Inspection on 09/09/08 for Stewart Lodge

This inspection was carried out on 9th September 2008.

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

Stewart Lodge 24/09/07

Stewart Lodge 13/02/07

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 Stewart Lodge 24 Rosecourt Road Croydon Surrey CR0 3BS Lead Inspector Emma Dove Key Unannounced Inspection 9th September 2008 1:45 Stewart Lodge DS0000068073.V371327.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 Stewart Lodge DS0000068073.V371327.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. Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stewart Lodge Address 24 Rosecourt Road Croydon Surrey CR0 3BS 020 8684 7333 020 8684 7333 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) Harvey Stewart & Smith Ltd Angela Doreen Gordon Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Stewart Lodge DS0000068073.V371327.R02.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 (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD (o the following age range: 18 years to 65 years) The maximum number of service users who can be accommodated is:3 2. Date of last inspection 24th September 2007 Brief Description of the Service: Stewart Lodge is a residential care home for adults who have experienced longterm mental health problems. Three people are currently living there. The home is a 3 bed roomed terraced house situated in a quiet residential road in Croydon. Local transport facilities are good. Fees for this service are from £1,000 per week. Information about CSCI is available at the home. Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. This unannounced inspection took place over four hours on the 9th September 2008. One regulation inspector visited, looked at records, spoke with people who use the service, the owner and staff. Questionnaires were sent to people who use the service and staff. We have received three completed questionnaires. The owner completed an Annual Quality Assurance Assessment (AQAA), which provided good information which has been included in this report. What the service does well: What has improved since the last inspection? What they could do better: Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 6 Consideration should be given to where information about individuals needs is available, to ensure peoples privacy and dignity are 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. The summary of this inspection report can be made available in other formats on request. Stewart Lodge DS0000068073.V371327.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 Stewart Lodge DS0000068073.V371327.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home understands the importance of having sufficient information when choosing a care home. Admissions are not made until a full needs assessment has been completed. EVIDENCE: The Statement of Purpose and Service Users Guide give people information about the services provided, staffing levels, the experience of the owner and manager, activities, what is included in the fees including the extras which may be charged, medical information and the complaints and allegation of abuse policies. These documents are in written format, which the owner said is accessible to people who currently live there. People who use the service confirmed that they ‘had enough information to help make the decision to move in’. The manager said they always have a full assessment and do their own assessment of an individual before they offer a place. We saw a full assessment completed by the owner before a new person was admitted. Stewart Lodge DS0000068073.V371327.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service involves people in planning their care. Staff understand the importance of people being supported to take control of their lives. People are encouraged and supported to make their own decisions and choices. Risk assessments are in place. EVIDENCE: The owner said care plans are developed using a person centred approach, in line with professionals Care Programme Approach (CPA). We saw care plans cover areas around communication, medication, rehabilitation and any areas of concern. Case files also contained information about individual’s life history and the reasons they require support and assistance at this time. People said that they meet with staff to talk about what they need and what they want to do. People told us that they are involved in planning their future. Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 10 We saw information about individuals on the wall in the kitchen/dining area. This information should not be on display for all to access, but in a cupboard or individuals bedrooms for staff to access easily. This was discussed with the owner who said information about individuals will be appropriately stored. We saw the risk assessment for one person to be minimal. The owner said that this was because staff were still getting to know the person and they could not include issues from previous placements because of the difference in the service. Staff are aware of previous issues and the owner said she is at the service more than usual for the next few weeks and is able to provide additional support to staff if required. Stewart Lodge DS0000068073.V371327.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a commitment to enabling people to develop and maintain social, emotional and independent living skills. People who use the service have the opportunity to develop and maintain important personal and family relationships. People receive a balanced diet that meets their cultural and health needs. EVIDENCE: People who use the service told us that they ‘always’ make decisions about what they do during the day, evening and at weekends. We saw people go out shopping, spend time watching television and talking with staff. People said that they go to the gym, cinema, walking, college and see family and friends. The owner said there is an individual activity programme in place for each person. We saw information about individual’s social and leisure preferences in Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 12 case files. People are supported to be independent. The owner said they want to continue to support people to live the life they choose. People who use the service said ‘staff cook the meals’ and ‘I like the food’. The home follows a repeating menu, although staff said people are asked in the morning what they want and this is prepared. Staff said they are able to meet people’s cultural and religious needs through their knowledge of individual’s culture and by providing African and Jamaican meals. Records are kept of food that has been eaten. Stewart Lodge DS0000068073.V371327.