Inspection on 03/08/09 for Stonesby Lodge

This inspection was carried out on 3rd August 2009.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stonesby Lodge 14/08/08

Stonesby Lodge 19/09/07

Stonesby Lodge 25/07/06

Stonesby Lodge 04/01/06

Stonesby Lodge 14/04/05

Stonesby Lodge 09/09/04

Stonesby Lodge 06/05/04

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report CARE HOME ADULTS 18-65 Stonesby Lodge 109 Stonesby Avenue Leicester LE2 6TY Lead Inspector Linda Clarke Key Unannounced Inspection 3rd August 2009 09:30 Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stonesby Lodge Address 109 Stonesby Avenue Leicester LE2 6TY 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) 0116 2830128/2701744 gbonom@dmu.ac.uk Mr R Bonomaully Mrs S Bates Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 14th August 2008 Brief Description of the Service: Stonesby Lodge provides a service for 12 people with mental health problems. The home, opened in 1989, is an extended detached house located on the edge of the Saffron Lodge estate. It has a large lounge-diner and a smaller lounge where staff and residents may smoke. The majority of residents rooms (7 single and 1 double) are located on the ground floor. There is one single and one double room located on the first floor. All rooms have wash hand basins and double rooms have appropriate screening for privacy. There are bathrooms, a shower room and toilets close to the bedrooms. The home has two internal courtyards, accessible for people to use with patio furniture. The home is situated on a main road, close to shops, churches, day services, the library and other amenities. There are regular bus services to Leicester and Wigston. The charges are assessed according to people’s needs, which are currently £295.00 per week. The Registered Manager provided this information during the site visit to the Home. Stonesby Lodge DS0000006370.V376875.R01.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 0 star. This means the people who use this service experience poor quality outcomes. ‘We’ as it appears throughout the inspection report refers to the ‘Care Quality Commission’. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is a selfassessment tool completed by a representative of the service, reviewing previous inspection reports, and any information we have received. The unannounced site visit took place on 3rd August 2009, between 09:30 and 15:30. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was ‘case tracking’. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Stonesby Lodge. Three people accessing services were chosen and discussion was held with all of them, along with others living at the home. We sent surveys to the ten people living at the home of which five were returned. We sent surveys to health care and social care professionals, and received comments from one health care professional. We also sent surveys to staff who work at the home but none were returned. What the service does well: People living at Stonesby Lodge are supported by staff who have worked at the home for many years, and who know them well. There is a good rapport between those that live at the home and those working at the home and the atmosphere is friendly and relaxed. Stonesby Lodge enables those living at the home to lead an independent lifestyle free from restrictions. People are encouraged to access the community independently and lead rewarding and fulfilling lives. People we spoke with who live at the home spoke very positively about the care and support they receive, with everyone saying that they wanted to continue living at the home, as the staff looked after them well, and they had no complaints. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Stonesby Lodge DS0000006370.V376875.R01.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 Stonesby Lodge DS0000006370.V376875.R01.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Stonesby Lodge enables people to make an informed decision as to whether the home is appropriate to their needs by encouraging visits to the home and through its assessment and review process. EVIDENCE: We sent surveys to people who live at the home, those that were returned to us stated that they had received information about the home prior to their moving in, and that this information had enabled them to make a decision about whether the home was suitable for their needs. We wanted to find out how the needs of people were determined so that the home knew whether they could meet someone’s needs before they moved into the home. We looked at the records of three people who live at Stonesby Lodge, and found that individuals had had their needs assessed by a Social Worker or health care professional, and that the assessment was given to the Registered Manager of the home, to enable her to determine whether the person’s needs Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 9 could be met. The Registered Manager told us that the person is encouraged to visit on several occasions, to help them decide whether Stonesby Lodge is the home for them. We found out by talking with people living at the home and the Registered Manager that when people move into the home, the first four weeks of the placement enable everyone to ensure needs can be met, as well as helping the person themselves decide whether this is the right home for them. A review involving the person and others involved in their care, including health and social care professionals, representatives of the home is carried out at this time. