Inspection on 27/01/06 for Stoke Lodge

This inspection was carried out on 27th January 2006.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stoke Lodge 29/08/06

Stoke Lodge 15/06/05

Stoke Lodge 06/01/05

Stoke Lodge 10/08/04

Similar services:

Hillview Farm

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 Inspection 27th January and 8 February 2006 10:00 th Stoke Lodge DS0000055569.V277472.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 Stoke Lodge DS0000055569.V277472.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. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stoke Lodge Address 85 Cliddesden Road Basingstoke Hampshire RG21 3EY 01189 581950 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) mark.morgan@choiceltd.co.uk Choice Limited Mark David Morgan Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 9 service users between 18 - 65 years of age with a Learning Disability may be accommodated. A service user with the date of birth 12/02/87 can be admitted to the home. 15th June 2005 Date of last inspection 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 DS0000055569.V277472.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 seven hours split across two days. 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 assistant manager and staff members who were on duty. The inspector made a second visit to the home to meet the manager and access further records. What the service does well: 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. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 6 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 Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 7 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): These standards were not assessed at this visit. EVIDENCE: Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 8 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 and 7 Improvements to the service user’s plans demonstrate that service users needs are documented and responded to. The practices of the home support service users to make decisions as part of every day life. EVIDENCE: The inspector examined a sample of three service users plans. Since the last inspection further work has been completed to develop the plans for each person. The plans contained statements about service user’s needs and how staff should respond to meet these needs. There was a fully completed profile on domestic, community and educational needs and abilities. Information on service user’s likes and dislikes, background history, important relationships and behavioural support plans were all contained within the plan. The inspector was able to see that goals are being developed with service users. One service user’s plan includes a goal to redecorate his room and the Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 9 inspector was asked by this person to come and see how he is progressing with achieving his goal. The service user was supported to choose and paint the room himself. A service user showed the inspector how they are being supported to plan and predict their daily routines. They are using pictorial activity boards that are situated in the dining room. The home has set up key-worker meetings to support service users to review their plans and goals. Staff members told the inspector that they are working on the regularity and consistency of these meetings. A record of regular service user’s meetings is maintained in the home and this meeting has been used to plan activities, make choices about meals and decide on the colour scheme for the communal parts of the home. 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 inspector saw a clear risk assessment and action plan for one service user for their support and supervision needs when in the garden. Staff were able to demonstrate a knowledge of this plan and the importance on maintaining the supervision of service users when outside of the home. Stoke Lodge DS0000055569.V277472.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): 16 and 17 The home recognises the rights and responsibilities of service users. Service users benefit from the provision of a well balanced diet reflecting their individual likes and dislikes. EVIDENCE: The inspector spoke to service users and staff members during the visits to the home. He also observed staff interacting positively with service users supporting them to prepare for activities and manage high anxiety situations. The inspector noted information with service users plans that details approaches to promote service users to manage and take more responsibility for their challenging behaviour. One service user works one day a week at the organisations head office taking on responsibilities to help build his independence. Staff stated that service users can have keys to their bedrooms and they are supported to maintain their privacy. Rooms are locked when service users are out of the home and staff members were observed to knock on doors before Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 11 entering. Service users have been given information on their rights and responsibilities in their service user’s guide and contract. The home has a chef who prepares the meals during the week. A menu plan is agreed with service users at the service user meeting. The chef confirmed that alternative meals are offered to individuals based on their wishes and preferences. The chef also works with service users to support them to prepare their own meals. The kitchen contained plenty of fresh fruit and vegetables and the menu was balanced and offered healthy choices. Stoke Lodge DS0000055569.V277472.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 cannot demonstrate that a satisfactory medication administration system is in place. EVIDENCE: The inspector examined the medication administration practices in the home. The service uses a monitored dosage system and medication is held in a secure metal drug cabinet. The home has a member of staff responsible for the monitoring on medication in the home and they explained the practices used in the home. The inspector noted that some medication has been altered on the medication administration records. The times and dosages have been changed and the inspector was told that these changes are as a result of healthcare reviews and visits from a consultant. One drug is prescribed four times a day and this has been changed to when required and another drug has been changed from twice a day to a lower does at night. These changes are not supported by evidence of prescription changes and discussions with staff indicated that the changes took place a number of months ago. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 13 The manager was required to take action to ensure the correct prescription is in place for each of these service users. The home keeps records of medication received into the service each month however some medication kept for longer does not have a stock record. The staff member was advised to keep a record of all medication in the home. The inspector was provided with information to confirm that staff have training in the administration of medication and are not allowed to dispense medication until they have received this training and are supervised a more experienced staff member. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 Complaints procedures are in place demonstrating that the views and concerns of service users, their families and representatives are recorded and responded to. The practices of the home protect service users from abuse. EVIDENCE: The inspector examined the homes complaint log and discussed the entries with the manager. The log contained clearer details of the actions that have been taken and the outcomes of the recorded complaints. Complaints related to noise and throwing objects over the fence remain unresolved and the manager outlined what steps had been taken to date to resolve the issues with complaints from neighbours. The manager stated that they would continue to monitor these concerns and take action if necessary to reduce noise and inconvenience where possible. Clear risk assessments are in place detailing the actions staff must take to support and supervise service users in the garden. Staff members were asked about these guidelines and they demonstrated that they are aware of what support service users require. The inspector confirmed by checking staff training records that staff receive training in protecting service users from abuse and this is supported by an adult protection policy. The home has a copy of the Hampshire Policy for the Protection of Vulnerable Adults. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 15 Staff told the inspector that the home supports service users to manage their monies. The inspector looked at service users records, which demonstrated that service users sign for the transactions that take place. The inspector saw documentary evidence to confirm that service users receive their personal allowances. An entry in one service user’s financial record indicates that they are paying another service user for damage to personal property. The senior staff was advised that they document this agreement and demonstrate that the service user has been supported to understand this agreement with input form their care manager or representative. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 25 Service users benefit from a comfortable and spacious home enhanced by a large garden and alternative quieter spaces within the home. The practices of the home encourage service users to take part in the personalisation of their rooms to meet their needs and preferences. EVIDENCE: The inspector toured the home and garden during the visit. The home was tidy and free from any unpleasant smells. The garden was tidy and well maintained. A new building has been erected at the side of the garden and the inspector was told that this is to be used as an activity room. The interior of the home was generally in a good state of repair. Some areas around doors are damaged and the manager stated that they have an ongoing maintenance programme to keep up with the repairs. On the first day of the inspection the inspector was told of plans to redecorate the communal areas of the home when he returned for the second visit this work had begun. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 17 A service user invited the inspector to look at their bedroom and the inspector saw the work the service user had undertaken to redecorate their own personal space. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36 Service users are supported by and effectively trained and supervised staff team. The recruitment practices of the home protect service users. EVIDENCE: The inspector met with the manager and member of staff responsible for coordinating the training programme in the home. Currently two staff have NVQ 3 awards in care and two more staff are working on their awards. The inspector was told that a further two staff are waiting for their start date. Seven other staff have completed requests to be included in the NVQ programme. A staff rota is in place in the home and when examined by the inspector it indicated that a minimum of four staff members are on duty throughout the day to support service users. In addition a day service coordinator works across the day to facilitate and organise activities. The inspector examined a sample of five staff records to confirm that appropriate checks are completed on staff before they start work in the home. Records confirmed that two written references and proof of identity are Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 19 obtained for each person and a Criminal Records Bureau (CRB) check and Protection of Vulnerable Adults (POVA) checks are completed. An induction programme is in place in the home and the inspector spoke to three staff about their experiences of starting work in the home. A checklist was seen for staff to confirm that the induction takes place and staff also confirmed that they worked alongside a more experienced members of staff when they started. A training programme covers a wide range of subjects including mandatory training in Moving and Handling, Food Hygiene, Health and Safety, First Aid and Protection of Vulnerable Adults. A number of new staff members were booked to attend training in the above subjects. The training coordinator told the inspector that they have changed training providers recently and the new company has now provided dates for these courses. Additional training is provided in epilepsy, managing aggression, personal relationships, communication and values and attitudes. Staff who are new to working with people with a learning disability also complete a Learning Disability Awards Framework (LDAF) induction and foundation workbook. At the last visit to the home the inspector noted that the home had an established system of supervision for staff and the deputy manager provided a record to demonstrate that staff are being supervised on a regular basis. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Service users are supported by a well managed home however this will be enhanced by the manager obtaining their NVQ four in management and care. 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. Improvements to the fire safety practice in the home keep service users safe. EVIDENCE: The manager discussed their current training and development with the inspector. The manager has attended a management development programme this year, which included training in recruitment and selection, employment law and anti-discriminatory practice. The manager has also attended training in restrictive techniques and food hygiene. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 21 The manager is undertaking his Registered Manager’s Award however he has not completed much work on this lately. The manager stated that he has a deadline of August 2006 to complete this award. The inspector advised that the manager would need to demonstrate that they have obtained a qualification in care and management at NVQ level four. The home has a system for monitoring the quality of the home, which is supported by a policy and procedure. The inspector saw documentary evidence of this process with comments from service users, relatives, staff and care managers. The inspector saw evidence that regular fire drills are taking place. The inspector spoke to the manager and deputy manager who stated that during a recent drill issues were raised about the safety of service users during a total evacuation. A visit has been arranged by the Health and safety consultant to look at what can be done to improve the procedures and the deputy manager said that he would keep the inspector informed of the outcome. Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 22 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 X 3 X 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 3 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 2 X 3 X X 3 X Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 23 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 YA20 Regulation 13 Requirement The registered manager must ensure that the medication being dispensed is supported by an accurate prescription. The manager must ensure that records of medication held in the home are accurately recorded. Timescale for action 08/03/06 2 YA20 13 08/03/06 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 Stoke Lodge DS0000055569.V277472.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hampshire 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 DS0000055569.V277472.R01.S.doc Version 5.1 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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