Inspection on 29/08/06 for Stoke Lodge

This inspection was carried out on 29th August 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

Stoke Lodge 27/01/06

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 Beverley Rand Unannounced Inspection 29th August 2006 10:00 Stoke Lodge DS0000055569.V308847.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 Stoke Lodge DS0000055569.V308847.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. Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 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.V308847.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user whose date of birth is 13/05/89 can be admitted to the home. 27th January 2006 Date of last inspection Brief Description of the Service: Stoke Lodge provides a service to nine younger adults with a learning disability. At present, all the service users are young men. 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. Fees are based on individual assessed needs and currently vary between £1656 and £1951 a week. Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and the inspector looked around the house and garden, spoke with two service users, two staff and the manager. The inspector also looked at records such as service user plans and staff training records. What the service does well: What has improved since the last inspection? What they could do better: Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 6 The home has a complaints procedure but the service users do not have their own copy. The procedure is also written which means that some service users would not be able to understand it. The home should think about other ways of giving the information to service users, for example, in pictures or on tape. 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.V308847.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 Stoke Lodge DS0000055569.V308847.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that new service users’ needs are assessed and that the home can meet their needs. EVIDENCE: The home is currently undertaking an assessment process for a service user. The process has involved obtaining a care management assessment, as well as completing their own, stays of various lengths including overnight and transition meetings to review the progress of these events. When the new service user moves in there will be a review after four weeks. The assessment showed particular interests, which can be provided by the home, as well as a health need which has also been fully considered by the staff. Stoke Lodge DS0000055569.V308847.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that individual needs are met. EVIDENCE: Service user plans were detailed and are reviewed every six months, with service user involvement. Plans showed individual needs in areas such as communication, goals, household tasks and intervention strategies. Files also showed information such as visits to healthcare professionals, name preference and family birthdays. A particular intervention was being used for one service user which was not detailed in his service user plan, and this should be rectified. It was evident that service users make decisions on a daily basis and that staff support where necessary. Examples of this included a service user planning a recipe for a cooking session, choice of bedroom colour, a resident buying a camera with his savings, two service users going to London for the day and individual choices for holidays. Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 10 Service users participate in activities which necessarily involve some level of risk, for example, going out and going horse riding. Risk assessments are in place for these activities and assessments are also in place for every day risks around the home. Stoke Lodge DS0000055569.V308847.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that service users can participate in activities, socialise and enjoy a varied diet. EVIDENCE: One service user attends college where he is undertaking a horticultural course and another has done courses in media and drama, but some are unable to attend college due to their individual needs. Staff are currently trying to access ‘Link Up’ which is an educational framework for people with learning disabilities who wish to enter the workplace. The course teaches people how to ensure they arrive at work on time, how to deal with being unwell, etc., which will assist service users to live independently. One service user has a part time paid job at the head office of Choice Ltd. The company employs a ‘day service organiser’ who takes the lead on in house ‘day care’ provision. All residents have a daily programme of activities, which is discussed with them, and displayed in a format they can understand. Service users often ask what they are doing next, so this is a useful way of ensuring they can find out easily. Service users have an individual cooking session with the chef, which they enjoy. On the day of the inspection one service user had made cheesy potato pie for his tea, and another service user was looking at instructions to make Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 12 chocolate mousse. One service user said he did not like day care, because it meant he had to get up. However, on further discussion, there were aspects he did enjoy and day care was part of his service user plan, to promote independent living skills. Outside activities include bowling, going to pubs, shopping, cinema, boat trips and days out. On the second day of the inspection, two service users went to London for a tour of the BBC studios. One of the service users sat and talked with the inspector for a while, and it was clear that he was very excited about going on the trip. The home has just purchased a summerhouse for the garden which they aim to use as a base for in house activities such as art and craft, which is currently undertaken in the dining room. The home has a computer with Internet access, and service users are supported to use this appropriately. All but one service user has had a holiday this year, and the remaining one is going next month. One service user told the inspector he had enjoyed his holiday, and that he had chosen where and when he would go. Staff are aware of the potential difficulties when accessing the community with service users who can display challenging behaviour, and strategies are in place to minimise this, for example, the number of staff needed to support each service user. Staff support family relationships as appropriate. Friendships have been formed between the service users who live at Stoke Lodge and those at other homes within the group. Service users’ bedroom doors are locked when they are not in them and some service users keep their own key. Staff were seen interacting in an appropriate way with service users. Service users do not have unrestricted access to all areas of the home but this is due to assessed need. Service users can access the kitchen, the computer room and the garden but need supervision at all times. Service users participate in household tasks such as setting or wiping the tables. One service user told the inspector he did not like a lot of the food on the menu, but that the chef would make him something else. The home employs a chef to make lunch and prepare an evening meal. Part of the chef’s role is to provide one to one or group cooking sessions with service users. The menu is discussed at service user meetings and worked out three weeks in advance. If a service user does not like what is on the menu, or if they do not want it on that day, they can go to the kitchen and make something else. On the first day of the inspection the chef was making garlic bread to go with the chilli he had made. A picture of the main meal is placed where service users can see it. The chef can cater for special diets and is conscious of the need for healthy eating so fruit and yoghurts are often offered. Stoke Lodge DS0000055569.V308847.