Inspection on 15/06/05 for Stoke Lodge

This inspection was carried out on 15th June 2005.

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 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

Stoke Lodge 29/08/06

Stoke Lodge 27/01/06

Stoke Lodge 06/01/05

Stoke Lodge 10/08/04

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Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Stoke Lodge 85 Cliddesden Road Basingstoke Hampshire RG21 3EY Lead Inspector John Vaughan Unannounced 15 June 2005, 10:00 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 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 Stationary 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. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stoke Lodge Address 85 Cliddesden Road, Basingstoke, Hampshire, RG21 3EY Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01189 581950 Community Homes of Intensive Care and Education LTD Mark David Morgan Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. A service user with the date of birth 12/02/87 can be admitted to the home. Date of last inspection 06/01/05 Brief Description of the Service: Stoke Lodge provides a service to nine younger adults with a learning disability. The home has been developed to work with service users with complex needs including service users who challenge the services provided for them. The home is owned and managed by C.H.O.I.C.E Ltd. Accommodation is provided on two floors in a large house that has been refurbished and redeveloped to provide this service. The house is situated on the outskirts of Basingstoke and is close to all local services. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours. Some of the service users were seen and the inspector spent time meeting with service users and individual staff members talking about their experiences of living and working in the home. The inspector looked around the home, was shown some of the service user’s bedrooms, sampled some of the homes records and talked to the manager and staff members who were on duty. What the service does well: What has improved since the last inspection? What they could do better: The manager has been asked to improve the care planning systems in the home to clearly document strategies to support service user’s development, goals and wishes. The home needs to look at how it records complaints and make sure all of the information needed is recorded in their log for the inspector to see at his visits. The manager must improve their supervision of staff to make sure they are getting the support they need to help them develop their skills and knowledge, he was also asked to carry out a fire drill and practice to ensure staff fire safety skills are monitored and responded to. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 6 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. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 standard(s) 2,3 and 4 The home can demonstrate that service users needs are assessed and service users can try out the service before they move in. EVIDENCE: The inspector met with a new service user and discussed the move into the home with the manager and staff. Information was seen on the individual’s file to confirm that a significant amount of work took place with the service user prior to moving into the home. Information and assessment work from the care manager was seen by the inspector together with a placement specification and service user’s history. A transitional plan was available to demonstrate how the person was supported to visit the home and to meet other service users and staff. The service users guide was also seen and this is laid out in a mixture of pictures, photographs and symbols to make it more accessible to service users. The manager stated that additional picture were taken of the home and the environment and these were given to the service user and their carers to assist with the move. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 standard(s) 6 and 9 The lack of fully documented support strategies means the home cannot demonstrate that service users ongoing needs are being met. EVIDENCE: The inspector sampled three service user’s plans during the course of the visit. A new format has been introduced and the manager stated this is to focus more on relevant information to help support service users. One plan sampled had significant gaps in information and two plans did not reflect other intervention strategies in place for the individuals. Goals for the individuals had not been identified and there were no documented action plans. A summary version of the plan is also available which is intended to document action plans. This was not available for two of the three plans sampled. One of these documents was seen and it detailed three prioritised actions starting Computer course, writing own diary and to do more exercise. The inspector discussed this with a staff member and advised that information on how the person is to be supported is required to achieve these goals. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 10 The manager and inspector discussed the current situation in relation to care planning. Work is needed to ensure all parts of the plan are completed and that strategies are fully documented. Risk assessments are in place covering a wide range of activities. A document seen includes a brief risk assessment summary followed by more detailed action plans. Areas covered include risks within the home, outdoor activities and supervision needs. A section indicates that wider consultation takes place on risks including family members, the care manager and psychologist. The home has stated that they are no longer able to meet the needs of one service user and are awaiting confirmation from the care manager on a suitable alternative placement. Additional support and intervention strategies have been put in place. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 15 Service users benefit from diverse activity programme including the support to maintain relationships and contacts with families and friends. EVIDENCE: The inspector spoke to service users about their activities and one person commented on how they had enjoyed the bowling trip earlier today. Three service users were out at college on the day of the inspection. Subjects undertaken by service users included craft, computers and horticulture The manager told the inspector that one service user enjoys music and this includes playing musical instruments. The inspector had the opportunity to listen to the service user when they played their guitar for the inspector. Later on the service user joined with some of their peers for a music session facilitated by a musician. The inspector was informed that they visit weekly. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 12 The activity programme would be greatly enhanced by linking it with personal development goals and structured support for individuals within their service users plans. The inspector noted information on family contacts and was told by staff that service users are supported to keep in touch with families by visits and use of the telephone. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 standard(s) 18 and 19 The home provides support for service users to access health Care professionals to meet their needs. EVIDENCE: The inspector noted information on service users rights with their files and service user guide. Staff were observed knocking on doors and encouraging service users to keep their rooms locked to maintain their privacy. When sampling service users plans the inspector was able to confirm that service users are registered with a general practitioner and are supported to visit specialists in connection with their medical needs. