Inspection on 13/02/06 for Stow Lodge

This inspection was carried out on 13th February 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 found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stow Lodge 02/09/08

Stow Lodge 23/10/06

Stow Lodge 18/05/05

Stow Lodge 02/11/04

Stow Lodge 17/06/04

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

CARE HOME ADULTS 18-65 Stow Lodge Oval Way Gerrards Cross Bucks SL9 8QB Lead Inspector Gill Gentles Unannounced Inspection 13th February 2006 15:00 Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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 Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Stow Lodge Address Oval Way Gerrards Cross Bucks SL9 8QB 01753 886522 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) Manager.winglodge@fremantletrust.org The Fremantle Trust Care Home 11 Category(ies) of Learning disability (10), Physical disability (1) registration, with number of places Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration of One Service user as Physical Disability (PD) This category of care relates to one specific service user within the home. Should this service user leave the home, this category of care will be rescinded. 18th June 2005 Date of last inspection Brief Description of the Service: Stow Lodge is a home for adults with Learning Disabilities managed by the Fremantle Trust. The home is situated in a quiet residential area of Gerrards Cross, within walking distance of all local amenities, there is a bus route nearby connecting the home with the local towns. The home accommodates eleven adults. The service user group has been predominantly male for several years now. There has been no change to the service user group since 1999. The house is detached and situated in large grounds with parking at the front for several cars and a huge rear garden mainly laid to lawn offering space for the residents to play outdoor sports. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on Monday 13th February 2006 by Gill Gentles and Nicky Cahill and consisted of speaking to residents, the manager, perusing documents and a brief tour of the building. What the service does well: What has improved since the last inspection? Care plans are adequate to ensure residents receive the appropriate care and Person Centre Plans are now being implemented and developed with individual residents. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 6 Clear written guidance and training is available to all staff in relation to Protection of Vulnerable Adults ensuring residents are protected from harm. Documentary evidence shows a high percentage of staff are adequately and appropriately trained to ensure residents are cared for by competent and qualified staff 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. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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 Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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): These standards were not assessed during this inspection. EVIDENCE: Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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 Care plans are adequate to ensure residents receive the appropriate care. Records identified that residents are encouraged and supported to make decisions and participate in the running of the home giving individuals independence. EVIDENCE: One care plan and two Person Centre Plans were viewed during the inspection and found to contain comprehensive information relating to residents personal care needs. The care plan was found to contain:• Photograph • Monthly checklist • Daily reports • Essential information • Personal lifestyle summary • Reviews • Last wishes Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 10 The home has continued to write the plans in the third person and not the first although they are easy for staff to follow. The care plan viewed was found to be clear and in general reflected current needs, however informative, are not resident friendly. The manager must ensure residents are given the opportunities to have ownership of their personal care plans. Along with the Care Plans the home has began to implement Person Centre Plans for two residents, both are in their infancy but there was clear evidence of resident input with information relating to a “circle of support”, “personal planning book” and notes from key-workers relating to the development sessions with residents. Person Centre Plans are excellent ways forward by ensuring residents clearly have a say in their own life and plans for the future. The manager is reminded that while Person Centre Plans are being developed she must ensure that Care Plans are maintained with resident involvement. Residents are encouraged to make decisions and participate in the daily running of the home by taking some responsibility in ensuring their bedrooms and communal rooms are kept clean and tidy with the support of a cleaner. Residents meetings take place frequently giving individuals the opportunity to ensure that their voices are heard. Residents spoken with evidently express individuality, one resident knits curtains and blankets, another enjoys playing darts in the bedroom. Residents’ finances were inspected and found to be appropriately maintained, with the adequate procedures for recording being followed. Receipts and monies were found to be correct at the time of the inspection. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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): 13, 15, 16, 17 Residents are supported and encouraged to have the opportunity for personal development, to take part appropriate activities, to become part of the local community and build relationships, ensuring individual independence and choice is maintained. Residents are supported and encouraged to be involved in the daily routines of the home, promoting personal independence and growth. The home provides a supply of nutritious and balanced foods ensuring residents are supported and encouraged to maintain a healthy diet. EVIDENCE: There is evidently a range of education, personal development, community links and leisure activities available. Records identified: • Food shopping • Cooking a meal • College • Shopping trips to High Wycombe and other local towns • Church Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 12 • Day centres • House meeting • Watching TV, listening to music • Playing games. • Pubs • Football • Day trips • Holidays All residents are registered on the electoral role and are given the opportunity to vote if they wish. Residents are encouraged to be involved in the daily routines of the home, staff support independence and promote individual choices. Entrance into resident bedrooms and bathrooms only occur with the individuals permission and normally in their presence maintaining privacy and dignity for all residents. All residents have unrestricted access to the home and grounds each having been offered a key to their own bedroom and the front door. Residents are encouraged to undertake some responsibility for cooking and cleaning of the home. The staff strive hard to promote a nutritious, balanced and varied diet. Breakfast and lunchtime meals are taken as and when required with a range of drinks and snacks being readily available throughout the day. The evening meal is prepared by staff and residents for everybody in the home. