Inspection on 04/10/05 for Saxon Lodge

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Saxon Lodge 16/05/07

Saxon Lodge 17/05/06

Saxon Lodge 18/01/06

Saxon Lodge 18/02/05

Saxon Lodge 13/08/04

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Coopers Mill Ltd

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Paradise Lodge

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Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Saxon Lodge Saxon Lodge 20 Smith Street Shoeburyness Essex SS3 9AL Lead Inspector Unannounced Inspection 4th October 2005 08:30 Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Saxon Lodge Address Saxon Lodge 20 Smith Street Shoeburyness Essex SS3 9AL 01702 295001 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) Southend on Sea Borough Council Miss Pauline Alice Marshall Care Home 13 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (13) of places Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Care and accommodation to be provided to no more than 13 persons. Care and accommodation to be provided to persons between the age of 18 and 65 with a learning disability (LD). Care and accommodation to be provided to persons aged over 65 years who have a learning disability and who have resided Care and accommodation to be provided to persons aged over 65 years who have a learning disability and who have resided in the home prior to their 65th birthday (LD(E)). 18th February 2005 Date of last inspection Brief Description of the Service: Saxon Lodge is owned and managed by Southend Borough Council. It is a purpose built establishment situated near to the main shopping centre of Shoeburyness and provides care to adults with a learning disability. It is close to local amenities and has a good local bus and train links to the area. The home offers single bed accommodation on the ground and first floor. Access to the first floor is by stairs, as a passenger lift is not available. There are two large lounge/dining areas on the ground/first floors. The home has its own car parking facilities to the rear of the property and there is some street parking. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by Michelle Love, inspector. The inspection took place over 5 hours. At this visit some care records and staff supervision records were inspected. During the inspection the inspector spoke with two residents, three members of support staff and the person in charge of the home on that day. What the service does well: What has improved since the last inspection? What they could do better: The registered provider must ensure that records such as pre admission assessments are readily available within the home and for inspection. More specialist training is required for staff in relation to the care needs and conditions of people who have a learning disability. PRN (as and when required medication) protocols must be devised for all residents who receive PRN Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 6 medication, detailing the reason for the medication and when it should be administered. The staff rosters must be accurate and staffing levels as agreed by the previous registration authority must be maintained. 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. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4 and 5 A formal assessment tool is available to assess prospective residents prior to admission. Not all residents had a pre admission assessment. Prospective residents are able to visit the home prior to making a decision as to whether or not Saxon Lodge is a care home they wish to live in. Each resident has an individual written contract. Training undertaken by support staff enables them to meet resident’s individual needs and to deliver satisfactory care. EVIDENCE: No evidence of pre admission assessments, were available for two residents newly admitted to Saxon Lodge. Information from placing authorities/social services, were only evident for one resident. The inspector was advised that one resident was unable to visit the home for a trial visit prior to admission, as the admission to Saxon Lodge was quite swift. Since admission both residents have been formally reviewed by social services. Since the last inspection, some staff have received and undertaken training pertaining to mandatory/specialist courses e.g. Manual Handling, Health and Safety, Basic First Aid, Medication Awareness, Sexuality/Relationships, Inclusive Communication, Sensory Impairment and Adult Abuse. Some staff require specific training related to the needs of people with a learning disability. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 Individual resident care plans/risk assessments are devised for all residents. Residents are empowered and where necessary supported to make decisions and participate within some aspects of daily life within the home. EVIDENCE: On inspection of two care plans and risk assessments, these were seen to be informative and relatively detailed and comprehensive. Daily care records were written daily and these too were detailed and informative, depicting care provided by support staff to residents and activities undertaken. Risk assessments had been devised for all areas of assessed risk. A new care plan format has been implemented, of the two care plans inspected, only one had been updated and most elements completed. Residents are actively encouraged wherever possible to make decisions and participate within the day-to-day running of the home e.g. personal laundry, basic cooking etc. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 All residents are encouraged to participate and pursue leisure interests and hobbies. Formal day care/education provision is available for most residents. Residents are offered a varied diet according to their individual needs and requirements. EVIDENCE: Within each resident’s care file, there is a written activities timetable identifying formal/informal activities undertaken on a weekly basis. The home’s activity book details resident’s participate and/or have the opportunity to participate within activities such as cooking, walks, video’s, gardening, shopping, going out for lunch, visiting local shops etc. In addition the majority of residents attend local formal day care/education facilities i.e. Bathseba, Maybrook/Avro Adult Training Centres, Southchurch Adult Education Centre. Residents are actively encouraged to form and maintain existing friendships. Family and friends are welcome to visit the care home at any reasonable time. Wherever possible residents are supported to maintain independent living skills. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 11 Nutritional records for residents were satisfactory and the home has a four week menu. One resident stated that food provided at the care home is very good. Residents are enabled to go out for lunch/have takeaways. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 12 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 and 20 Residents receive healthcare provision from a variety of professionals. Medication systems within the home are satisfactory. EVIDENCE: Individual care plans/associated documentation evidenced that residents are enabled and supported to access a range of healthcare facilities and professionals e.g. Consultant Psychiatry, Chiropody, Southend General Hospital (Audiology Dept), Community Nurse Services, District Nurse Services, Social Services etc. Information recorded the specific nature/reasoning behind the visit/treatment and outcome. The home’s medication storage, policies and procedures and medication administration records remain satisfactory. No PRN (as and when required medication) protocols were evident for those residents who receive such medication. Since the last inspection 14 members of staff have received training pertaining to medication administration. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The home has a complaints policy and procedure, which allows visitors and residents to make complaints and give compliments. A Protection of Vulnerable Adults policy and procedure is available which enables residents to be safeguarded from abuse or neglect. EVIDENCE: The home has received one complaint since the last inspection. Information relating to the nature of the complaint, investigation and outcome were readily available. Several letters/notes depicting compliments were readily available. The home’s complaints procedure was displayed and available for visitors and residents. Several members of staff have received training relating to conflict management and adult abuse/protection of vulnerable adults. No protection of vulnerable adults issues have been highlighted since the last inspection. Following discussions with three members of staff, staff were unclear as to some aspects of adult abuse/protection of vulnerable adults procedures. In addition staff did not have access to blank documentation on all occasions. The registered person must ensure that this issue is rectified with immediate affect. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 14 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): None to record on this occasion. EVIDENCE: No standards relating to the home’s environment were inspected on this occasion. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 15 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): 31, 32, 33, 34, 35 and 36 Staffing levels/deployment of staff were not always appropriate to meet the needs of current residents. The staff roster evidences a high usage of agency staff on occasions. It was unclear as to whether all agency staff were given an induction. Records evidence, support staff receive formal supervision. EVIDENCE: Staffing rosters evidence that on most occasions staffing levels were appropriate to meet the needs of residents. However, on some occasions the staff rosters over a four week period indicated that there were insufficient staff on duty and not in line with the levels agreed by the previous registration authority e.g. week commencing 25.9.05 it was unclear as to who the second waking night person on shift was on three occasions. The roster was not accurate and did not depict the specific/correct hours worked by some members of staff. No new staff have been recruited to the care home since the last inspection. New members of agency staff have worked at Saxon Lodge, but no formal induction documentation was available for three. A basic `tick chart` is used to evidence induction training given to agency staff members. This is seen as inadequate and should be reviewed for the future. All staff receive formal supervision every 4-6 weeks. Records were readily available and detailed. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 16 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 and 38 The home does not currently have a registered manager, but in the interim is managed by a joint management team. EVIDENCE: Since the middle of September 2005, the home has been without a registered manager. In the interim period and until a suitable person is appointed two people with experience have been placed in charge of running the care home as part of a `job share`. Residents appeared unaware and unaffected by the changes to the management of the home. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 2 2 3 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 2 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Saxon Lodge Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X X X DS0000039678.V251121.R01.S.doc Version 5.0 Page 18 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. 1 Standard YA2 Regulation 14 Requirement Timescale for action 07/12/05 2 YA3 3 YA20 4 YA23 5 YA33 Ensure that detailed and comprehensive assessments are compiled, which determine that the home can meet the needs of residents. These must be available for inspection. 18(1)(a)18(1)(c) Ensure that all staff at the care home undertake appropriate training to the work they perform and the needs of the residents. 13(2) Ensure that PRN protocols are devised for all residents who receive PRN medication. 13(6) Ensure that all support staff receive additional training pertaining to protection of vulnerable adults. 18(1)(a) Ensure that at all times there are suitably qualified, competent and experienced persons working at the care home in such numbers as are appropriate for the health and welfare of residents. 01/04/06 01/01/06 01/02/06 07/12/05 Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 19 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 YA35 YA32 Good Practice Recommendations All staff whether permanent or agency must receive a suitable induction and records should be available for inspection. 50 of care staff working in the care home should attain and achieve NVQ Level 2 or equivalent. Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 Saxon Lodge DS0000039678.V251121.R01.S.doc Version 5.0 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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