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22 Complaints procedures are in place demonstrating that the views and concerns of service users, their families and representatives are recorded and responded to Procedures however the home cannot fully demonstrate that these are being used effectively. EVIDENCE: The inspector examined the homes complaint log and discussed the entries with the manager. Two complaints have not been entered into the log correctly and do not contain any details of the actions that have been taken and the outcomes of these complaints. One complaint related to noise has not been resolved yet and the manager outline what steps had been taken to date to resolve the issues with complaints from neighbours. The manager was required to ensure all complaints are fully documented, dated and all actions and outcomes are on record. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24, 26 and 30 The home provides communal and private spaces assessable to service users demonstrating that individual needs are met and service users privacy and independence are promoted. EVIDENCE: The inspector toured the home with assistance from the manager and service users. The home has a large dinning room interconnected with a lounge area. A separate small quiet room is close to the office and a sensory room is located on the first floor. A serious leak was being repaired at the time of the visit and this had caused damage to walls and the ceiling in the front reception areas of the home. The garden is well maintained and the inspector was informed that some parts are to be developed as horticultural areas where service users can be supported to grow plants, flowers and vegetables. Fences have been erected in response to concerns raised by neighbours. The manager stated that items have been thrown into neighbouring gardens and the boundaries have been enlarged in an effort to limit such incidents. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 16 Four service users bedrooms were viewed and the inspector noted very different styles and layouts with clear evidence of personalisation. Service users have brought with them personal belongings and equipment such as TV’s, video and DVD players. Two rooms at the front of the property are clearly overlooked from outside and the manager was advised to look at increasing the privacy of these windows in consultation with the service users. One service user’s room has had new windows installed and the manager stated that these are more robust and have been installed based on the need of the individual. The manager stated that this service user also chose new paint colours and carpet. Some parts of the communal areas and doorways are looking shabby and have been damaged. The inspector observed maintenance staff repairing and redecoration these areas. The home was found to be generally clean and free from any unpleasant odours. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 and 36 An appropriately trained staff team is in place to meet service users needs however the home cannot demonstrate that staff are effectively supervised. EVIDENCE: The inspector met with two staff working in the home and discussed the training and induction programme. Staff confirmed that they work alongside experienced staff when the started in the home and received information and documentation to read in relation to policies and procedures and service users needs. Staff confirmed that they receive regular training and had an induction when they started in the home. Recent training included physical intervention updates and autism. A record for each staff is maintained in the home and records sampled provided evidence that training has been completed in areas such as fire safety, moving and handling, food hygiene and first aid. The induction records for three staff were sampled and two of these have not been filled in properly. The manager stated that these staff have had a full induction but the record had not been completed and he gave an undertaking to complete these documents. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 18 A supervision system is in place and this was confirmed by staff however the records indicated that it is not happening regularly. Some staff have not had supervision in six months, some have had sessions last month. The senior member of staff assisting the inspector at this point stated that the shortfall in supervision has been recognised. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 Systems for monitoring the quality and development of the service are in place supporting service users and their representatives to raise concerns and comment on the running of the home. However these have not had any impact on the delivery of the service. The lack of regular fire practices could place service users and staff at risk. EVIDENCE: Regulation 26 visits are undertaken and a report is sent to the commission. At the last visit the inspector was informed that a service audit had taken place however the report was not available at the time of the inspection. The manager was unable to find this report and staff did not appear to be aware of the audit. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 20 The inspector discussed this with the manager and advised that further work is needed to complete this process and to demonstrate that they are responding to the feedback of the participants of the audit. The inspector examined the fire safety records of to confirm that regular checks and servicing of the fire systems are carried out. The fire alarm system was last serviced 9/6/05 and weekly checks of the system are carried out. A fire risk assessment is in place detailing the actions the home has taken to minimise the risk of fire in the home. The last fire drill was carried out 4/8/04 and the manager was advised that he needs to carry a drill out as soon as possible to ensure staff are practiced in evacuation. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stoke Lodge Score x 3 x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 22 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. 1. Standard 6 Regulation 15 Timescale for action The registered manager must 15th ensure all service users plans are September reviewed and updated.This must 2005 include clear strategies for supporting service users to achieve goals and aspirations. The registered person must ensure that complaints are fully recorded including the action they have taken, outcomes and clear dates when these actions took place. The registered manager must ensure that all staff have regular supervision. The registered manager must ensure that regular fire practices are undertaken and a clear record of these practices is maintained in the home. 15th July 2005 Requirement 2. 22 22.3 3. 4. 36 42 18 23 15th August 2005 15th July 2005 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 Good Practice Recommendations H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 23 Stoke Lodge 1. Standard 39 The manager should complete the quality audit anaysis and communicate its outcomes to the service users and all other participants. Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Hampshire Area Office 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Stoke Lodge H54 S55569 Stoke Lodge V233180 150605 Stage 4.doc Version 1.30 Page 25 - 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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