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service receive minimal personal support appropriate to meet their needs. People have access to community healthcare facilities. Medication is well managed. EVIDENCE: We saw case files contain details of individuals health needs. People are registered with a GP and access community health facilities as required. We saw records of health appointments and any actions of follow ups required. The owner said they have good links with the community mental health team who are available to offer support and advise. The owner said they promote independence and are available to help and support people with personal care tasks when required. Staff said they are aware of people’s cultural needs and how to meet them. Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 14 Medication is appropriately stored with good records of medication received, administered and any returned to the pharmacy. People are happy that staff assist them with medication. The owner told us that staff have completed training in medication administration. The medication policy was updated at the time of our visit to include the relevant legislation for medication administration and storage. Stewart Lodge DS0000068073.V371327.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is clear and easy to understand. Appropriate policies are in place for safeguarding and staff have completed training and are aware of their responsibilities. EVIDENCE: People said they would speak to the manager, their social worker or their relatives if they have any worries or concerns. The owner said the complaints procedure is included in the Statement of Purpose and Service Users Guide. We have not received any complaints since the last inspection. The service has not had any complaints. The service follows the local authorities procedure for safeguarding. The owner said staff have completed training in safeguarding and have access to a DVD with more training on adult protection. The owner told us that the placing authorities are ‘appointees’ for individual’s finances and that staff support people to manage their finances. Stewart Lodge DS0000068073.V371327.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to meet the needs of the people who live there. Bedrooms are single and people are encouraged to personalise their rooms. There are sufficient bathrooms and toilets to meet people’s needs. The home is well lit, clean and tidy. EVIDENCE: Stewart Lodge is a small terraced house in a residential area of Croydon. People have access to a lounge, laundry area and kitchen/dining room on the ground floor. A small enclosed garden is accessed through the kitchen with a gym in a building at the end. Bedrooms, a bathroom with toilet and a small office are on the first floor. The owner said people are encouraged to personalise their bedrooms. People said they have all they need in their rooms. People told us that the home is ‘always’ clean and fresh. One person said they keep their room clean and tidy. Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 17 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 and 35 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. There are enough staff to meet peoples needs. Staff have access to relevant training. Staff recruitment is in line with regulations. EVIDENCE: The published staff rota noted one member of staff on duty during the day and at night. People who use the service, the owner and staff confirmed that the staff levels are sufficient to meet people’s needs. A comment that it ‘can be hectic at times’ indicated that more staff may be needed during the day. The owner said that there is usually an overlap of staff during the day to enable people to go out to the places and activities of their choice and that nobody misses their chosen outing or activity due to lack of staff. People told us that staff ‘always’ listen and act on what they say’. One person said ‘staff help me live a careful lifestyle’ which is important to them. We saw positive relationships between staff and people who use the service. Staff demonstrated a detailed knowledge of people’s needs and preferences. Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 18 Staff files contained two written references, with one exception. The owner explained that the member of staff has been at the home for some time and getting a second reference would not be possible now. The owner is aware of the need to get a full employment history, two references including one from the most current employer. The employment information for one member of staff was updated during out visit to include a full employment history. The owner told us that staff have access to training to help them carry out their role. Staff confirmed that they have completed NVQ training and do short courses relevant to their job. Stewart Lodge DS0000068073.V371327.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The owner works closely with the manager to ensure a good level of service is provided. Quality assurance systems are in place which offer people the opportunity to comment about the service they receive. Good systems are in place for health and safety. EVIDENCE: The owner and manager have many years experience in residential care settings for people with mental health and learning disabilities. People who use the service are confident that staff and the manager will listen and act on what they say and that issues will be resolved. They feel involved in the day-to-day running of the home. Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 20 The owner said she completes satisfaction surveys with people who use the service each month. Any issues raised in these surveys are discussed with staff and addressed, although the sample we saw were positive with no actions required. There is also a suggestion box at the home for people who use the service. Regular ‘house’ meetings are held where people can discuss the menu, activities, outings and any suggestions for the future. A health and safety audit is completed every month. In addition, the fire alarm system is checked weekly and annually as required. The electrical supply was checked in November 2006, portable electrical appliances were tested in November 2007 and gas safety was checked in April 2008. Stewart Lodge DS0000068073.V371327.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 3 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Stewart Lodge DS0000068073.V371327.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. Refer to Standard Good Practice Recommendations Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 23 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Stewart Lodge DS0000068073.V371327.R02.S.doc Version 5.2 Page 24 - 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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