Inspection on 07/02/08 for Queens Lodge

This inspection was carried out on 7th February 2008.

CSCI found this care home to be providing an Good service.

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

Queens Lodge 14/06/06

Queens Lodge 12/12/05

Queens Lodge 30/08/05

Queens Lodge 07/12/04

Queens Lodge 23/04/04

Queens Lodge 11/07/02

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

CARE HOME ADULTS 18-65 Queens Lodge 2-4 Goffs Park Southgate Crawley West Sussex RH11 8AY Lead Inspector Merle Blakeley Key Unannounced Inspection 7th February 2008 10:00 Queens Lodge DS0000014675.V356747.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 Queens Lodge DS0000014675.V356747.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. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queens Lodge Address 2-4 Goffs Park Southgate Crawley West Sussex RH11 8AY 01293 510734 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) Outreach 3 Way Mrs Lisa Ann Oxlade Care Home 20 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disabilities - (LD) - 10 in Queens Lodge Learning disabilities, over the age of 65 years - (LD(E)) - 10 in South View The maximum number of service users to be accommodated is 20. 2. Date of last inspection 14th June 2006 Brief Description of the Service: Queens Lodge and Southview is a service registered to provide care for up to twenty people in the Category LD, Learning Disability, including up to ten people over the age of sixty-five. The properties are purpose built and are situated near to Crawley town centre. The home consists of two buildings; Queens Lodge provides short stay accommodation for up to ten people with a learning disability and Southview that provides long-term accommodation for up to ten people over the age of sixty-five with a learning disability. In both buildings accommodation is provided on ground and first floor level. All bedroom accommodation is for single occupancy. There are lounge and dining facilities in both buildings. Outreach 3 Way is a charitable trust. For Queens Lodge respite service the current fees range from £103.00 to £155.00 per day. In Southview the fees are £837.79 per week. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality Rating for this service is 2 Star. This means the people who use this service experience Good quality outcomes. This unannounced inspection was carried out by Merle Blakeley Inspector over a period of six hours on February 7th 2008. As well as this site visit information was also gained from a returned Annual Quality Assurance Assessment (AQAA) and feedback surveys from five relatives, five staff members and three residents. During the visit we were able to talk to three residents, three staff, both registered managers, and two service managers of Outreach 3 Way Trust. We also looked at four care plans and all supporting documentation such as risk assessments, daily records and healthcare information and a check was carried out on how medications are being stored and administered within the homes. Records of how complaints and safeguarding issues had been dealt with were discussed. We also viewed staff records, which included recruitment procedures, qualifications and the types of training courses that are offered to staff. The homes quality assurance system, how people’s finances are managed and health and safety procedures were also viewed and discussed. It is the intention of Outreach 3 Way to register Queens Lodge and Southview as two separate services, as Queens Lodge is a respite service for ten young adults with learning disabilities and Southview provides long term care for ten older people with a learning disability who are aged over sixty-five years. What the service does well: What has improved since the last inspection? Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 6 Three requirements were made during the last inspection and Queens Lodge has met these. Fire training is being provided on a regular basis, two references are always obtained before a new employee commences work and care plans are kept under regular review. Other improvements that have been made to the services include employing a new in-house trainer to provide all core skills training and an external training consortium for more specialist subject training, a new cook and housekeeper have been employed and additional specialist equipment has been purchased. Areas within both homes have been redecorated and new furniture and carpets have been purchased. The garden area has been landscaped to improve accessibility. A new family link system has been introduced to provide a better communication system between the service and relatives/friends and advocates. 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 Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Queens Lodge DS0000014675.V356747.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 Queens Lodge DS0000014675.V356747.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed prior to moving into the home. EVIDENCE: How people’s needs are assessed before they move into the home was discussed with both managers from Queens Lodge and Southview, as their needs are very different. Queens Lodge provides a respite service for young adults who may use the service periodically throughout the year whereas Southview provides permanent long-term care for people over the age of sixtyfive years. Queens Lodge normally receives assessments from the local placing authority and in normal admissions the manager would meet with the person and offer several trial visits and produce their own assessment of the person. There are occasions when emergency respite admissions occur and the manager stated that the home does not always receive comprehensive pre-admission information from care managers. In Southview people are assessed prior to moving into this long-term care service. Trial visits are also offered. No new residents have moved into the home since the last inspection. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples assessed needs and personal goals are reflected in their care plans. People are assisted to make decisions about their own lives and supported to take risks. EVIDENCE: Two care plans were viewed in Queens Lodge and two in Southview. The plans were comprehensive and provided details on the personal, health and social needs of each person. The person’s key worker carries out reviews of care plans six-monthly or more frequently if their needs change. Family or friends would also be involved in this process, as the people who live here have varying degrees of learning disabilities and it is difficult to determine how many would have an understanding of their own assessed needs. As well as care plans there are also detailed risk assessments for each person, which cover the areas such as out in the community, personal care, mealtimes, health and safety and medication. People are supported to lead an independent lifestyle within a risk-assessed framework and staff have received training in Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 11 dignity and choice. Picture books are used to help people to communicate their wishes and choices. The homes try to ensure that family and friends are kept informed of any changes to the care of their relative and a new family link service has been introduced. The six relative, carer & advocate surveys that were returned all stated that the home always keeps them up to date with important issues that concern their relative or friend. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All people have the opportunity to be involved with meaningful activities. Residents are able to maintain contacts with family and friends. People’s views are respected. A varied menu is provided. EVIDENCE: Information from both Queens Lodge and Southview showed that everyone has the opportunity to be involved in meaningful activities. The vast majority of people attend local colleges, clubs and day centres throughout the week and various other activities are offered such as shopping, meals out and day trips. People who visit Queens Lodge for short stays tend to maintain the routines they have when they are at home and the service ensures that they have the transport to take them to and from their local day care centres. People are out and about in the community on most days and visit local shops, parks and pubs. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 13 In Queens Lodge all the residents tend to have family members and they only use this respite service for very short periods. The people in Southview are all aged over sixty-five years and some people no longer have any living relatives or family members. These people are on the waiting list to receive support from an advocacy service. Other people maintain their family contacts with visits and phone calls. Staff ensure that residents rights and views are respected. The home has produced a Dignity Challenge DVD and staff have received further training in Equality, Diversity and Spiritualism. On the day staff were seen to treat people with care and respect. Picture boards are used with residents so that they are able to make their own choices and decisions about what they want. The homes rotate a four weekly rolling menu for meals and this appeared reasonably healthy and varied. Staff stated that they were other options available and various diets could be catered for. It was discussed with the manager at Queens Lodge that having pictures of the daily meal options on the notice board for residents might be more useful than just the written menu. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home tries to ensure that people receive personal care in the way they prefer. People’s healthcare needs are being met. Medication is being appropriately administered. EVIDENCE: Care plans detail how each person wishes to have their personal care needs carried out. This is done in pictorial format with the resident and their key worker. Staff try to support people to be as independent as possible and encourage them to assist with their personal care where they are able. In Queens Lodge the two ground floor bedrooms have en suite facilities the other bedrooms on the first floor do not, so bathrooms are shared. Assisted bathing equipment is available in both of the homes. The healthcare needs of people in Queens Lodge and Southview were discussed with both managers. There was written evidence in peoples care plans that showed they had access to a good range of healthcare professionals such as doctors, district nurses, occupational therapists, psychiatrists, speech Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 15 and language therapists etc. Additional specialist aids are also available to assist people with their independence. Medication records were checked in both services and all medicines are being appropriately administered and stored by staff. All staff that administer medication have undertaken accredited training in this subject. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has taken the appropriate action in regards to complaints and safeguarding adult referrals. EVIDENCE: Both services have produced a complaints procedure, which is in written text and a pictorial format. There have been eight complaints from Southview and these were viewed and discussed with the manager. They mainly involved minor misunderstandings between some of the residents. The manager stated that these issues had now been resolved and dealt with appropriately. There have been no further complaints. The home also has produced a safeguarding adults policy and procedure. All staff have received training in this subject. Since the last inspection eight safeguarding referrals were made at Queens Lodge and three at Southview. The managers stated that any incident, however minor is passed onto the local teams. Some of the incidents occurred outside the home and some involved people presenting with changing behaviours. All have been appropriately investigated with no further action to be taken. Both Queens Lodge and Southview maintain the finances for some of the residents. Records were checked in both services and they were found to be well maintained. Staff said that people’s finances were checked at each handover to ensure that all monies were accounted for. