adjacent has its own entrance and separate staff team and is run largely independently. Park Lodge is located about one hundred metres from the main road running along the sea front at Roker, Sunderland. It is opposite a large park and close to shops and local entertainment. Bus routes to Sunderland and South Shields are located on the main road close to the home. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced visit. They spent the day speaking to people using the service and staff. The inspector also looked around the houses and checked the standard of the record keeping. Park Lodge cares for younger adults with an Autism Spectrum Disorder. The residents have difficulty understanding abstract thoughts. And, find changes in routine very difficult. Also they find it hard to understand other people’s needs and feelings. Some residents find meeting strangers extremely challenging and if given the option would not like to spend time talking to new people. These people’s wishes were respected. Prior to the visit the inspector looked at comment forms from people had been at the home. Several residents’ care was tracked through what people said and looking at the service user plans and other records. Staff practice, attitude and approach were also watched and judgements made on how well staff worked with people. During this inspection all of the key standards were checked. What the service does well: The manager, deputy manager and staff are very skilled. Staff have shown that they are able to successfully work with people who have Autism Spectrum Disorders. They understand the difficulties people with Autism Spectrum Disorder have and care a great deal about the residents. The home has been open just over 18 months. The manager oversees the running of the home next door, which has been open 3 years and is well managed. The staff team is made up of people who have worked with people with Autism Spectrum Disorders, people who have worked in care before and some who have not. The manager and deputy manager have worked hard and been successful in shaping a team that work together well and with the common goal of making sure all of the residents are looked after and helped to find ways to become more independent. Relatives said ‘ park Lodge is a lovely place to visit. My son is very happy there. The staff are very friendly and approachable. I feel standards at Park Lodge are very high’’. The staffing levels at Park Lodge are very good and this means that the people who find it very difficult going out can still join in activities they like because two to three staff go with them. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 6 Autism North runs a day centre, Gorse House, which has rock climbing facilities, cinema, a swimming pool, cafe and craft workshops. This means that all the residents can try something new and experience things many take for granted. Also the owners have worked with a local college and now a lot of the residents go there and college staff stay with them at these times rather than the home staff. Residents have really enjoyed this experience. Autism North runs care services specifically for people who have an Autism Spectrum disorder and have an excellent understanding people’s needs. The owner always try to make the services better and that staff use up to date practice. They employ some health care professionals including a psychiatrist and they help staff find ways to meet residents’ needs. Park Lodge is a converted private residence and the owners have made sure the room sizes are above those required in the standards. Thus all of the bedrooms are well in excess of 12m² and are equipped with an en suite bathroom. The lounges and dining rooms are large and roomy. What has improved since the last inspection? What they could do better: A third of the residents use sign language such as Makaton communication systems. Although staff have had basic training in this they do not have all the skills needed to understand what people are saying. Prior to writing the report the manager got in touch to say he has arranged for staff to have more in depth training on using sign along systems. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 7 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. Park Lodge DS0000063966.V299135.R02.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 DS0000063966.V299135.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are filling assessments out to shows how they work with residents. Information about fees and contracts are not available. More work is needed for residents to be confident that staff know how to work with them. EVIDENCE: Blank contracts are included in the service user guide. But the signed copies, which have the fee levels or the local authority placing agreement, are kept at the home. The local authority placing agreements sometimes say how many staff they want for a person. Without contracts people cannot check that the service they are getting is what they expected and value for money. Autism North is working with local authorities to get the agreements. Case tracking showed that before anyone moves to this home a full assessment of their needs is carried out. Everyone involved in the resident’s care can help decide if the service is right. However, it takes staff a number of months to write all of this information in their records so for some people bits were missing. The staff do work hard to produce detailed reports and show all of the residents needs and aspirations. Staff find the format a bit confusing and repetitive so the manager is looking to see if still asks for the right information and whether it can be made better. