Inspection on 06/03/06 for Preceptory Lodge

This inspection was carried out on 6th March 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Preceptory Lodge 23/10/08

Preceptory Lodge 15/11/06

Preceptory Lodge 13/09/05

Preceptory Lodge 01/03/05

Preceptory Lodge 14/09/04

Preceptory Lodge 04/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

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

CARE HOME ADULTS 18-65 Preceptory Lodge Preceptory Lodge Temple Hirst Selby North Yorkshire YO8 8QN Lead Inspector Ms Wilma Crawford Unannounced Inspection 6th March 2006 11:30 Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 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 Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 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. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Preceptory Lodge Address Preceptory Lodge Temple Hirst Selby North Yorkshire YO8 8QN 01757 270095 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) Mr Donald Smith *** Post Vacant *** Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Preceptory Lodge is a single storey building providing personal care and accommodation for service users with Autism in a domestic environment. The bungalow is situated in the private grounds of Preceptory Farm. Preceptory Lodge is registered for two adults, currently there is one resident living in the home. The home is located between Selby and Doncaster and transport is provided for access local amenities and leisure activities. The home was first registered in March 2003 and is privately owned by Mr D Smith. There is building work being completed to extend the home and an application to vary the home’s registration will be made in respect of this. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over four and a half hours. A tour of the premises was carried out which included service users’ private accommodation. A tour of the premises was conducted with the resident of the home. The main method of inspection used was called case tracking which involved examining the residents records, tracking the care they receive, discussion with them, the care staff and observation of care practices. The acting manager, two members of staff and the resident were spoken with. A sample of the home’s records, were looked at and time was spent observing the activity in the home. The acting manager was available throughout the inspection and the findings were discussed with her at the close of the inspection. The comments and views of people spoken with are included within this report. What the service does well: The home was well maintained, warm, clean and comfortable at the time of this inspection. Residents are involved in all aspects of the day to day running of the home, including; choosing the décor for their bedrooms, involvement in staff recruitment, planning menus and food shopping. An environment, in which service users can develop new skills that help them cope with daily living and experience new social and leisure activities is provided. The resident living in the home said that they particularly liked living in the home because it was small and quiet which suited them. “ I can go out whenever I like.” “I am always asked what I think and I even got to help choose the new staff.” The home is managed in such a way that service users are involved in making decisions about their lives, the daily activity in the home and looking at ways to ensure risk is minimised to keep them safe from harm. Good relationships have been developed with external agencies that are involved with the service users. Clear, comprehensive care plans are in place, containing guidance for staff about all aspects of residents personal and development needs. Regular reviews are held and care plans updated. Staff, are kept up to date with regular key worker meetings. They are also provided with the necessary training, supervision and support to enable them to deliver the required care and support to residents. “ I feel well supported in my role and have been given the necessary training to do my job well.” “ Everyone is really helpful, there is good communication and I have never felt that I have been in a position where I haven’t known anything.” “ We have regular, key worker and staff meetings, as well as supervision.” Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 6 Records within the home are well maintained and residents have access to their own records. “ I can write in my care plan if I want to, it’s up to me.” Recruitment and selection procedures are robust, ensuring that service users are protected. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 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 Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 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, and 5. People are provided with information in suitable formats to help them make an informed choice about moving into the home. Information is gathered about people prior to them moving in to ensure that their needs can be met in a safe manner. EVIDENCE: Prospective service users’ needs are assessed prior to them moving in, this involves meeting with the service user, their representatives and family where appropriate, to ensure that all their needs and aspirations are identified and can be met by the staff before an agreement is reached to arrange a trial visit to the home. The assessment process continues after admission, so that individual care plans can be developed further to meet identified needs. Care plans are agreed with the resident and all other parties involved. The resident spoken with was aware of the content of their care plan and had been involved in the development of this. A statement of purpose and a service user guide is available and copies of these are maintained in residents’ personal files. The contents of the documents are discussed with the service users. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 9 The home currently accommodates one resident, but building work is underway to provide accommodation for a further two residents. All service users are issued with a contract/terms and conditions document and copies of these are kept on their personal files. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 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): 6,7,8,9 and 10. Service users are enabled to live as independently as possible taking into account any risks that need to be considered. EVIDENCE: The care plan for the resident living in the home, gave clear information about all aspects of the residents’ personal, social and health care needs. Care plans are developed from the assessments and they set out how the residents’ needs are to be met and by whom. Information is available about the type and level of support needed and what they are able to do independently. Residents are fully involved in planning their care and informed about any strategies that are in place for the management of risk and challenging behaviour. Action plans are agreed as to the level of involvement they will have in the daily running of the home such as cooking, shopping and domestic duties around the house. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 11 All risk is assessed and the actions that need to be taken to minimise risk are identified and recorded. Strategies are also in place to offer guidance in managing specific behaviours. Each service user has a key worker, this arrangement ensures that they have one to one time and support with the activities of daily living and time to discuss any problems or concerns they may have. The skill mix of the staff is important to ensure that residents’ care needs are met and that they can enjoy a wide variety of leisure activities. Residents are fully aware that information is held about them and they have access to their care plans. Up to date information about any treatments and interventions from external health care professional including input from the mental health services. There are systems in place for staff to keep regular records about the service users and for the review of their care. The home has a confidentiality policy that staff are aware of and residents know that information kept about them is kept secure. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 12 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, and16. Residents enjoy a varied lifestyle and have opportunities to take part in social and activities in the local community. EVIDENCE: Residents care plans detail their individual preference of activities and the contact they have with their families and friends. During discussion the resident made positive comments about life in the home and the activities and opportunities made available to them. This included days out to places of interest, shopping, pub visits, swimming, visits to a social club. Residents are enabled to take responsibility for most aspects of their lives and they are involved in making decisions about the daily activity in the home. They are involved in taking care of their own rooms, planning menus, shopping, attending day services, engaging in their own interests and hobbies and going on holidays. The resident spoken with explained that he and his key worker were planning a holiday to Ireland. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 13 Menus are planned with the resident, who is also responsible for writing the shopping list and doing the grocery shopping. Staff offer support to residents with food preparation. The staff team support residents to maintain contact with their family and friends. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 14 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 There are good systems in place to ensure that the service users person and health care needs are met. EVIDENCE: The care plans gave information about the service users health and personal care needs and the arrangements that are in place for these to be met. This information included their personal care and the type and level of supported needed from the staff. The resident is registered with a general practitioner and have input form external health care professionals including the psychiatric services with regard to their mental health and behaviour management. Risk is assessed and plans were in place to assist the resident and the staff in minimising risk without too much restriction on freedom and independence. Regular reviews of health care concerns had been carried out including medication reviews. The outcomes of all reviews are recorded and where indicated the care plans are changed in line with changing needs. The monitored dosage medication system is operated by the home and all medication is safely stored and the records were accurate. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 15 Residents are given the opportunity to make a will and record their wishes in the event of their death. This is done at different times for each individual depending on their individual needs and level of understanding, in order that they are not caused undue distress by this process. The acting manager stated that in the event of a terminal illness, the home would do their utmost to support the individual at home with support from other professionals. In the event of any resident requiring hospital treatment, they are supported by staff, from the home, twenty four hours a day, during their stay. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 16 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): These outcomes were not looked at. EVIDENCE: Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30 The residents live in a comfortable, pleasant and safe environment, with both private and communal space being suitable for their needs. EVIDENCE: Preceptory Lodge is a bungalow and is situated in an expanse of wellmaintained grounds and away from a main road. Transport is needed for the service users to access local facilities and the proprietor provides this. There is a day service facility in the grounds and this is available to the service users if they wish to take part in the activities provided. A swimming pool and pool table are also available for residents’ use in the grounds. All bedrooms are for single occupancy and have wash hand basins. The resident living in the bungalow has his own spacious room, which is decorated to his taste with a collection of personal belongings in it. The resident said that he had been involved in choosing the décor and furnishings for their room. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 18 There is a lounge, a bathroom with toilet and shower and a well-equipped kitchen/dining room. The home was clean and free from offensive odours, all dangerous substances were stored correctly and the insurance certificate was current. Currently there is no specialist equipment required by the resident living in the home. However, should this situation change then any necessary equipment would be provided. The decoration and furniture within the home is of a good standard. The whole of the bungalow is due to be refurbished on completion of the extension. The resident said that they had been involved in choosing new furnishings and décor for the bungalow and the extension. There is a written programme for the routine maintenance and all the required safety certificates were in place, which showed that all equipment is tested and upgraded as required. The home was meeting the requirements of the fire safety department and has a fire risk assessment in place. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 19 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): 32,34,35,36 Staff are well trained and supported, and there are sufficient numbers to meet the needs of service users. Recruitment and selection procedures are robust, ensuring that service users are protected. EVIDENCE: A staff member is available for the resident from 8 a.m. until 11 p.m. and provides sleeping in cover overnight. The acting manager is also available and their hours are supernumerary. The staff recruitment and selection procedure is robust and the required staff records were in place. There was evidence that the required references had been taken up and the required CRB and POVA checks undertaken prior to all new staff taking up their positions. All staff are subject to an induction and statutory training, which includes, autism, health and safety, protection of vulnerable adults, fire safety, food handling, medication and first aid. Staff meetings and key worker meetings are held on a regular basis and records are kept of the outcomes and the actions agreed. All staff are supervised providing them with an opportunity to discuss training needs and any issues of concern. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40,41, 42 and 43. Residents benefit from a well managed home in which their needs and wishes are put first and their rights and best interests are safeguarded. EVIDENCE: There is currently no registered manager in post and arrangements have been made for a manager of another home to take on management responsibilities. An application has been made to the CSCI for them to become the registered manager. They have considerable management and care experience, eleven years of which was working with adults with Autism. The acting manager holds an NVQ level 4, the registered managers award and is also an NVQ assessor. The home has a quality assurance and monitoring system in place and the views of the service users and other stakeholders are gathered and recorded. This information enables the service to continually develop and identifies areas of concern. The questionnaires are available in suitable format for residents’ use. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 21 The proprietor visits the home on a regular basis to monitor the activity and produces a report on the conduct of the home. During these visits the views of the resident and the staff are sought and recorded. There is a suitable on call system in the event of any emergency and the proprietor lives within close proximity of the home. From examining the records the inspector was satisfied that the home had policies and procedures that covered a wide range of topics, were detailed and clear and gave staff clear guidance on how to conduct themselves. Staff spoken to could demonstrate their knowledge of the policies and procedures and how to implement them in practice. The policies and procedures were kept under review. All of the required records were in place they were in good order and are kept secure. There is a health and safety policy and procedure in place and all staff have attended the required training. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 3 3 3 3 3 3 Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 23 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. Refer to Standard YA32 Good Practice Recommendations It is recommended that 50 of the care staff are trained to NVQ Level 2. Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Preceptory Lodge DS0000038302.V285069.R01.S.doc Version 5.1 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. 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. 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