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Some positive improvements have been made to the environment in both services. EVIDENCE: Since the last inspection Queens Lodge has new carpets and new flooring has been laid in the dining room and redecoration is now underway in each of the bedrooms and communal areas. Southview has been repainted throughout with new flooring in the toilet and new chairs for the lounge area. New dining room furniture is also on order. Some bedrooms in Southview are due to be redecorated in April 2008. The garden area has been landscaped to provide better accessibility for people. On the day both services were found to be very clean and tidy. One relative did comment that he found the communal spaces in Southview somewhat cramped at times. The managers stated that Outreach 3 Way agreed with this and there is a possibility that the service for older people with learning disabilities maybe expanded to larger premises in the future. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by a caring and competent staff. The vast majority of staff have obtained an NVQ qualification in Care. Suitable recruitment procedures are carried out and staff have access to a good level of training. EVIDENCE: In Queens Lodge the staffing requirements vary, as it is a respite service and the numbers of people being accommodated can fluctuate from one week to another. There are four permanent day staff, one night staff and three relief staff. Agency staff are being used at present to cover a vacant night post. The manager stated that they always ensure that the same agency worker is available to provide consistency of care to people. All four permanent staff have obtained an NVQ qualification in Care. The deputy manager also holds NVQ Level 4 and the Registered Managers Award (RMA). Recruitment files were viewed and they contained all the required information. Southview provides long-term care and therefore there is a core staff team of fifteen. There are normally three staff on duty in the morning and three in the afternoon plus two waking night staff. A cook is employed for 30 hours per Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 19 week and the home is currently recruiting for a part-time housekeeper. Ten of the fifteen staff hold an NVQ qualification and a further four are hoping to commence this training in the near future. Southview also occasionally use agency staff for some night duties and when the permanent staff are on annual leave or sick leave. Recruitment files were also viewed at Southview and they contained all the required information. Outreach 3 Way employs a Training Development Manager who provides the staff teams with all the necessary core skills training such as manual handling, health & safety, food hygiene, infection etc. Plus another training consortium offers other courses such as conflict resolution, dignity, makaton training, and epilepsy and dementia awareness. Staff felt that they received a very good level of training, which supported them to carry out their roles and provide people with the best possible care. Staff teams in both homes appeared to work well together and they were knowledgeable about each person’s individual needs. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Both services are well managed by competent and qualified managers. The home has a quality assurance system. The health, welfare and safety of both residents and staff are promoted at all times. EVIDENCE: A new manager was appointed for Queens Lodge in 2006 and the CSCI registration process was completed in July 2007. The registered manager has worked for Outreach 3 Way for twenty years and so she has had a lot of experience in working with people who have learning disabilities, she has also obtained NVQ Level 4 qualification plus the Registered Managers Award (RMA). The registered manager for Southview is also very experienced and she has worked for Outreach 3 Way for sixteen years and has obtained the NVQ Level 4 Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 21 and the RMA qualification. She has been the registered manager at Southview for three years. The deputy manager at Queens Lodge has obtained NVQ Level 4 and the Registered Managers Award and the deputy manager at Southview is also intending to obtain these qualifications. Staff who were spoken to on the day stated that they felt well supported by their managers. Both services have produced a quality assurance programme. Monthly Regulation 26 visits are carried out and a sample of the reports were viewed. Families/friends and visiting professionals are provided with surveys so that they can comment on the care that people receive. The results from one of the surveys were viewed and there were some very positive comments made about the level of care the homes provide. People who live in the homes also receive satisfaction surveys and residents meetings are held monthly. Fire risk assessments were carried out on both services in 2007. A requirement was made during the last inspection for the homes to carry out more regular fire training sessions and this has been carried out. When the inspector arrived at Southview unannounced a staff member conducted a fire safety walk through of the building to show her where all the fire exits were located and this is very commendable. Fire drills are carried out monthly with fire points and emergency lighting tested quarterly. Fire alarms and door guards are checked weekly. All residents have undergone a fire risk assessment check to ensure they understand what they need to do should a fire occur in the home. Outreach 3 Way employ a Health and Safety Manager whose role is to ensure that all the registered homes comply with the required and most up to date legislation. All the staff have received first aid training and have completed the core skills training requirements. Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 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 X 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 3 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 Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 23 NO 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. Refer to Standard Good Practice Recommendations Queens Lodge DS0000014675.V356747.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone, Kent ME16 9NT 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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