Inspection on 28/02/06 for St Michael`s Lodge

This inspection was carried out on 28th February 2006.

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

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

Other inspections for this house

St Michael`s Lodge 25/02/09

St Michael`s Lodge 28/02/07

St Michael`s Lodge 02/03/05

St Michael`s Lodge 19/04/04

St Michael`s Lodge 09/01/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOME ADULTS 18-65 St Michael`s Lodge 6-8 St Michael`s Avenue Northampton Northants NN1 4JQ Lead Inspector Mr Patrick Toner Unannounced Inspection 28th February 2006 09:30 St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Michael`s Lodge Address 6-8 St Michael`s Avenue Northampton Northants NN1 4JQ 01604 250355 01604 638496 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Raymond Galbraith Mrs Anne Going, Mr Kenneth Going, Mrs Marian Galbriath Mr Raymond Galbraith Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may continue to provide care for 2 existing named service users under 45 years of age The Home provides care for Service Users in the Age category of 45yrs to 65yrs and 65yrs and over. 28th June 2005 Date of last inspection Brief Description of the Service: St Michaels Lodge is a care home providing care and accommodation for 13 service users with Mental Disorders excluding Learning Disabilities and Dementia. Mr K. and Mrs A. Going and Mr R. and Mrs M. Galbraith own the home. Mr R. Galbraith is the Registered Manager. The home is situated within easy access to the Tying Centre and adjacent to a local shopping centre. The home was opened in 1989 and consists of a large Victorian three-storey building providing three double bedrooms and seven single rooms. The home has a stair lift to the basement floor. There are two lounges and a dining room and service users have access to the rear garden St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over approximately 1 1/2 hours during the morning and was carried out as part of the regular inspection visits required by law. Prior to the inspection time was taken to review the information on file and plan for the inspection visit. The method of inspection was to track the lives of several service users. This was achieved by speaking to them, staff on duty and the manager, giving part of the home and observing the relationships in routines. St Michaels house is the sister home located across the street and is also owned and run by Mr and Mrs Cumming and Mr and Mrs Galbraith. The majority of the administration is run from St Michaels house and both homes share a common system of documentation as such with the agreement of both managers inspections are carried out in close proximity to each other, for example there has been a recent inspection of St Michaels house with a focus on the administration system. No requirements or recommendations were made at this inspection. What the service does well: The home provides long-term stability for a group of otherwise vulnerable service users. In discussions with several service users they stressed how happy and content they are living in the home, they have developed friendships with each other and trust in the staff. There is a mixture of dependency levels within the home, several service users are able to attend and benefit from structured community activities, others choose to spend more time on their own, while yet others prefer to be in the company of each other yet enjoy the relaxed atmosphere in the home provides. During this visit the manager was on duty and a second member of staff was carrying out other duties related to the care of service users. The manager was clearly available to service users, they find him approachable and able to offer direction and support. The home continues to maintain a high profile for training and encourages all staff to develop their career potential. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The home enables service users to make an informed choice about whether to come and live at St Michaels Lodge. EVIDENCE: This is an established home and the manager is experienced in the process of pre-placement assessment. The manager is careful not to embellish what the home can provide and ensures that the specific needs of a potential service user can be met without major disruption to the established group of service users. There are opportunities for pre-placement discussions, a review of case histories, short visits, longer visits, overnight stays, and an early review of placement where are risk assessments would dictate this. The manager is aware that moving in and out of the home is a key transition phase which may affect service users behaviours and therefore takes time to reflect on the appropriateness of any decision to admit to the home. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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 The home provides appropriate levels of support based on the assess needs of individual service users. EVIDENCE: A positive aspect of care is the strength of relationships between the manager, staff and service users. Most contact is informal though there are formal systems to review Care Plans. In discussions with the manager he was able to describe the arrangements for personal health care and support as detailed in service users individual plan of care. The manager is proactive and will look for changing mood, habits, weight loss/gain and patterns of relationships for any tensions or stress that these produce. Where concerns are identified action is taken. Action may include reviewing diet or eating patterns, involving GP services or other community services or referral to Community Psychiatric Nurses. There is effective peer support from the manager of the sister home who would share a common understanding of service users needs, rights and aspirations. Listening St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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): 12,15,16,17 Their home has a protective but flexible support system for service users which enables them to enjoy their chosen lifestyle while encouraging community integration. EVIDENCE: Several service users said they liked living in the home and the opportunities are provided either to be alone when they wanted or to engage with others. A number of service users find social integration difficult or on helpful, the home recognises this and supports them with a range of interests which are less stressful. A number of service users will have strained family relationships, where service users express an interest in maintaining either family or other friendships the home will actively promote this on their behalf. Several service users in discussions confirmed they are treated well, with respect and have a high degree of privacy should they wish. One service user who shared a bedroom confirmed it was his wish and he gained great benefit from the friendship which developed from sharing. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 11 The menu plan for the week showed a good range of wholesome if traditional meals was available at all times, the menu is devised with input from service users and it was clear their preferences were being provided. Several service users had a cooked breakfast on the day of the inspection, and another cooked breakfast was planned for later in the week and the manager stressed that in fact a cooked breakfast is available to any service user who requests it. In addition to the normal range of cereals and toast, porridge is always available and this appealed to several residents as a great comfort food. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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): 20 The home provides appropriate personal and health care support. EVIDENCE: The home has a contract arrangement with a local pharmacy which provides quarterly monitoring visits and an annual audit of the homes medication system. Routine medication is dispensed from blister pack systems. In response to the last respects report the home has purchased a secure/locked medication Cabinet. All service users medication is closely monitored and as stated elsewhere any change of mood following changes or omissions/commencement of medication are recorded and reported. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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 robust complaints and panel protection system. EVIDENCE: During discussions several service users confirmed they would feel at ease either making a complaint or raising a general concern, they find the staff approachable and supportive. The manager stressed that staff on duty are always vigilant in relation to interpersonal relationships and will act as advocates for service users who may not feel able or motivated to raise concerns, there are no complaints currently being investigated. Staff have received training in the reporting of Protection of Vulnerable Adults Act concerns and are aware of the procedures, again staff may raise concerns on behalf of service users either in the home or when they are are in the community. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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): 24,30 The home maintains a safe environment. EVIDENCE: The home provides a good range of accommodation and encourages service users to personalise their rooms. Several service users have taken a great interest in their possessions and decorated the room according to their tastes. This is seen as therapeutic and confirmation of their integration with the home. Despite its size it is non-institutional and all service users spoken to regarded it as their home, the place they like to be. During the inspection visit the daily domestic cleaning routine was in progress. Several service users bedrooms were a sample checked as was the social spaces and the kitchen/dining room. The manager confirmed there are ongoing maintenance issues being addressed including the planned replacement for some flooring in the double bedroom observed during the visit. The extractor fan to one of the lounges provides additional relief from service users smoking habits and there is a separate lounge available, known as the quiet lounge, which is a smoke-free zone. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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): 34 The home maintains effective staffing arrangements. EVIDENCE: In discussions with the manager he described the historically low staff turnover pattern. This has led to staff employed acquiring appropriate skills and training and a thorough understanding of the homes routines and the individual care needs of all service users. It is felt this consistency of care and the quality of relationships is what underpins the homes ability to meet the service users needs and enableds them to maintain/ develop coping skills and healthier lifestyles. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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): 39,42 The home is properly managed. EVIDENCE: The service users spoken to had every confidence in the ability of the manager and in the staff to meet their needs. They are supported, consultant and encouraged to express their views and where possible to see their views acted on for the benefit of the home. There are appropriate health and safety risk assessment processes and regular welfare checks, which influence the care planning and review process. Staff welfare is given proper attention and any risk factors associated with either alone working or the need for increased vigilance is communicated and recorded effectively. St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 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 Standard No Score 1 x 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 x 33 x 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 3 x x x 3 x x 3 x St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 18 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 St Michael`s Lodge DS0000012926.V281906.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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. 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