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents’ and relatives are involved in working out how best to meet their needs and goals. Records are starting to show how staff work with residents but need more information to show that residents’ needs are met. EVIDENCE: The manager and staff have writing out care plans, risk assessments and behavioural guidelines. Case tracking showed that sometimes the information could just as easily refer to some one else at the home, as it was not completely specific to the person. The risk assessment formats give general information about the presenting risk and actions staff have to take to reduce or work with the risk. No information was recorded about how to communicate with people who used Makaton such as what a certain sign meant or how to use photo boards. The manager is looking at how to make the records show all of the good practice seen at the home plus be easier for staff to follow and complete. Park Lodge DS0000063966.V299135.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are helped to choose how they live but staff need to work with relatives to make sure residents desires are treated as the main goals. Residents that use languages other than English do not have staff at hand that fully understand what they are saying. Thus, not all of the residents can be confident that their needs will be met. EVIDENCE: Case tracking showed that one person family were members of a particular religion and before moving to the home that had been a practicing of this church. Staff felt that some of the practices such as being vegetarian and dress code were not strictly in line with the religious practices. Although a church following this religion was close by staff had not been to find out more about the religion or to see if the resident could attend. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 12 Three people use sign language systems, as the main way of communicating and the home had said they could met these people’s needs. Staff said they had recently been on a one-day course about using specialist visual language systems and found this very useful for talking to residents. Staff said that now they understood some of the symbols residents were less frustrated as they could make staff understand what they wanted. This had meant that residents did not get angry and therefore staff did not need to use physical interventions as much. Although staff were very keen to have more of this training none of the staff could be classed as fully competent at using sign language and other types of communication methods for people with limited verbal language. It would be expected that before anyone with these types of needs were offered a service that staff would have the necessary skills to talk to them. Following the inspection the manager made sure that staff were given more training in the use of communication methods. He expects to make sure that at least the core staff are competent using sign along communication and picture boards. Family are constantly involved in the care of their loved ones and are aware of how staff are working with people. 6 out of 8 relatives who sent in comment cards were pleased with the service saying ‘we are very happy with the general standard of care’. Other people said ‘ it is okay it but needs to be more personcentred and a better use of care plans’. Case tracking showed that sometimes resident’s wanted to one thing but their relative did not agree that this was right. The staff tend to take on board relative’s views and not go with the changes. However, this means residents have restrictions on choices imposed and are not helped to become more independent. It was recognised that relatives want the best for the resident but with the introduction of the Mental Capacity Act staff must show that the actions they take on behalf on residents take account of what they want. People with Autism Spectrum Disorders find it difficult to form meaningful relationships, understand other people’s needs and prefer fixed routines. However staff have not become fixed in the way they work with people. Residents are helped by staff and specialists to learn about social skills and how to form relationships with others. A number of residents now go to a local college and need less support from staff at these times. This has been achieved because of the skilled ways staff have worked with residents to help them cope with change. The cook is very skilled and makes sure healthy, balanced diets are provided. She is good at making residents meals interesting and appealing. Park Lodge DS0000063966.V299135.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Systems for making sure resident’s physical and emotional health needs are looked after work well. Thus residents can be confident that their health and emotional needs will be met by the service. EVIDENCE: The staff have a very good understanding of Autism Spectrum disorder and how to meet people’s needs. Staff recognise changes in people’s health and help people to go to the local doctors. The owners employ health care professionals who help staff to meet residents’ needs. Staff have made sure the medication is stored and given out properly. The records were satisfactory. Resident’s are not able to look after their medication. The psychiatrist often makes changes to the medication in order to improve people’s well being. However he must bear in mind that if active treatment is being delivered at the home the registration may needs to change to a private and voluntary hospital. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The owners have shown that they will check that the service is working well, help people to raise concern and take all actions necessary to resolve issues. Thus, residents can expect that poor practice will not be tolerated. EVIDENCE: The complaints procedure is made available to residents and relatives through the service user guide as well as being sent out separately as a reminder. Relatives said ‘I think overall the standard of care is good and the staff team seem caring and pleasant’, ‘the staff are very friendly and approachable. Case tracking showed that when people had raised concerns such as staff not always meeting people’s personal care needs staff treated these seriously and took action to resolve the issue. The manager tries to make sure relatives feel able to raise concerns. But with this being a relatively new service it is taking time to make everyone feel confident that their concerns will be dealt with fully. Park Lodge has an appropriate protection of vulnerable adults policy and follow Sunderland Social Services Department guidance. Staff do not have experience of using the procedures, as allegations of abuse have never been made but staff receive regular training and up dates. Senior managers are aware that if residents or staff behave abusively that this must be looked under the POVA guidance, and CSCI need to be alerted. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Park Lodge is well maintained and has been thoughtfully up graded and refurbished to meet the needs of this resident group. EVIDENCE: Park Lodge is a converted private dwelling. Autism North have completed extensive works to up grade the home. Eight places are currently offered. All of the bedrooms are in excess of 12m² with one bedrooms layout making it ideal to use almost as a bed sit. All of the bedrooms have en suite bathrooms. Park Lodge has a homely feel and is attractively decorated with good quality furniture that suits the age and lifestyle of the people who live there. Resident’s bedrooms are decorated in keeping with their age and likes. The home has two comfortable lounges, one is used as a quiet area and service users were seen to make good use of these sitting areas and also of their own bedrooms for privacy. All areas of the home examined were seen to be clean. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The good staffing levels and range of training people get means that on the whole residents can be confident that their needs are met. EVIDENCE: At least 8 staff are on duty during the day and waking night staff are employed. Many of the residents have very complex needs and without these good staffing levels would not be able to join in the range of activities they do. Some residents need to have two to three staff stop with them so that they remain safe inside and outside the house. Park Lodge employs a housekeeper, who prepares the meals. She is knowledgeable about people’s needs and makes sure the menu is meets peoples’ likes and gives a balanced diet. The manager is supernumerary. The staff files include a range of appropriate information. The manager told about new legislation related to age, diversity and protection of staff from harassment that will need to be incorporated into the recruitment practices and management policies. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 17 The manager now is in control of the training programme and makes sure staff get the training they need and in a timely fashion. 21 of staff have completed NVQ level 2 with remaining staff are being helped to complete this award. Some of the staff have also completed level 3 awards. Staff have been going training about how to make sure people’s equality and diversity needs are met plus insight into the Mental Capacity Act. Also staff have received basic training on using sign along methods for people who do not have verbal language. The manager has recently arranged for staff to have more training in this area. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management systems on the whole meet the needs of residents living at Park Lodge. EVIDENCE: The manager is a very competent. He recently finished the registered managers award and makes sure his practices are up to date. A deputy manager helps him run Park Lodge. She has been responsible for making sure the day-to-day practices meet the needs of people. The staff team are very friendly, helpful and have a good knowledge of people’s needs. Autism North has developed a robust quality assurance system. The operational manager completes different audits and uses this improve the service. The manager has recently ordered door guards, so fire safety is met. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 2 3 X 4 X 5 2 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 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 2 12 2 13 3 14 X 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 20 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 YA1 Regulation 5 (3) Requirement The owner must provide a copy of the local authority placing agreements to service users or their representative and should keep a copy in the home. Staff must make sure they understand people’s religious beliefs and cultural practices Sufficient staff must be competent when using Makaton and other communication methods to assist residents participate in all aspects of daily life. Timescale for action 13/07/07 2. YA11 12 13/07/07 3. YA15 18 11/08/07 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 YA6 Good Practice Recommendations Further development of care plans and recording systems should continue DS0000063966.V299135.R02.S.doc Version 5.2 Page 21 Park Lodge 2. YA18 The employed healthcare professionals should not use the service in a manner that would suggest clinical and nursing treatment is being delivered by the owners and residential care staff. If it is a service to be offered the owners should re-register as a private hospital. Park Lodge DS0000063966.V299135.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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