Inspection on 19/02/07 for Shepherds Lodge

This inspection was carried out on 19th February 2007.

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

Shepherds Lodge 23/01/08

Shepherds Lodge 02/02/06

Shepherds Lodge 01/12/05

Shepherds Lodge 24/11/04

Shepherds Lodge 19/07/04

Shepherds Lodge 18/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Shepherds Lodge 4 West Mount Barrow-in-Furness Cumbria LA14 5LQ Lead Inspector Ray Mowat Unannounced Inspection 19th February 2007 03:30 Shepherds Lodge DS0000022629.V309967.R02.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 Shepherds Lodge DS0000022629.V309967.R02.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. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shepherds Lodge Address 4 West Mount Barrow-in-Furness Cumbria LA14 5LQ 01229 431439 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) Mrs Adrienne Beattie Mrs Adrienne Beattie Care Home 6 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users to include: Up to 4 service users in the category LD (Learning Disability under 65 years of age) Up to 2 service users in the category MD (Mental Disorder under 65 years of age) 2nd February 2006 Date of last inspection Brief Description of the Service: Shepherd’s Lodge is a large end of terrace house, situated at the end of a quiet cul de sac in a residential area of Barrow-in-Furness. It is registered to provide residential care for a maximum of six people, with up to two people with a mental disorder and four people with a learning disability. The house is located near to a bus route and is within walking distance of the amenities of the town centre and the railway station. On the ground floor of the house there are two lounges and a conservatory, a kitchen/dining room, a separate kitchen and two bedrooms. One is a resident’s bedroom, the other being a staff sleep-in room and office. There are also laundry facilities outside the home at the rear of the property. There are wellmaintained gardens to the front and rear of the home. There are five resident’s bedrooms on the first floor and two bathrooms with toilets and shower facilities. The home supplies information to residents in an informative service user guide including the services provided and the fees, which are £545 per week. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit took place in the late afternoon and early evening to enable me to see the evening routines of the home and to meet with all the residents who attend day services. I met with the manager, deputy manager and care staff on duty. I also met with all of the residents during the evening. I received feedback from residents and relative’s surveys, which were sent out as part of this inspection. What the service does well: What has improved since the last inspection? Access to the home has been improved with the installation of a new path to the front of the home and steps at the rear. Medication procedures have been looked at to make sure that all the medication is stored and handled safely. All the residents has now been given a new contract of terms and conditions that explains the rules about living in the home, what services are provided and the cost of the service. These have been agreed with residents and their representatives. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 6 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. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 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 Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 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, 5. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. The home has good systems in place to ensure prospective residents are fully assessed so that the home knows they are able to meet their needs. Suitable information is supplied to people in the service user guide. EVIDENCE: There have been no new admissions to the home since my last visit, however one resident has left the home leaving a vacancy. The manager has sent out the service user guide to prospective residents. This contains relevant information but ways of making it more accessible and easy to understand by people with communication difficulties should be explored. The home is working closely with the social work team and other agencies regarding the placement of a new resident. The manager is aware of the importance of ensuring any new resident is compatible with the existing residents and that their needs can be met within the home’s resources. I examined resident’s personal files, which contained new contracts of terms and conditions. Most of the contracts had been signed by the resident and their representative, with the remainder having been forwarded to residents’ representatives to sign on behalf of the resident. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 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, 9, 10. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. The home keeps detailed records of resident’s personal and healthcare needs and preferences to ensure an appropriate service is provided. Staff have a good understanding of resident’s and take on an enabling role to promote their independence and choice. EVIDENCE: Through consultation with residents, their representatives and other agencies the home has developed detailed care plans for all the residents. They record personal and healthcare information including all health interventions recorded in an informative “Health Action Plan”. This is a personal record retained by the resident that documents all health related information and interventions ensuring individuals receive an appropriate health service based on their needs. Social and emotional needs are also well documented, which helps staff to provide appropriate support in a consistent manner. Some residents with specialist needs have detailed strategies in place to guide and support staff in responding to their individual needs, these have been developed with support and guidance from other agencies, which is good practice. The home also retains a copy of the day service care plan that ensures a consistent approach is maintained in the different services. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 10 A good range of risk assessments is held on file that promotes residents independence. The home has a positive approach to risk taking ensuring residents do not miss out on opportunities for personal growth and development. Some of these have been developed through working closely with other agencies such as the community health team as they have addressed some complex issues regarding rights and choices. Daily diary notes are recorded at the end of each shift to ensure information is shared with other staff members and a consistent service is provided. Other useful information has been compiled with residents regarding their daily routines. They are encouraged to be involved and take some responsibility for all aspects of home life, which is proving effective in increasing their independence around the home. The residents enjoy a high level of autonomy and are able to communicate their needs and preferences to staff. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 11 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, 14, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. Residents enjoy a good quality of life and have a high level of autonomy in how they live their lives both in the home and in the local community. EVIDENCE: Individual care plans have been agreed with residents that identify how they prefer to spend their time both in the home and in the local community. Likes and dislikes and personal interests and hobbies are recorded with staff providing unobtrusive support to enable residents to pursue their chosen lifestyle. All of the residents attend some form of day service or work placement on either a full or part time basis. This provides them with a good range of both educational and vocational activities. The home staff work closely with these other agencies to ensure residents needs and preferences are responded to consistently. Some of the residents enjoy a high level of independence in their lives, which presents a challenge to staff to not get too involved and stifle their growth and Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 12 development. These “boundaries” are constantly being reviewed through consultation with residents and other interested parties to ensure safety and wellbeing are assessed, whilst independence and personal choice are promoted and respected. It was evident from examining personal care plans and observing staff with residents that they have a good understanding of the individuals and their needs and preferences. Residents were relaxed in their home environment and were able to enjoy “their own space” or the company of others. The catering arrangements have recently changed to try and offer the residents a greater degree of flexibility and choice around meals and mealtimes. One of the senior staff has taken a lead role in consulting with residents and other agencies to ensure residents are being offered a varied and nutritious diet that reflects personal tastes. A detailed record of people’s likes and dislikes is recorded. Also if alternative choices are provided and individual’s fruit and vegetable intake is also recorded. There have been some health benefits noted since the changes were introduced and the residents were very complimentary about the food provided. A weight chart is also completed on a regular basis so that fluctuations in weight are noted and responded to promptly. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 13 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. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. The personal and healthcare needs of residents are well documented and responded to in a consistent manner. EVIDENCE: As described previously the home have developed detailed care plans and specific strategies to ensure staff can provide a personalised but flexible service. These include preferred daily routines, which are particularly helpful for staff, in ensuring people’s rights and choices are respected. The home works closely with a number of specialist services including the psychology, psychiatry and community health teams to make sure specific needs are recorded and responded to. Detailed strategies have been developed to ensure the most complex needs are being met in a consistent manner. The success of this approach is evident as some of the residents are enjoying a very settled period in their lives, which is attributable to the commitment of the staff team and the effective multi-agency approach. The home has reviewed their medication procedures and introduced a new checking system for all medication coming into, leaving and administered in the home. I checked the medication records against the medication held and found these to be up to date and accurate. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 14 Individual preferences in relation to how to deal with death and dying have been explored with residents and their wishes recorded. These reflected personal, religious and cultural preferences, which is good practice. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 15 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, 23. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. The residents felt safe in the home and said that their views are listened to and respected by staff. EVIDENCE: There have been no formal complaints recorded since the last inspection. The home has a suitable policy and procedure in place and this is displayed in the home and is included in information supplied to new and prospective residents and their representatives. Although the home has a mistreatment and abuse policy and procedure in place it is recommended that this be reviewed in line with the new multiagency procedures and guidelines produced by the Adult Social Care department. Staff receive training at induction and foundation and also through NVQ training. In addition the manager is completing a “train the trainer” course to enable her to deliver further training to staff as required. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 16 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, 26, 28, 30. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. The home provides a good quality and homely living environment where residents feel safe and comfortable. EVIDENCE: The home is well maintained and decorated to a good standard. There is an ongoing programme of repairs and renewals with recent improvements being a new path at the front of the house, improved access at the rear and the installation of fitted bedroom furniture in one residents room. I examined servicing and maintenance records, which were all in order. Residents and staff confirmed work is carried out in a timely manner. There were no obvious hazards noted around the home and the need for aids and adaptations was minimal. There are two main lounges and a conservatory in addition to a kitchen and kitchen/dining room, residents moved freely around the home and were able to spend time alone or socialise with others. The gardens at the front and rear of the home are private and have seated areas enabling residents to enjoy being outside in the better weather. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 17 When I was talking to two residents one of them described the home as a “ lovely place, very comfortable”. Shepherds Lodge DS0000022629.V309967.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. The home benefits from a settled and experienced staff team who receive relevant training and provide a safe and reliable service. EVIDENCE: There is a core group of staff that provides the majority of the care in the home who have all worked there for a number of years. The benefits of a settled staff team are evident in how they interact with residents and each other. They have a good understanding of individual needs and work well as a team in ensuring a good quality and consistent service is provided. The manager has identified key staff to take responsibility for different aspects of care, which is working effectively and makes them feel valued and part of a team. I examined staff records for all new staff including staff that had subsequently left the home. They all contained appropriate records including application forms, Criminal Record Bureau disclosures and two references. Staff felt the interview process was in line with equal opportunities guidance. The manager was aware of data protection guidelines in relation to disclosures. Individual training records are maintained which were up to date and reflected a good range of training being provided. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 19 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, 42. Quality in this outcome area is good. This judgement has been made using all available evidence including a site visit. The home continues to be managed effectively with residents involved in all aspects of home life. EVIDENCE: The manager ensures the residents and staff contribute to the smooth running of the home and are consulted on an ongoing basis both on a formal and informal level. Staff and resident’s meetings are held on a regular basis, which are recorded with actions identified. Staff said they were receiving “regular supervision” and they felt well supported and they said “management are approachable and we can raise any issues or concerns at any time”. An annual quality assurance survey is issued by the home to residents, their representatives and other professionals. The feedback from these is then incorporated into the home’s business plan or actions agreed if something needs to be responded to. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 20 I examined the maintenance and servicing records as required by regulation including electrical wiring, portable appliance testing, gas safety and the fire log and fire equipment servicing record. These were all up to date and accurate. The home had reviewed risk assessments on a regular basis ensuring they are still relevant and safeguarding residents and staff. Due to recent changes to the Fire Regulations the home had been liaising with the fire service and making the necessary adjustments to the fire risk assessment for the home. Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 X X 3 X Shepherds Lodge DS0000022629.V309967.R02.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA1 YA23 Good Practice Recommendations It is recommended the service user guide and other information supplied to residents is accessible and easy to understand. It is recommended the home’s mistreatment and abuse policy and guidelines be reviewed in line with the new multi-agency procedures and guidelines produced by the Adult Social Care department. 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