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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 Residents receive personal support in the way they prefer ensuring sensitivity and flexibility to maximise privacy dignity and independence. Residents are supported to take control and manage their own healthcare ensuring their physical and emotional needs are being met. EVIDENCE: The residents living in this home are given all the support and encouragement to live their lives the way they prefer and require. Residents require differing degrees of input from the staff team however the majority need support, reassurance, guidance and encouragement to choose times for getting up/going to bed, baths, meals activities and clothes and hair styles they wish to wear. The manager ensures that the health care needs of each individual resident are met. The residents living in the home have access and support from their GP and any other medical professional as and when required. Health is monitored with issues being dealt with by appropriate specialists. The home has recently implemented the use of a Health Care Passport which is proving invaluable. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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): 23 Clear written guidance and training is available to all staff in relation to Protection of Vulnerable Adults ensuring residents are protected from harm. EVIDENCE: The home/organisation has a Vulnerable Adult Protection policy in place; a requirement was issued at the previous inspection that staff must be trained in Protection of Vulnerable Adults. Records indicate that all ten members of staff have received the appropriate training required. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 . EVIDENCE: These standards were not fully assessed during this inspection except for a brief tour of the areas that required work from the previous inspection. Which were:• • • • • Second floor bathroom/shower room, needs a complete refurbishment, this is a repeat requirement. The landing and corridors woodwork needs painting. One of the toilets is in need of painting. The kitchen needs some major work carried out, such as the flooring replaced, new kick boards under all the units and a thorough steam clean as it was found to be very greasy. Second floor landing needs completely redecorating as the décor has been touched up and does not match, looking unsightly. It was disappointing to realise that very little maintenance work had been carried out to this home since May 05 and that the timescale for completion Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 16 was 15.9.05. The inspector acknowledges that there are development plans for all Fremantle homes. Stow lodge needs maintenance carried out now and it is not to be delayed due to the future plans. If the home/organisation fails to comply with these requirements legal advise will be sought in relation to issuing enforcements to the home. All requirements relating to the environment are listed individually under requirements. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 The home now operates a recruitment procedure, that ensures all staff are appropriately vetted to ensure residents are safe from abuse. Documentary evidence shows a high percentage of staff are adequately and appropriately trained to ensure residents are cared for by competent and qualified staff. EVIDENCE: Staff appeared to have developed good relationships with residents, they support and are able to meet individual needs, with particular attention being paid to gender, age, cultural background and personal interests. Staff seem to respect service users and are approachable, good listeners, good communicators, reliable and honest. Training for care staff has improved since the previous inspection when a requirement was issued in relation to mandatory training. The majority of staff, with a couple of exceptions have now all been trained in Fire Prevention, Manual Handling, Food Hygiene, First Aid, Protection of Vulnerable Adults, Medication and Infection Control. Four team members have completed NVQ level 2, two are assessors, two have started level 3. The home has achieved 50 of the staff team with NVQ qualifications. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 18 The homes recruitment practices and documentation were inspected and found to comply with schedules 2 and 4 of the National Minimum Standards. All documentation was stored in compliance with the Data Protection Act 1998 with only the manager having access to them. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Health and safety procedures are carried out ensuring residents are free from harm. EVIDENCE: The manager ensures the health, safety and welfare of residents and staff are adhered to. Good records are maintained and appropriate checks carried out. Gas safety and portable electrical appliance testing, are carried out annually and certificates were available in the home. Lat serviced October and November 05. Legioella testing was completed in July 05. Hoists are all serviced six-monthly last recorded was September 05. Fixed wire was inspected in October 04. Fire records indicated all the appropriate tests were being carried out, except for a three week gap in testing the fire alarms weekly while the manager was on leave. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 20 Generic risk assessments for staff, residents and visitors to the home are in place and produced by the organisation. It was noted that they are approaching the time for reviewing. Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X x Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 2 2 X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stow Lodge Score 3 3 x X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000023026.V269882.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA27 Regulation 23(2)(d) Requirement That the second floor bathroom is refurbished. PREVIOUS TIMESCALE OF 15/01/05 AND 15/09/05 NOT MET. It is required that the downstairs shower room is decorated. It is required that window restrictors are installed in the first floor shower room. It is required that the toilet is decorated. PREVIOUS TIMESCALE OF 15/09/05 NOT MET It is required that the second floor landing is redecorated. PREVIOUS TIMESCALE OF 15/09/05 NOT MET It is required that the woodwork in the hall stairs and landings are painted. PREVIOUS TIMESCALE OF 15/09/05 NOT MET It is required that the first floor corridors are painted It is required that the carpets in the hall stairs and landing are replaced Timescale for action 15/03/06 2 3 4 YA27 YA7 YA27 23(2)(d) 13(4) 23(2)(d) 01/04/06 28/02/06 15/03/06 5 YA28 23(2)(d) 15/03/06 6 YA28 23(2)(d) 15/03/06 7 8 YA28 YA28 23(2)(d) 16(2)(c) 01/04/06 30/04/06 Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 23 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 Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Stow Lodge DS0000023026.V269882.R01.S.doc Version 5.0 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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