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that service users’ personal and healthcare needs are met and that they are protected by the medication administration systems. EVIDENCE: The home operates a ‘keyworker’ system and keyworkers are responsible for reviewing service user plans. Staff gave examples as to how they conducted personal care whilst maintaining privacy and dignity. Examples included ensuring that doors were closed, supporting service users to maintain their own dignity and discussing private issues away from the group. However, the inspector looked at the minutes from the last two service user meetings and saw that staff had raised issues to the group with regard to the personal care needs of individual service users. The manager agreed this was not appropriate and made a note to address the issue. Service users communicate with staff in differing ways, including speech, the Picture Exchange Communication System or Makaton. There are posters regarding the latter two, and staff keep pictures of key Makaton signs on their keyrings. Service users have access to healthcare professionals such as doctors, dentists and chiropodists. The home is proactive in seeking professional advice when they notice a behaviour change, for example, from GPs and the consultant Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 14 psychologist. Behaviour observation charts are completed when necessary so that any patterns can be seen and medication or support plans can be reviewed. The medication is stored appropriately and the administration procedure requires two staff to administer and record all medication. There were guidelines in place for staff to follow when administering drugs when needed to calm service users’ down. Staff have training in the administration of medication and are not allowed to dispense medication until they have received this training and are supervised by a more experienced staff member. Stoke Lodge DS0000055569.V308847.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Whilst the procedures in place ensure the service users are protected, distribution of a user friendly version of the complaints procedure to individuals would benefit services users. EVIDENCE: The home has a complaints procedure in place which gives details regarding timescales. However, service users or their families do not have a copy. The majority of service users would not be able to access the content of a written format, although the manager thought some could understand if it was in a format which they could understand, such as pictures. The home has an adult protection procedure in place but does not have a child protection procedure. The home should have this because, on occasion, service users move in who are under 18. Staff have received training in this regard and were aware of what to do if there was an allegation or suspicion of abuse. Due to the nature of the challenging behaviour at the home, physical intervention is sometimes necessary. All staff have received training in Strategies for Crisis Intervention and Prevention which includes techniques for physical intervention. The home looks after money for service users and two records were looked at. Receipts are kept and the money matched the records. Stoke Lodge DS0000055569.V308847.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The provider ensures service users live in a clean and safe environment. EVIDENCE: Due to the needs of the current service users, the home has an on-going programme of maintenance and repair. The home has a ‘quiet’ lounge and a room which has sofas, a television and a dining area. All the bedrooms have an en-suite facility. Communal parts of the home and some bedrooms are sparsely furnished with the television being behind Perspex. This is due to individual service users’ needs and challenging behaviour. However, some of the bedrooms were highly individualised, with it being evident what their particular interests are. One service user who was asked said he was happy with the colour of his room. Another one said his room was going to be painted soon and he would like blue and cream. One service user’s room is painted red, which was his choice, and he helped to paint it. The home has a large garden with lots of seating and a trampoline. In response to some service users throwing items over the fence into the neighbouring garden, a second fence has been built inside the boundary. This Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 17 part of the garden is being planted by staff and service users as a sensory garden, and they are planning to plant a vegetable patch. Staff told the inspector how they worked with soiled laundry to reduce the risk of cross infection, and how they used laundry bags and disposable gloves and aprons. Staff confirmed there was always a good supply of these items. Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 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, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The training programme ensures that staff are well trained and the qualification programme is ongoing. The home ensures that service users are protected by the recruitment procedures. EVIDENCE: The home employs eighteen support staff. Four have achieved a National Vocational Qualification, (NVQ) in Care, at level 2 or above and nine are currently studying for an NVQ. The manager said that the home has previously had more qualified staff but that this has changed due to previous staff turnover. When the staff currently working towards an NVQ complete the course, the home will have more than 50 of staff trained to this level. The manager explained the recruitment procedure which includes applicants completing an application form, face to face interviews, references and Criminal Records Bureau checks. The inspector looked at the recruitment file for a new staff member and found that it included all the necessary checks in place before the person started work. There is a rolling programme of training which includes core subjects such as moving and handling, first aid, food hygiene and fire safety. Other training includes Strategies for Crisis Intervention and Prevention, Autism and Aspergers and Makaton. Training is well attended and staff said they found the Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 19 training useful. New staff undergo formal induction training, using a booklet, which is signed and dated. The new staff member has done this induction and is currently working through the Learning Disability Award Framework induction. Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are supported by a well managed home however this will be enhanced by the manager completing the Registered Manager’s Award. Systems are in place to monitor the quality of the service offered. The manager ensures that service users live in a safe home. EVIDENCE: The manager has attended various training since the last inspection, including the Strategies for Crisis Intervention and Prevention Foundation course, Autism and Aspergers refresher, Values and Attitudes and Protection of Children. He has continued working towards achieving the Registered Manager’s Award and hopes to complete his work modules in about four weeks. The home has a system in place for monitoring the performance of the home. A questionnaire is sent to service users, families and staff every year. The results are analysed by head office and feedback is given the home. A development plan is then drawn up. Service users also complete a questionnaire when they have their six monthly reviews. Service user meetings Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 21 are held approximately every month, but although minutes are taken, these are in a written format so not available to everyone. The home should consider how minutes could be accessed by more service users. The home has been working on re-writing the fire safety procedure due to particular issues with the current service users, to ensure the safety of all involved. The staff have worked on a programme to reduce the risks involved in testing the fire alarms, which the manager said has worked well. An external company tests and maintains the fire equipment and internal checks are done on a weekly basis. Maintenance certificates were sampled for the testing of electrical equipment and the boiler. The hazardous substances are stored in a locked cupboard. Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 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 3 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 2 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 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X 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 2 X 3 X X 3 X Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 Page 23 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. 1 2 Refer to Standard YA22 YA23 Good Practice Recommendations The home should look at ways in which the complaints procedure can be made available to service users. The home should have a child protection policy. Stoke Lodge DS0000055569.V308847.R02.S.doc Version 5.2 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.V308847.R02.S.doc Version 5.2 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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