Inspection on 03/12/07 for Siloam Lodge

This inspection was carried out on 3rd December 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Siloam Lodge 03/11/08

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

CARE HOME ADULTS 18-65 Siloam Lodge 75 Bushgrove Road Dagenham Essex RM8 3SL Lead Inspector Liz O`Reilly Announced Inspection 3 December 2007 11:45 rd Siloam Lodge DS0000069560.V355325.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 Siloam Lodge DS0000069560.V355325.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. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Siloam Lodge Address 75 Bushgrove Road Dagenham Essex RM8 3SL 020 8592 3977 020 8592 3977 siloamlodge@hotmail.co.uk 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) Siloam Carehomes Ltd Christine Owusu Care Home 2 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (2) of places Siloam Lodge DS0000069560.V355325.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 - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 2 New Service Date of last inspection Brief Description of the Service: Siloam Lodge is a small domestic style care home which provides accommodation and care for up to two people with mental health needs. The service is situated in Dagenham in a residential area. The home is a two storey semi terraced new build house. Off street parking is available for two vehicles at the front of the building. Public transport is near by. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection of the service since opening in May 2007. The inspection was unannounced and carried out by one regulation inspector. The inspector had the opportunity to discuss the service with the owner/manager, one member of staff and briefly, the one person living at the home at the time. Surveys were provided for staff and the person living at the home. The owner/manager has completed a self assessment of the service. The judgements in this report have been made taking into account information from all of the above sources as well as observations made on the day of the visit. What the service does well: What has improved since the last inspection? What they could do better: Staff have made a good start on care planning but this should be expanded to include the strengths, needs and goals of individuals along with how these will be met and timescales. Care plans should be signed by all those involved including the person using the service. Staff should be provided with training on person centred care planning. Staff should be provided with on going training on mental health issues to ensure that they receive up to date information to develop their skills and experience. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 6 Individual risk assessments need to be in place to show that staff are supporting people to live the life they choose. In order to ensure that medication can be audited and tracked a record of all medication coming into and going out of the home needs to be kept. Evidence that portable electrical appliances are checked annually needs to be kept in the home. In order to ensure the safe storage of food a record of the fridge and freezer temperatures needs to be kept. 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. The summary of this inspection report can be made available in other formats on request. Siloam Lodge DS0000069560.V355325.R01.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 Siloam Lodge DS0000069560.V355325.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. Admissions are not made until a full needs assessment has been undertaken. The home understands the importance of having sufficient information when choosing a care home. People are given the opportunity to visit and spend time in the home before making any decision about moving in. EVIDENCE: Although only one person has moved into the home since it opened it was clear that care had been taken to ensure that the home could meet this persons needs. A care management assessment was carried out before admission and the service manager visited the person to carry out their own assessment. This ensured that staff were provided with good information on the needs of the person before they moved in. The person using the service visited the home twice with their care manager and a family member before making their decision. The option of spending a night at the service was also offered but was not needed. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 9 A Statement of Purpose and Service User Guide has been produced which provides information on what people can expect from the service. This information is included in a welcome pack which also includes how to make a complaint, the menu and space for people to enter useful contact numbers for themselves. Feedback from the person using the service indicated that they felt they were given the information they needed to make a decision about moving in. Siloam Lodge DS0000069560.V355325.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, 8 & 9 People who use this service receive adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The service recognises the right of individuals to take control of their lives and to make their own decisions and choices. An individual care plan is produced which provides information on the needs of individuals. The care plan needs to be more detailed and person centred. Risk assessments need to be individualised. EVIDENCE: The pre admission assessments are used to set up an initial care plan which ensures that staff are provided with information they can work with as soon as the person arrives. Care plans were seen to set out basic needs along with actions and aims and objectives. Staff need to work on the care planning to ensure that they include the strengths, wishes and goals of the individual along with how these will be met with timescales. Care plans could be expanded and staff should be provided with training on person centred care and planning. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 11 To show that people who use the service are involved in the care planning process care plans should be signed by all of those involved in the process. Risk assessments need to be further developed and individualised to show that people who use the service are adequately supported to lead the life they choose. Feedback from the person using the service indicated that they felt they made their own decisions about day to day activities. A Keyworker system is in place and support meetings are provided once or twice a week, which provides opportunities for consultation on life in the home. Staff were seen to be keeping good daily records. The policy on respecting the dignity of people who use the service was on display. Siloam Lodge DS0000069560.V355325.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 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to develop and maintain important personal and family relationships. Where appropriate education and occupation opportunities are encouraged and promoted. People who use the service are involved in the domestic routines of the home. Staff have a strong commitment to enabling people to develop their social and independent living skills. EVIDENCE: Feedback from the person who uses the service indicated that they made their own decisions on their day to day activities. This was observed during this visit. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 13 Staff support people to increase their independence and to use local community services. The person using the service makes independent trips to local shops and town centres. Staff have worked with the person to make more long term plans for attending further education courses of their choice and for increasing their independence with daily living activities. The manager is aware of the importance of maintaining family contacts and this is being facilitated. Staff have also supported the person in re establishing family contacts. Support is provided for regular visits to and from family members. The religious needs and wishes of people who use the service are noted and staff will support people to attend religious centres of their choice. Staff were found to have a good knowledge of the preferences of the person they support and work with the person to meet their needs and wishes. Siloam Lodge DS0000069560.V355325.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 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service have access to healthcare services and staff encourage people to be as independent as possible in this area. Personal support is provided in accordance with the individual needs and preferences of the people using the service. Medication is adequately managed. A record of medication coming in and out of the home will assist in this area. EVIDENCE: Feedback from the person using the service indicated that they were happy with the way in which they were supported by staff. Arrangements are in place for people who use the service to be registered with local GP practices. Regular visits are made by community health care professionals to provide support to individuals and advice if needed to staff. The manager and staff have a good understanding of the support people with mental health issues may need and they have good relationships with other professionals who can offer support. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 15 The person using the service is supported to partially manager their medication by re ordering and collecting prescriptions. Local community services will be used for other health care needs such as dentist and optician if needed. Medication is stored appropriately and records of any medication administered by staff are kept. Staff are provided with training on the management of medication. The manager needs to ensure that all staff who administer medication are provided with accredited training on medication. In order to be able to track medication a record of all medication brought into the home and returned to the pharmacy needs to be kept. Siloam Lodge DS0000069560.V355325.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 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The home has an open culture with people who use the service encouraged to voice their views. The complaints procedure is accessible and systems are in place to record any concerns. People who use the service know how to make a complaint. Staff are aware of the procedures to be followed for safeguarding adults. EVIDENCE: Systems are in place for the recording of any complaints. No complaints have been received either in the home or by the CSCI. The person who uses the service told us that they were aware of how to make a complaint. The complaints procedure is provided for each person when they move in and is on display in the house. A copy of the local authority procedure for safeguarding adults is available in the home. Staff are aware of their responsibility to report any concerns they may have about a persons welfare and who to report to. The manager is aware of the need to safeguard the rights of people who use the service and has completed training on the mental capacity act. None of the staff are involved in managing the finances of people who use the service. Siloam Lodge DS0000069560.V355325.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 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service are happy with the facilities. Furnishings and décor are of a good standard. The home is well lit, clean and tidy. EVIDENCE: People who use the service are provided with a comfortable environment. The home consists of a lounge, kitchen/diner and bathroom on the ground floor, two residents bedrooms, a toilet and office on the first floor. There is a large garden to the rear of the house. The manager informed us that she was planning to add a conservatory at a later date. Each person is provided with their own single bedroom. We found the home to be clean and tidy at the time of this visit. The person who uses the service told us that the home was always fresh and clean. All Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 18 areas of the home were seen to be decorated to a good standard and well maintained. Furnishings are of a good standard. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 People who use this service receive good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. People who use the service have confidence in the staff that support them. There are sufficient staff on duty to meet the needs of the person using the service. The manager is aware of the importance of staff training to keep up to date with good practice. Appropriate checks are carried out on staff to assist in protecting the people who use the service. EVIDENCE: The staff group have not been fully recruited as the service is fairly new. A number of staff are working in the service as part of a training course on health and social care. The manager informed us that recruitment of staff was in progress. An induction programme is in place for new staff and it is recommended that the manager make use of the Skills for Care induction programme. Staff told us that they felt they had good training opportunities which helped in meeting the needs of the present resident and in preparation for a second person Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 20 moving in. Recent training has included customer care, the mental capacity act and supporting people with challenging behaviour. Staff have also taken part in infection control, first aid and manual handling training. New staff are provided with an overview of supporting people with mental health needs. The manager should ensure that staff are provided with on going training on mental health issues and are provided with up to date information on good practice in mental health care. Staff felt they were well supported by the manager who was available to offer advice and guidance if needed. The person living at the service told us that staff always treated him well and that carers listened to him and took action on what he said. The manager has started the staff supervision and appraisal system which will ensure that staff work in line with the aims, objectives and philosophy of the service. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 21 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 People who use this service receive adequate quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The manager is aware of the need to keep up to date with practice and continually develop management skills. A quality monitoring system is in place which includes consulting with people who use the service. Records of health and safety checks need to be kept in the home. EVIDENCE: The owner/manager has appropriate experience to manager this type of service and has registered on a course which starts this month so that she can achieve the registered managers award. Systems are in place for formal consultation on the running of the service with the people who live there. The manager has started the quality monitoring and assurance process with questionnaires for people who use and are Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 22 connected with the service. We found staff consulting with the person who lives at the home on day to day issues throughout this visit. To further ensure the safety of people who use the service the manager is arranging to have the smoke alarms connected to the electrical system as advised by the local authority health and safety officer. Risk assessments are in place to make sure that cleaning materials are stored and used safely. Checks are carried out on the building to ensure the safety of people who use and visit the home. In order to ensure food continues to be stored safely staff must keep a record of the temperature of fridges and freezers in line with food safety guidelines. Evidence that testing of portable electrical equipment is carried out annually must be available. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 23 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 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 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 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 2 X 2 X 2 X X 2 X Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Not Applicable 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 YA6 Regulation 15 Timescale for action In order to show that people who 01/02/08 use the service are consulted about and agree their care plan these documents must be signed by all those involved. In order to show that staff 01/02/08 support people to lead the life they choose individual risk assessments need to be developed and reviewed on a regular basis. To ensure that medication can 01/02/08 be audited and tracked a record of all medication brought into the home and returned to the pharmacy must be kept. In order to protect the health 20/01/08 and safety of people who use the service a record of fridge and freezer temperatures must be kept. Fridge temperatures must be checked daily. Freezer temperatures must be checked twice weekly. In order to protect the health 01/02/08 and safety of people who use the service evidence of the annual testing of portable electrical equipment must be available. Requirement 2. YA9 13(4) 3. YA20 13(2) 4. YA42 13(4) 5. YA42 13(4) Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 25 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 YA6 YA35 Good Practice Recommendations Work should be carried out to expand the care plans to include the strengths, needs and goals of individuals along with how these will be met and timescales. In order to meet the needs of people who use the service staff should be provided with on going training on mental health care. Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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. Extracts may not be used or reproduced without the express permission of CSCI Siloam Lodge DS0000069560.V355325.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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