CARE HOME ADULTS 18-65
Pearce Lodge 9 Dorchester Road Hazel Grove Stockport Cheshire SK7 5HE Lead Inspector
Jacqueline Kelly Unannounced Inspection 19th June 2007 10:30 Pearce Lodge DS0000008552.V334353.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 Pearce Lodge DS0000008552.V334353.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. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Pearce Lodge Address 9 Dorchester Road Hazel Grove Stockport Cheshire SK7 5HE 0161-483 5442 0161 456 7376 pearcelodge@togethertrust.org 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) The Together Trust Richard Gajewski Care Home 5 Category(ies) of Learning disability (5), Mental disorder, registration, with number excluding learning disability or dementia (5), of places Physical disability (5) Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 5 service users to include: *up to 5 service users in the category of MD (Mental disorder excluding learning disability or dementia 16 years to 25 years of age). *up to 5 service users in the category of LD (Learning disabilities 16 years to 25 years of age). *up to 5 service users in the category of PD (Physical disabilities 16 years to 25 years of age). Date of last inspection 8 March 2006 Brief Description of the Service: Pearce Lodge was developed by Boys and Girls Welfare Society (now known as the Together Trust) in October 1998 to meet the needs of young people and adults who have a disability. The organisation is a registered charity, and has been in existence for more than one hundred and twenty five years, offering a range of services to young people and their families. The services are provided primarily around residential care and education. Pearce Lodge supports five young people who have either a physical and/or a learning difficulty in a bungalow, which is situated, in a quiet residential area on the borders of Hazel Grove and Bramhall. There are shops, a public house, restaurants and swimming pool within a fiveminute walk. Other facilities such as train station; banks, post office, church and cinemas are a short car ride away. Public transport is available but the bus service is limited however the home does have two adapted vehicles. Fees range from £2645.00 to £3682.00 depending on the amount of support, personal care and one-to-one support required. Transport costs for education are not covered; the relevant local authority meets these expenses. There is a statement of purpose and service user guide available along with the Inspection reports. The organisation has the Investors in People Award. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place over one day and one evening. Time was spent talking with the manager Mr Richard Gajewski support workers and young people. Documents were looked for both the young people and support workers all of which provided information that was necessary to meet the needs of the young people. Criminal Record Bureau (CRB) disclosures and other recruitment and selection records were kept at head office; they were not seen during this inspection. On the day of the inspection the home had no vacancies. Questionnaires had been sent to the home for the young people to complete. The manager was looking for an independent person to support the young people to complete the forms. At the time of writing this report none had been returned. Neither the home nor the Commission for Social Care Inspection had received any complaints or any safe guarding adult referrals. The home had recently become aware of the need for the floor to be repaired in the kitchen. The outcome of the need for a new floor will require a new kitchen, which had already been ordered. Once the major work has been done the corridor and two of the bedrooms will be decorated and re-carpeted. The support workers had raised money to improve the garden area to make it suitable for people who use a wheelchair. Work is due to start within the next few months. The young people are encouraged and enabled to achieve as much independence as their capabilities would allow. What the service does well:
All the young peoples’ bedrooms reflected their individual personalities such as; one had posters, curtains and bedding in Manchester United colours. They were also supported to access their own beliefs and culture as far as they were able. Health care needs were met by the support workers however wherever possible the young people were encouraged to take as much responsibility as they could. On the day of the inspection all of the residents were out following their various activities. Two weeks prior to the inspection all had been on holiday to Centre Parcs, which had been enjoyed by everyone.
Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 6 The inspector returned one evening to see the young people. One was practising their DJ skills as they were hosting a birthday party at another establishment the following evening. Others were watching their favourite soap on television or having a bath. The support workers and manager were welcoming and had good relationships with the young people, which showed in the young peoples happy and relaxed manner. One person said that they liked living at Pearce Lodge and the staff were ‘great’. Relatives were welcomed, kept informed, encouraged to visit and take part in house parties for birthdays, Christmas and other special occasions. The young people were kept informed of events and planning of menus through the weekly Sunday house meetings. All the support workers either had a National Vocational Qualification (NVQ) Level 3 in promoting independence or were working towards it. The organisation had also provided mandatory training such as food hygiene, first aid, safe guarding adults and safe handling of medicines. Support workers were given regular supervision where their training and development was discussed. All the support workers who were spoken with were happy working at Pearce Lodge and said that they received good support from the manager and fellow workers. What has improved since the last inspection?
