Inspection on 27/09/05 for Park Lodge Care Home

This inspection was carried out on 27th September 2005.

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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park Lodge Care Home 15/09/08

Park Lodge Care Home 13/07/06

Park Lodge Care Home 12/04/05

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

CARE HOME ADULTS 18-65 Park Lodge Care Home 249 - 251 Victoria Park Road Hackney London E9 7BQ Lead Inspector Robert Sobotka Unannounced Inspection 27th September 2005 10:20 Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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 Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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 Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Park Lodge Care Home Address 249 - 251 Victoria Park Road Hackney London E9 7BQ 020 8533 2425 020 8533 3103 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) Sanctuary Care Limited Ms Jean Hoyte Care Home 20 Category(ies) of Past or present alcohol dependence (20), Past or registration, with number present drug dependence (20), Mental Disorder, of places excluding learning disability or dementia - over 65 years of age (20), Physical disability (20) Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th April 2005 Brief Description of the Service: Park Lodge is a residential home, which is registered to provide care up to 20 service users with past or present alcohol dependence, past or present drug dependence, mental disorder, excluding learning disability or dementia - over 65 years of age, and physical disability. The home is owned by Sanctuary Care Ltd, which is a non-for-profit organisation. The building has ground and two upper floors, and is divided into 20 self-contained flats. The communal areas consist of: a sitting room, a dining room, an entrance lobby, a small laundry room and a garden at the back of the house. Park Lodge is situated in Hackney, near Victoria Park. It can be accessed by a number of busses from various parts of East London. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day and was unannounced. The inspector spoke to some of the service users accommodated in the home, some members of staff and the registered manager. The inspector also conducted a tour of the premises and viewed various records. The aim of this unannounced inspection was to check the home’s progress towards full compliance with the legislation. What the service does well: What has improved since the last inspection? The home has now employed a new chef and those spoken to stated that they were happy with the quality of food offered. The inspector was also satisfied that there has been an improvement in activities offered to the service users. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 6 Staff continue to obtain their National Vocational Qualifications. They have also received training in relation to drug and alcohol awareness. The home has also got a new administrator, who works on a part-time basis. 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. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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 Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. The home’s Statement of Purpose required updating. Good admission system was in place. EVIDENCE: The home’s statement of purpose required further updating. The service users’ guide has been further developed as required during the last inspection visit. There have been one new admissions to the home since the last inspection. The home manager carried out a thorough assessment to ensure that the home was able to meet the needs of prospective users. Apart from meeting with prospective users, she also liaised with other professionals involved in the person’s care. Prospective users were invited to visit the home to see the environment, meet other people who use the service and to meet staff working there. They could have a meal in the home. Overnight stays were organised. This standard continues to be met. Each service user also had a costed contract/statement of terms and conditions in place. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. The home had a good care planning system in place and service users and/or their representatives were actively taking part in the care planning process. Those who use the service were encouraged to take part in making decisions relating to the care they needed. EVIDENCE: The inspector viewed 4 care plans, which were chosen at random. Previous inspection visit identified that the quality of care plans varied depending on the experience of staff. The inspector was satisfied that the registered manager has worked with her staff to ensure that consistency in a way care plans are written is achevied. All care plans viewed were up-do-date, they were regularly reviewed. In one case where the service user refused to sign their care plan, this was recorded accordingly. The recommendation from the previous inspection visit that any refusals of keyworking sessions should be recoded in individual care plans has now been met. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 10 The service users’ meetings were regularly held, during which those who used the service were asked some questions about their views as to how the home should be run. The service users were seen making choices during the course of this inspection. Each individual care plan viewed had relevant risk assessments in place. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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): 12, 13, 14, 15, 17. Those who live in the home were encouraged to pursue their education and to seek paid and meaningful employment. There has been an improvement in the level of activities offered to service users. The service users enjoyed food in the home. EVIDENCE: Some of those who spoke to the inspector said that they were attending colleges and daycentres. Following discussion with those who lived in the home, reviewing individual files and interviewing staff working in the home, the inspector was satisfied that there has been an improvement in the level of activities offered to service users. The home organised monthly home outing, such as: visit to the aquarium, trip to Southend-on-Sea and Brighton, trip to Madame Tussauds and cinema. Those who lived in the home were also able to go out in the community independently. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 12 Families and visitors are welcome to the home. Visitors are required to sign the visitor’s book. Members of staff working in the home were respecting the service user’s rights. They spoke to service users kindly and were friendly. Those who lived in the home were invited to participate in weekly house meetings, during which they could make any suggestions about how the home should be run and what could be improved. Most of the people living in the home, who spoke to the inspector, said that they were very happy with the care and support offered to them. The home has now got a new chef. She has previous experience of working in the home. The inspector viewed the kitchen premises, which were kept clean and hygienic. All food was appropriately stored and all food safety checks were carried out on regular basis. The chef said that she was very happy working in the home and it was evident that she has established a good rapport with the service users and was aware of their dietary needs, likes and dislikes. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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, 20, 21. Service user’s physical and emotional health needs were being met. Medication systems were well managed, however further work was needed to improve recording of medication administered to the service users. EVIDENCE: Care plans viewed showed that those who live in the service received appropriate care from the healthcare professionals. Each care plan included section on how the service user should be encouraged/supported in maintaining his/her personal care, this included comprehensive and clear guidelines for staff. Medication systems were found to be satisfactory, however recording on medication administered to the service users required improvement. The current systems require service users to sign for medication on the MAR (Medication Administration Record) sheet, and staff countersign a separate sheet. Records viewed on the day of inspection contained some entries made by service users in wrong places and one signature written over two spaces. The inspector discussed this issue with the registered manager and suggested that MAR sheets should be signed by staff responsible for administering medication, and service users are asked to sign a separate sheet, which could Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 14 contain larger spaces to make signing for medication easier for those with poorer eyesight etc. The inspector was satisfied that the issue of exploring individual service user wishes in relation to illness, death and dying has now been addressed. Individual care plans viewed on the day of this visit contained relevant information in relation to this matter. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Those who use the service were free to make complaints, which were promptly and efficiently dealt with. They were also protected from abuse neglect and self-harm. EVIDENCE: Those people who spoke to the inspector said that they felt comfortable to complain and said their concerns were quickly dealt with. The complaints procedure was available for viewing in the main hall. Service users were also free to bring up any concerns during the home meetings. The home had an Adult Protection Procedure and a Whistleblowing Policy in place. Members of staff who spoke to the inspector were aware of adult protection issues. All accidents were clearly recorded and all records/ documentation were reviewed by the manager on a regular basis. The majority of people managed their own finances. Where it is felt that support or guidance in managing finances is needed by service users, this is readily available from members of staff. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Service users would benefit from a more homely environment. Individual flats required updating and new furniture. Some flats required cleaning. EVIDENCE: The condition of the premises remains unchanged. The home appeared to be uninviting and some areas required cleaning. Some of the furniture required updating. The home manager said that each flat would be redecorated, new carpets would be laid throughout the building and new furniture would be purchased. Some of those who used the service said that they would like to have television sets provided in their rooms, as opposed to just in the communal areas. At the time of the inspection the home did not provide accommodation for those requiring specialist mobility equipment, however all floors of the premises can be accessed by those who use wheelchairs. As previously mentioned, the registered manager stated that the redecoration work was due to commence at the end of September. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 17 The inspector was also informed that there were plans to increase the number of bedroom to 23. This required approval from the Commission. The responsible person must therefore submit an application for the major variation (in respect of the proposed increase of number of service users accommodated in the home) to the Commission. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35, 36. Service users were supported by an effective staff team, which was appropriately selected, managed and supervised. EVIDENCE: There were no staff vacancies at the time of this inspection. Staff spoken to stated that they were happy with the way the home was run and with the training offered to them. The requirement for staff to receive training in drug and alcohol awareness has now been met. 7 members of staff have obtained their NVQ Level 2 qualifications, in addition one person was awaiting her certificate. Four members of staff were working towards achieving NVQ Level 3. Staff personnel files were not checked during this inspection, as they were checked and found in order during the last inspection visit. Staff continue to receive regular supervision sessions and attend regular staff meetings. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 19 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, 42. Those who live in the home benefited from a well-run service, which is managed by a competent manager. The health and safety records were up-todate, however some equipment required replacement/testing. EVIDENCE: The home is managed by a competent manager, who is a registered nurse and has a relevant management qualification. Those who spoke to the inspector gave positive feedback about her openness and management style. Health and safety records kept in the home were well maintained. Regular fire safety, hot water temperature and fridge/freezer temperature checks were being carried out. Regular monthly unannounced visits from the responsible person were carried out and reports from those were also forwarded to the Commission. The home’s electrical wiring certificate issued in September 2004, which was valid for one year, stated that the wiring was unsatisfactory. This work was Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 20 due to be rectified during the forthcoming building works to be undertaken in the home. This is a repeat requirement and must be met without further delay. Landlord’s Gas Safety Certificate has been obtained since the last inspection visit. Portable Appliances Testing was overdue. The home had appropriate insurance cover in place. Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Park Lodge Care Home Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 X DS0000061585.V256506.R01.S.doc Version 5.0 Page 22 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 YA30 Regulation 16(2)(j) Requirement Ensure that all parts of the building, including service users flats, are kept clean. This might involve supervision and/or support provision to the service users. (Timescales of 15/05/04, 01/10/04 and 01/06/05 not met.) The responsible person must ensure that the home’s Statement of Purpose is further developed. The registered manager must esnure that each service user is provided with furniture and fittings sufficient and suitable to meet their needs and lifestyles. Any old/worn furniture must be replaced. (Previous timescale of 01/08/05 was not met.) All portable appliances must be tested without delay. The electrical wiring in the home must be rectified without delay. (Previous timescale of 01/08/05 was not met.) Timescale for action 01/04/06 2 YA1 4 15/11/05 3 YA26 23(2)(c) 01/04/06 4 5 YA42 YA42 23(2)(c) 23(2)(b) 01/01/06 01/04/06 Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 23 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. 2 Refer to Standard YA24 YA20 Good Practice Recommendations Explore and implement ways to provide a more homely atmosphere. It is recommended that MAR sheets are signed by staff responsible for administering medication, and service users are asked to sign a separate sheet Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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. Extracts may not be used or reproduced without the express permission of CSCI Park Lodge Care Home DS0000061585.V256506.R01.S.doc Version 5.0 Page 25 - 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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