Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: Pegasus Lodge 22 Lee Brigg Normanton Wakefield West Yorks WF6 2JJ The quality rating for this care home is:
three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Railton
Date: 1 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home
Name of care home: Address: Pegasus Lodge 22 Lee Brigg Normanton Wakefield West Yorks WF6 2JJ 01924896713 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Real Life Options care home 6 Number of places (if applicable): Under 65 Over 65 0 0 0 learning disability mental disorder, excluding learning disability or dementia physical disability Additional conditions: Date of last inspection Brief description of the care home 6 6 6 Pegasus Lodge is a home for six adults with special needs run by Real Life Options. There is a small and caring staff team who are experienced in providing care and support to this service user group. Pegasus Lodge is situated on the outskirts of the small town of Normanton which has a good range of shops and community facilities. There is also good access to Wakefield, Pontefract and Leeds through local transport services and the home has its own minibus. The home is built on two floors, set back from the road behind a small car park. The surrounding area is of other residential property. Each service user is provided with a single bedroom with two downstairs bedrooms being joined through a large, well-equipped bathroom, which both rooms share. There is a good sized and nicely kept rear garden, which is safely enclosed offering a pleasant area for sitting out. Service users are encouraged to access local community facilities, including attendance at college and Local Authority-run day Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home services. On 24 May 2007 the fees for living in the home ranged between #975.70 and #1201.53. Further information regarding the service and the CSCI can be obtained from the home. Care Homes for Adults (18-65 years) Page 5 of 27 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home
peterchart Poor Adequate Good Excellent How we did our inspection: Following this visit the service has been given a Three Star rating which means people living in the home experience excellent quality outcomes. This visit commenced at 08:00 and ended at 12:30. During the visit there was the opportunity to meet everyone living in the home, the registered manager, support workers, the homes driver, and Area Manager. Some peoples records were seen and included assessments, support plans, reviews, daily and medical records. Some staff records were seen and included application forms, interview notes, references, Police and POVA (Protection of Vulnerable Adults List) checks. Staff training records were seen, and some supervision notes. Other information considered included the previous inspection visit report, the CSCI service History, annual quality assurance report and Regulation 26 providers visit reports. Other information included the maintenance records and fire equipment Care Homes for Adults (18-65 years)
Page 6 of 27 testing records. There was the opportunity to observe the morning routines and the way people live their daily lives. This was a very positive key inspection visit and the inspector would like to thank the people living in the home, the manager and the staff team for their hospitality and patience throughout the visit. What the care home does well: What has improved since the last inspection? For the comfort and benefit of people living in the home the Registered Manager says a number of bedrooms have been redecorated since the previous inspection visit. A tour of the premises confirmed this. There has also been some work to improve the garden for people to relax in the summer months. To make sure peoples needs are met by qualified staff the records show all staff have a Care Homes for Adults (18-65 years) Page 8 of 27 National Vocational Qualification at level 2 or above or are currently registered on NVQ courses. To make sure peoples health care needs are fully met staff have had specialist training for some as necessary medication prescribed for some people living in the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings
Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To make sure peoples care and support needs are met these are assessed before coming to live in the home and are reviewed regularly with peoples and their relatives involvement. Evidence: Records show peoples assessments are very comprehensive and detailed this enables the home to provide the care and support they need and require. Because people living in the home have profound disabilities that include difficulties with communicating the assessments include peoples facial expressions, body language, gestures and the noises they make. To help staff to communicate better and understand the assessments records show they have Intensive Interaction Training. This training along with experience of working with people with profound disabilities helps them understand how people are feeling and what their personal needs are. Discussion with support workers found they have a good understanding of the needs of people living in the home. Care Homes for Adults (18-65 years) Page 11 of 27 Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assisted to make decisions about their lives and their choices and preferences are set out in their support plans. Evidence: Records show to make sure peoples care and support needs are met these are set out in their support plans. The support plans are very detailed and include instruction on how people communicate their care needs. The care plans include peoples facial expressions, body language and noises and a description of what they mean. Observation of two support workers found they are very skilled at interpreting peoples movements and gestures and responding accordingly. Support workers were also observed using limited Makaton signing with one person that appeared to be very effective. People were observed making decisions about what they did and were they went within the home. The support plans also contain peoples likes , dislikes , choices and preferences. The daily records contain descriptive words to reflect and show peoples choices. The reviews show and record the involvement of peoples relatives,
Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: specialist Social Workers and Community Learning Disability Team Nurses. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assisted and supported to access ordinary leisure services, to be part of their local community and to live as ordinary a lifestyle as possible. People are offered a varied and balanced diet of their choice. Evidence: Despite having profound disabilities the records show people are supported to live as ordinary a lifestyle as possible. Records show people attend Local Authority run day opportunities. Records also show people are supported to be part of the local community by using the library, shops, supermarkets, cafes and restaurants, public houses and clubs. Records also show people enjoy swimming and benefit from such therapeutic activities as reflexology. The photographs displayed confirmed people enjoy holidays and outings to the coast and weekend stays with their relatives. Records show there are risk assessments completed to enable people to take part in
Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: these activities. Discussion with the Registered manager and support workers found they are very committed to ensuring people enjoy living an ordinary lifestyle. The Registered manager says the home has its own transport, a people carrier and a driver to assist people participating in activities. The inspector was impressed with the positive attitude of the staff team and the efforts made in accessing ordinary community based services. The menus show people are offered a varied and balanced diet of their choice. The assessments are very comprehensive and show peoples likes dislikes choices and preferences with regard to menu. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. To make sure peoples health care needs are met they are supported to use ordinary community based health care services. They are also protected by the way medicines are dealt with and the specialist training offered to support workers. Evidence: To make sure peoples health care needs are met they are supported to use ordinary community based health care services. However, some people are also supported by the Community Learning Disability Team Nurses and hospital based consultants. The reviews show people and their relatives and other visiting professionals are fully involved and have a say in how peoples health care needs are met. To make sure peoples health care needs are fully met staff training records show they have Moving and Handling, First Aid, Epilepsy, Behavior Management and Intensive Interaction training. The registered manager says the key to making sure people remain healthy is due to the specialist knowledge of the staff team. The support workers say the support plans are very detailed and show peoples behaviors, body language, facial expressions and sounds and the skill is recognizing different behaviors that usually indicate when someone is not feeling well. The assessments show that guidance is given to staff of
Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: peoples behaviors and what they might mean. Some people are prescribed special medicines when they need them and staff training records show they are trained to give this safely. The medicine administration systems were looked at and found to be safe. The medicine weekly and monthly audit checks show they looked at regularly to make sure they are safe. Staff training records show they are trained in how to give medicines safely. Some people use wheelchairs as they cannot move around independently. To make sure their health care needs are fully met staff training records show they have Moving and Handling , Pressure Care Awareness training and training in the use of mechanical hoists. The registered manager commended the staff team for their efforts as no one living in the home has pressure sores. Records also show some people benefit from the use of other therapies such as Hydrotherapy and Reflexology. Care Homes for Adults (18-65 years) Page 18 of 27 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People and their relatives and other visitors to the home have the opportunity to comment on the quality of the services provided and people living in the home and those caring for them are protected from any kind of abuse. Evidence: To make sure people are safe the home provides a Safeguarding Policy and Procedure that includes the Local Authority Safeguarding Protocols. To make sure people remain safe staff training records show they have Safeguarding training in how to recognize and prevent any kind of abuse. Discussion with the registered manager and support workers confirmed this. To make sure people and their relatives know how to make a complaint there is a Complaints policy and procedure that is accessible and displayed in the home. The reviews and minutes of relatives meetings show they have the opportunity to comment on the quality of the services and support provided. The CSCI service history and the homes record of complaints show the home has not received any complaints since the previous inspection visit. Care Homes for Adults (18-65 years) Page 19 of 27 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in an environment that is comfortable , homely and safe. Evidence: A tour of the premises found it to be well decorated, well maintained and homely. People were observed relaxing in the dining room and lounge. People appeared to be relaxed comfortable and happy. People live in a home that is safe as maintenance records show it is well maintained. The Report from the Environmental Health Department shows the homes kitchen is safe. The fire alarm test records show they are tested regularly. The registered manager says two bedrooms have been redecorated since the previous inspection visit. The reviews show people and their relatives have the opportunity to comment on the running of the home and the services provided. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care and suport needs are met by skilled, trained, qualified and supervised staff and they are protected by the way staff are recruited and selected. Evidence: People are protected by the way staff are recruited and selected as records show references, Police and POVA (Protection of Vulnerable Adults List) checks are taken up before they are employed. The application forms show that information about staffs previous employment is sought and the interview notes show questions are asked to make sure people have the right qualities for working with people that have profound handicaps. The manager confirmed that the staff selection process is rigorous and makes sure the right people are chosen. People are treated with dignity and their wishes are respected as staff were observed throughout the visit treating people with dignity and respecting their wishes. People were also observed fostering good positive relationships and demonstrating excellent communication skills. To make sure peoples support needs are fully met staff records show they have Intensive Communication, Signing and Behavior management training. Records also show staff have Autism Awareness and Epilepsy training. To make sure people are safe staff also have Safeguarding training and Safe Administration of Medicine training. Records also show some staff have specialist medicine training for those who require as necessary
Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: medicines. Discussion with support workers found they have a very good knowledge and understanding of the care and support needs of people living in the home. To make sure people remain safe staff records show they have pressure sore awareness training and training in the use of hoists as some people use wheelchairs and cannot move independently. People are supported by staff that are qualified as records show they either have a National Vocational Qualification at Level 2 or above or they are registered on NVQ courses. The minutes of the key worker meetings show they have an intimate knowledge of those living in the home and have a say in the quality of services provided. People are cared for by staff that are supervised as supervision records show they have regular line management supervision over and above that recommended by the Minimum Standards. Records show there is also observed supervision. This practice is to be commended. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home where they and their relatives have a say and where they are safe. Evidence: The daily records and observation of the daily routines show people living in the home have a say in what happens to them and how they live their lives. People in the home have severe problems communicating, however the support workers were observed skillfully communicating and responding to peoples personal care needs. The support and care provided were observed to be driven by those living in the home. The annual quality assurance report shows the views of people, their relatives and other visiting professionals is sought on the quality of the services provided. However, the quality assurance report is collated and provided by the organization regionally. The registered manager says they would prefer a quality assurance report specifically for Pegasus Lodge to show people the excellent service they provide. To make sure people living in the home and those supporting them remain safe, the regulation 26 providers visit reports show the health and safety systems including fire and maintenance checks
Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: are completed regularly. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 39 As a matter of good practice the organization may consider providing an annual quality assurance report specifically to reflect peoples comments about the quality of services provided at Pegasus Lodge only. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