The organisation had set up a group, which was made up of a senior manager and support workers from each of the units under the heading of ‘Participation Champions’. The aim is to promote the views of the young people in order to provide a service, which meets with their wishes and choices. In conjunction with the ‘Participation Champions’ a computer programme has been set up called ‘Viewpoint’ which will provide further opportunities for the young people to air their views and make comments about the place they live in. There were quality systems in place, which included a feedback questionnaire, which was sent to relatives and representatives every six months. The newly appointed quality assurance officer visited the home regularly and followed up with a report. Other documentation in the form of ‘handover sheets’ had been introduced which ensured that there was effective communication between the staff group. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 7 The young people were now being invited to staff meetings as well as attending the weekly Sunday meetings. 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. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard1,2. Quality in this outcome area is excellent. Prospective residents for the most part received sufficient information and went through an assessment and transition process that assured them their needs would be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose needs to be amended to describe what the home sets out to do specifically for young people aged sixteen and seventeen in order to meet with the supplementary standards. All the young people were only admitted on the basis of a full assessment, which was provided by the relevant local authority, and the organisations own assessment process. Prior to being offered a permanent place the young person visited the home in a planned and structured way, which fitted their personalities and circumstances; this could take up to twelve months. Relatives were also encouraged to visit the home and ask as many questions as they felt necessary. All had a placement plan irrespective of their age, which stated their assessed needs, the objectives of the placement, and how these were to be met, by the home on a day-to-day and long term basis. The placement plan also included Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 10 transition plans for those young people nearing or becoming twenty-five years of age. The organisation had introduced ‘Participation Champions’ and ‘View point’ both of which had been set up to improve the way in which the young peoples views and opinions could be sought. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,9. Quality in this outcome area is excellent. The care plans reflect the young peoples needs and requirements to enable them to lead as independent life as their capabilities would allow. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Person centred plans and risk assessments were in place and were reviewed at regular intervals or when circumstances necessitated change. The organisation was hoping to improve the format of the care plan over the next twelve months to make them easier to use for everyone. House meetings took place every Sunday when the following weeks menu was planned, activities chosen and day-to-day running of the home discussed. The young people were also now being invited to team meetings. Weekly planners were in place, which showed; day care, education, health care appointments and planned activities appertaining to the young person.
Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 12 Handover sheets had been introduced for staff to complete in order to improve communication. ‘Participation champions’ and ‘Viewpoint’ (a computer programme) had been introduced to gain the views and opinions of the young people who use the services of the ‘Together Trust’. All the young people had an advocate who was in the main a relative. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16,17. Quality in this outcome area is excellent. The young people accessed education, community/leisure facilities and maintained family contact. The support workers respected the young peoples rights. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each of the young people had an individual activity plan. All attended college or other groups such as ‘Stockport Skills Group’ throughout the week. One person was at present on work experience organised through college. On the day of the inspection all the young people were out so the inspector returned in the evening to see them. Activities which the young people had taken part in over the past months during their leisure time were; shopping, going to the pub/restaurant, hydrotherapy pool, swimming at local swimming pool, football, gym, cinema, golf and holidays. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 14 Planned theme nights had been organised throughout year where different cultural beliefs were celebrated. Pictures of special occasions were displayed for everyone to see. Maintenance of family and friend relationships was encouraged either within Peace Lodge or with visits to the family home. All visits home were within the guidance on the care plan. The young people were encouraged to maintain and improve their independence and daily living skills as far as their capabilities would allow. The aim was to prepare the young person with as many skills as possible to live in the community either independently or with the support required. The young people discussed menus at their weekly meetings and any other issues about the day-to-day running of the home. The dietary requirements, which reflected the young peoples cultural needs, were met. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 15 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): Standard 18,19,20. Quality in this outcome area is excellent. The young people received support, which ensured that their personal, social and health care needs were fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The overall function of the home is to prepare the young people to live in the community as independently as possible. Each of the young people had a key worker and a co- key worker who were responsible for ensuring that the requirements of the support plan were carried out. The plan contained the young peoples likes and dislikes together with their personal care needs and educational needs. All had a health care booklet and all were supported to access doctors and other professional medical services. All of the young people looked well nourished and were dressed in an age related manner. None of the current group of young people was capable of managing their own medication. Support workers had received training in administering medication. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 16 Awareness training on the dangers of drug and alcohol abuse and sex education was provided to the young people as and when necessary. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 17 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): Standard 22,23. Quality in this outcome area is excellent. The ‘Together Trust’ and the support workers at Pearce Lodge protected the young people through the complaints procedure, training and daily monitoring. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was a comprehensive policy and procedure for reporting complaints and protecting the young people from abuse. Complaints were a standing item at the house meetings. ‘Together Trust’ acknowledged that it could be difficult for some of the young people to voice their concerns due to communication difficulties. Therefore the organisation was putting in place a system to allow the young people access to a computer programme that will give them a chance to air their views anonymously. Neither the home nor the Commission for Social Care Inspection had received any complaints or safe guarding adult referrals. The home had introduced daily handover sheets (one for each young person), which was a formal process to monitor their daily well being. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 18 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): Standard 24,30. Quality in this outcome area is excellent. The home was clean, well maintained and decorated to a high standard. All furnishings, fittings and equipment were in good condition and suitable for the needs of the young people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A fault had been found with the kitchen floor, which means that a complete new floor is to be laid and as a result of this is a new kitchen is also to be fitted. The planned re-decoration of the corridor and two of the bedrooms has been delayed until the work has been completed. The remainder of the home was well decorated and furnished according to the needs and preferences of the young people. The home was clean and free from offensive odours. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 19 The garden was soon to be re-designed to make it more easily accessible for people who use a wheelchair. The staff at Pearce Lodge had raised money for this project. The manager was now able to employ local people to do maintenance jobs around the home and was currently looking to employ a handyman whose hours would be shared with another establishment so that it would be a full time post. A planned maintenance programme would be established with the handyman when appointed. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 20 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): Standard 34,35. Quality in this outcome area is excellent. The recruitment and selection methods used ensured that suitable care workers were employed. Experienced and trained care workers looked after the young people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The organisation had a recruitment and selection policy, which included the completion of an application form, references, interviews and Criminal Record Bureau checks. None of these were seen at the home as all documentation is kept a head office however those support workers who were spoken with confirmed that they had gone through a recruitment and selection process. The interview consisted of a panel, which did not include any of the young people who use the service apart from ‘meeting and greeting’ or ‘information days’. However the young people had been involved in drawing up the type of questions to be asked at the interview. To try and improve the young peoples participation in the process the organisation was reviewing there procedures to involve the young people more
Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 21 such as; inviting potential recruits to the home to have tea or join in an activity. The supervision files were looked at and found to be satisfactory. Learning and development were part of supervision with support workers having taken training in the Learning Disability Award Framework (LDAF) training and National Vocational Qualification (NVQ) Level 3. The staff who were spoken with during the inspection liked working at Pearce Lodge and felt that they had good support from the managers and other staff members. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 22 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): Standard 37,39,42. Quality in this outcome area is excellent. The home was run for the young people by a staff team who were experienced and were aware of the development, health, and safety needs of the young people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has the necessary qualifications and experience to manage the home. He also ensured that the health and safety needs and requirements of the young people and support workers within the home were met. The newly appointed Quality Assurance officer was now making monitoring visits to the home, which were previously done by a senior manager. The forms that are completed after each visit are to form the basis of the annual quality assurance report. This report should be sent to the Commission for Social Care Inspection and made available to the young people and their
Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 23 relatives or representatives. The manager has agreed to send the report to the Commission by the 31 September 2007. As the home is part of a larger organisation which is a registered charity accounts are published each year. Each of the units within the organisation is required by senior management to develop a team plan, which will be linked into the organisations strategic plan and will include the development plans for the next twelve months. Once this has been completed the manager will forward a copy to the Commission. The young peoples relative are sent a questionnaire every 6 months asking for their opinions about the service. Their opinions and views are taken into account for future planning. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 24 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 2 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 x 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 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 3 x x 3 x Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 25 Partially met. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA1 YA39 Good Practice Recommendations The statement of purpose and service user guide should provide information as to who the needs will be met of people who are between the ages of sixteen and eighteen. A copy of the quality assurance report, which is specific to Pearce Lodge, should be sent to the Commission for Social Care Inspection. Copies should also be made available to service users or their representative. Pearce Lodge DS0000008552.V334353.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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