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stonesby Lodge are supported to make choices and decisions about their day to day lives; however the support people require is not documented or reviewed well. EVIDENCE: We looked at the care plans and records of three people living at the home, and found that in two instances where people had lived at the home for many years, their care plan had not been reviewed for between two and six years. The home had not developed a care plan for the third person who had very recently moved into the home, a care plan completed by a health care professional was in place, which was to support the persons transfer from a health provision to a residential placement. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 11 We also found care plans were not comprehensive and did not reflect the needs of people with mental health, and provided no guidance to staff as to how a person should be supported. We spoke with staff and looked at staff training records and found that staff had not received training about different mental health conditions such as Schizophrenia. We spoke with the Registered Manager who had a comprehensive understanding of the needs of people living at the home, including significant historical information. They were able to tell us about the support people required, and how people had improved since living at the home. We spoke with two staff on duty who said they were aware of the needs of people and that staff who worked at the home had done so for many years and knew people living at the home well. There is a wealth of information that the Registered Manager and staff know about those who live on the home, but this is not documented, and therefore cannot be viewed by new staff, or health and social care professionals who may need to review a persons needs. We spoke with the three people living at the home along with two others, they were able to tell us that they were looked after well, and one person was able to tell us about how they had been helped and supported with their mental health, and how the improvement to their health meant that they now lived a rewarding and fulfilling life. We spoke with the Registered Manger about a different style of care plan approach called person centred care, which focuses on the specific needs of a person from their perspective as well as including information as to their goals and aspirations, the person centred plan that details how a persons aspirations and goals are to be supported and the role of staff in provided the support. We found that reviews were carried out by health and social care professionals, and reviews that had been carried out detailed that all we happy with the care provided by the home, and in some instances alternatives had been suggested to some people, including ‘supported living’ but individuals had chosen to continue to live at Stonesby Lodge, this shows that people are encouraged to make decisions about their lives. We observed throughout the day people leaving the home to go about their day to day lives, without restriction. Risk assessments were not in place for the people whose records we had viewed, the Registered Manager told us that the way in which the three people conducted their lives meant no risks had been identified, there was no documentary evidence to support that assessments had taken place to conclude that their were no risks. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 12 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): This is what people staying in this care home experience: 12, 13, 15, 16 and 17. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Stonesby Lodge encourages people to live a lifestyle of their choosing however this is not documented well or supported by a care plan. EVIDENCE: We wanted to find out how people spend their day, and how the staff working at the home support people to make decisions and stay in contact with relatives and friends. When we arrived at Stonesby Lodge some people were already out attending college or day centres or visiting friends and family, whilst others were still at home. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 13 We sent surveys to people who live at the home, answers to questions in surveys told us that people take part in activities and that they enjoy the meals provided by Stonesby Lodge. Information provided by the Registered Manager within the self assessment tool prior to our visit detailed that some people access the Lindwood Centre, which provides therapeutic activities and is run by health care professionals. We spoke with one person in the afternoon and they told us that their parent and sibling live close by and that they had just returned from visiting them. Someone else we spoke with said that they regularly have weekend trips to visit relatives and friends, and the Registered Manager said that the person themselves book the travel independently. We were also told that friends and family and welcome to visit at anytime. We noticed that people made decisions about what they wanted to do, we saw that one person who had recently moved into the home was gardening, they told us that they hope to grow vegetables and that the Registered Person for Stonesby Lodge had taken them into Leicester to buy seeds. People told us that on their Birthday, they have a birthday cake and everyone sings happy birthday, they also told us that they have parties at Easter, Halloween and Christmas and other festivities. Two other people we spoke with told us that they were good friends and that they enjoyed going to Church, attending coffee mornings organised by the Church, going for walks and visiting museums. In the afternoon of our visit they both went to Leicester Cathedral. People we spoke with said that they had a bus pass which enabled them to travel independently. One person said that they had attended drama classes, which included studying the classics and performing plays at the College. Others told us that they enjoyed drawing, visiting the library, and reading history books. Whilst someone else told us that they have a season ticket for home matches for Leicester City Football Club, and that they often attend with the owner of the home. People living at the home were seen making themselves a drink when they chose; some told us that they helped in the kitchen whilst others did not. Everyone we spoke with said that the cleaning including washing and ironing is undertaken by staff. The Registered Manager told us that people could undertake these tasks if they wanted to. People’s involvement with daily activities in the home is an area which should be included within peoples care plans, which may be considered as goals for achievement and aspiration We saw people helping to set and clear away the tables for the lunchtime meal, and one person told us that they accompany the Registered Manager on a weekly basis to do the grocery shopping. Information as to peoples’ involvement in influencing the menu was mixed; with some saying that they Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 14 are consulted whilst others said they were not. Everyone we spoke with said that they enjoyed the meals provided. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care needs of people are met. Staff training in the administration of medication and the storage of medication needs to be improved. EVIDENCE: We wanted to find out how the health and personal care needs of people living at the home were met. Daily records and information held by the home evidenced that people have access to health care professionals including General Practitioners, Dentists and Opticians. One person told us that a nurse visits them regularly. We sent surveys to people who live at the home, which asked them whether their health care needs were met, all said that they were. Care plans provided no information about peoples health care needs, which is an area for improvement. People living at the home require no support with personal care, but some require encouragement. No specialist equipment is required by people currently living at the home. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 16 We spoke with a health care professional prior to our visit and they told us that they visit the home every 3 weeks to see one person, and that in their view the health and welfare of that person has improved since moving into Stonesby Lodge. They went onto say that everyone appears to be looked after well, and that they have no concerns as to the approach of staff, and believe everyone living at the home is spoken to with respect. The lack of recorded information means that health and social care professionals and other interested parties are reliant on verbal information to ascertain improvements or concerns relating to peoples health. We looked at the medication records and medication of three people whose records we had looked at and found all to be in good order. The Registered Manager could provide no evidence that the Pharmacist that supplies the medication had inspected the storage and management of medication within the home for the previous two years, and we found that medication whilst locked was kept in a metal filing cabinet. We found that the Registered Manager and one member of care staff are responsible for the administration of medication, and that only the Registered Manager has received training, the carer told us that the Registered Manager had trained them. All staff responsible for the administration of medication need to receive training that provides them with information, to ensure the safe administration and storage of medication; this was a requirement of the previous key inspection which has not been met. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stonesby Lodge are able to express concerns, and have access to a complaints procedure; however peoples welfare may be compromised by the lack of training staff have received in safeguarding. EVIDENCE: We wanted to find out how the staff at Stonesby Lodge promote the safety and welfare of people who live at the home, written information supplied by the Registered Manager before our visit told us that people who live at the home are aware of the complaints procedure and that there are good channels of communication in the home, they also said that meetings are used to tackle some issues. Stonesby Lodge and the Care Quality Commission have not received any complaints or concerns in the last twelve months. We spoke with people who live at the home when we visited, and they told us that they would speak with the Registered Manager or owner of the home or a member of staff if they were not happy. Everyone we spoke with said that they didn’t have any concerns, and that they were very happy. We observed that those that live at the home and staff employed have a good rapport, and that no one was excluded from conversations, everyone got on well, and conversed and shared jokes. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 18 We looked at staff training records and found that staff had not received training as to their role and responsibilities in protecting adults from abuse, this was a requirement made at the previous key inspection which has not been met. This has the potential for people who live at the home not to receive the support they require if such an instance was to occur. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Stonesby Lodge provides adequate accommodation; significant improvements to some facilities both internal and external to the home are needed to enhance the comfort and lifestyle of those living at the home. EVIDENCE: We had a tour of the communal areas of Stonesby Lodge; we found that bathrooms, toilets and showers whilst clean, were in need of modernisation. The flooring in some areas was of a poor quality, and we noted that tiles were cracked or missing, this poses a potential health and safety hazard. The previous key inspection identified that flooring in toilet areas needed to be replaced and a requirement was made that the Registered Person of the home devise a maintenance programme this requirement has not been met. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 20 The lounge/dining room, which gives access to the kitchen, and patio doors leading to the garden was in an adequate state of repair, new dining tables and chairs had been purchased, we did note that the carpet was torn in one area which was a potential trip hazard. Stonesby Lodge has two garden areas, we noted that someone who lives at the home was gardening during our visit, and that the other garden area was in the form of a courtyard, with seating and tables, and on the day of our visit was being used by those living at the home to sit outside in the sunshine. The exterior of the property has benefited from new windows, but we noted that exterior of the home could benefit from maintenance. The driveway and front garden were not well maintained, with tall grass and weeds, this does not create a positive environment for people to live. Stonesby Lodge provides single and shared rooms, which are without en-suite facilities. We sent surveys to people who live at the home, which told us that the home is always fresh and clean. We spoke with a person employed to clean the home, and they told us that they work six days a week. The home was clean and tidy when we visited. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stonesby Lodge are supported by staff that know them well, but who are not all sufficiently trained which has the potential to impact on the quality of care and support available to service users. EVIDENCE: People who live at Stonesby Lodge are supported by a consistent staff team who have worked at the home for many years, and this has enabled good supportive relationships to be developed. There are always two members of staff on duty during the day; this sometimes includes the Registered Manager. One member of staff is at work during the night. We found that 56 of staff has attained a National Vocational Qualification (NVQ), at level 2 and/or 3. The home employs nine members of staff of which only a small number have received training in mandatory topics, which include fire training, first aid, food hygiene and moving and handling. All staff need to access training in all mandatory topics including training on the Mental Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 22 Capacity Act. We found that staff have not received training on mental health, which is of concern given that everyone living at the home has an identified mental health need. Staff need to access training that enables them to understand how different conditions affect people, so that person centred care plans can be developed which identify how people need to be supported. Stonesby Lodge has a small staff team, and staff told us that they regularly see the Registered Manager, as she works at the home six days a week, which enables them to discuss any issues of concern. We found that staff meetings do not take place and staff do not receive a formal supervision. Staff meetings and supervisions should take place to provide a formal opportunity to discuss issues of concern and promote consistent and good quality care to people who live at the home; the lack of documentary evidence in the home is of concern. We looked at the recruitment records of care staff working at the home and found that they included an application form and a Criminal Record Bureau (CRB) disclosure and written references, this means that people who live at Stonesby Lodge can be confident that the people who support them have been vetted. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42. People using the service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are significant shortfalls in the management of Stonesby Lodge regarding the maintenance of care records, training of staff and a commitment to improve the service. EVIDENCE: The Registered Manager of Stonesby Lodge has worked at the home for many years, and they told us that they have very recently commenced a course relevant to their role as Manager entitled ‘Leadership and Management of Care Services Award.’ Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 24 Information provided within the self assessment tool, was not comprehensive and we found some areas which included the maintenance of equipment within the home and the viewing of policies and procedures was not completed. Record keeping in the home is poor, which has the potential to impact on the care people receive and the quality of their lives. Care plans are not comprehensive or regularly reviewed. There is no evidence that people who live in the home are consulted. Meetings involving people who live at the home and staff do not take place, nor do staff receive a formal supervision. We also found that there is no maintenance and refurbishment programme of the home. The Registered Manager spoke to us at length about everyone who lives at the home, and was able to demonstrate a good understanding of everyone’s needs, including relevant historical and family information, however this is not supported by documentary evidence such as up to date and comprehensive care plans. The Registered Manager is thought of well by her staff team, who said that she is always available and works alongside them in the home. We found that there are no formal mechanisms for supporting staff nor is there any documentary evidence as to the support staff receive. Staff meetings and supervisions are not held. We spoke with the Registered Person and Manager who were not aware of how the Care Quality Commission determines judgements for a home and the overall rating following a Key Inspection; this is of concern as it is the responsibility of both to keep up to date with good practice including information provided by the organisation which regulates them. We wanted to find out how people who live at the home influence the day to day running of the home, we found that staff spoke with everyone throughout the day and that people went about their daily lives without restriction. There is no formal process for establishing the views of people who live at the home through a quality assurance process, and we found that meetings do not take place that would enable issues to be discussed. Information provided by the Registered Manager within the self-assessment tool which we received prior to our visit, provided no information as to how people were consulted and influenced the day to day running of the home neither was their any evidence that quality assurance processes were in place. The previous inspection required that a formal quality assurance process be developed; this requirement has not been met. As part of the quality assurance processes it is the responsibility of the Registered Person to visit the home unannounced on a monthly basis and produce a report as to their findings. Their visit should include speaking with people who live at the home, staff, and viewing records and the environment Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 25 to ensure that the home is being managed well and that those living at the home are being supported well. People who live at the home and the Registered Manager told us that the Registered Person regularly visits the home, and in some instances takes out those living at the home. We spoke with the Registered Person who confirmed that they regularly visit the home, and the dates for their visit were recorded, however there was no documentary evidence as to what was discussed or looked at on these visits, and no evidence as to whether any improvements needed to be taken by the Registered Manager or themselves. This was a requirement of the previous inspection and has not been met. The Registered Person was not familiar with the regulation which required him to do this, which is of concern given the position of responsibility they hold. We have found that requirements made at the previous inspection have not been met, which is of concern to the Care Quality Commission as it is the responsibility of the Registered Person to ensure compliance with the regulations, non compliance can lead to regulatory enforcement procedures being taken which could put the future of the service at risk. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 26 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 3 23 1 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 1 34 3 35 1 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 1 X 1 X 1 1 X Version 5.2 Page 27 Stonesby Lodge DS0000006370.V376875.R01.S.doc Yes 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 YA6 Regulation 15 Requirement Timescale for action 01/01/10 2. YA20 13 3. YA20 13 & 18 The registered person to ensure that all service users have an up to date care plan, which is regularly reviewed, and includes information as to a person’s goals and aspirations, and includes guidance for staff as to how support is to be provided. The registered person to 01/01/10 purchase and install a cabinet for the storage of controlled drugs, which complies with the Misuse of Drugs (Safe Custody) Regulation 1973. Staff must receive regular 01/01/10 training in or by other measures to safely administer medication and records available to verify that trained staff meets their needs. To ensure resident’s health, safety and wellbeing. The previous timescale Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 28 of 14/10/08 was not met 4. YA23 13 Staff must receive regular training in or by other measures to prevent residents from harm and abuse or being placed at risk of abuse and records available to verify that trained staff meets their needs. To ensure resident’s health, safety and wellbeing. The previous timescale of 14/010/08 was not met. 5. YA35 18 All staff to receive training in the following topics:• Moving and handing • Fire safety • First aid • Food hygiene • Infection control • Mental Capacity Act • Mental Health. 01/01/10 01/01/10 6. YA36 18 7. YA39 24 To ensure that people who receive a service at Stonesby Lodge are supported by knowledgeable staff and have their health and safety needs met. The registered person to 01/01/10 establish a system for the formal supervision of staff with a record of the supervision kept. The registered person 01/01/10 must introduce a method of quality assurance to measure the standards are maintained and improved through seeking DS0000006370.V376875.R01.S.doc Version 5.2 Page 29 Stonesby Lodge the views of people using the service and key stakeholders. To ensure the health, safety and wellbeing of the residents. The previous timescale of 14/010/08 was not met. 8. YA39 26 The registered person must carry out the monthly visits to the Home and produce a report of the findings and action plan to address any issues. To ensure the health, safety and wellbeing of the residents. The previous timescale of 14/010/08 was not met. 01/10/10 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. 3. Refer to Standard YA20 YA39 Good Practice Recommendations A medication cupboard to be purchased for the storage of medication. Meetings are held on a regular basis to which everyone who is living at the home is invited, providing an opportunity to discuss the day to day running of the home. Staff meetings are held on a regular basis to promote the effective running of the home and ensure the needs of people living at the home are consistently provided. YA39 Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 30 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.eastmidlands@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Stonesby Lodge DS0000006370.V376875.R01.S.doc Version 5.2 Page 31 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!