Inspection on 18/05/05 for Stow Lodge

This inspection was carried out on 18th May 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Stow Lodge 02/09/08

Stow Lodge 23/10/06

Stow Lodge 13/02/06

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 18 May 2005 09:30 a.m. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stow Lodge Address Oval Way, Gerrards Cross, Bucks, SL9 8QB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01753 886522 The Fremantle Trust Care Home 11 Category(ies) of Learning disability (10), Physical disability (1) registration, with number of places Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 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. Date of last inspection 02 November 2004 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 H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s first unannounced visit for this year, which took place between 9.30 and 11.30 am. The inspection was limited due to the manager and the staff member on duty attending resident reviews. The time was spent talking to the manager, examining records, policies and procedures. Residents and Staff were briefly spoken to during the course of the inspection, as residents were setting off to the day centres and staff were busy organising the reviews. What the service does well: What has improved since the last inspection? What they could do better: • • • • Ensure residents or their representatives understand the implications of the annual rent increase. Produce care plans in a resident friendly format. Staff training in Vulnerable Adult Protection. Ensure that all maintenance issues are achieved within the identified timescales. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 The home has produced comprehensive documentation to ensure residents are able to make an informed choice about the home they live, or wish to live in. Contracts are in place, which enables residents to know what they are paying for. EVIDENCE: The new manager (unregistered) of Stow Lodge reviewed the Statement of Purpose and Service Users Guide in February 05, ensuring all the information is current and correct. Residents were involved in producing the Service Users Guide and decided on the photographs that are incorporated in the document. A current fee for this home is approximately £552.51; this is made clear to residents annually including their individual contribution. Fremantle Trust writes to residents as and when the fees are increased. There was evidence in the home that the letters had been sent for this year and were held on individual files. There was no evidence of whether residents had been informed of the increases directly. Contracts are in place with a number evidently signed by the residents, it was advised that the rent increase letters from Fremantle be copied and attached to the contracts at the back without the need for new contracts being issued each year. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,9,10 Care plans are adequate to ensure residents receive the appropriate care. The plans are not written in the first person and are not resident friendly, to do this would give residents ownership of their own plans. Individual risk assessments are appropriate for each person ensuring residents are safe. All information pertinent to residents, is stored appropriately in accordance with the Data Protection Act 1998, ensuring residents are protected. EVIDENCE: Two care plans were selected at random and found to contain comprehensive information relating to residents personal care needs. The plans were found to be written in the third person with clear actions for staff to follow. The care plans viewed were found to be clear and in general reflected current needs. The key workers had reviewed the plans at the end of 04. Evidence of monthly reviews by the key workers and every three months by the manager were found to be contained at the front of the plans. However, one plan clearly stated that one parent had passed away, and further into the care plan it stated “parents are both alive”. The manager needs to ensure that all plans reflect current situations and when reviewing the plans, should be looking at all the details. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 10 The care plans, however informative, are not resident friendly. There is a need for the new manager to begin to format ways in which residents can become owners of their personal care plans if they wish to do so. Personal resident risk assessments are in place within the care plan file and were found to be easy to understand and pertinent to individual residents. One risk assessment clearly stated “to be constantly supervised when moving around the house, visual hazard checks to be carried out daily”, there was no evidence to support whether this has been happening. The manager was advised to ensure that statements like the one above are supported with evidence in the future. The home appears to handle all information relating to residents in accordance with the Data Protection Act 1998, by locking everything in filing cabinets, cupboards or in the office. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,14, The home staff successfully ensures that the residents have the opportunity to access the local community, group decisions are made during the weekly group meeting, which enables residents to make decisions about their lives, encourages choice and independence. EVIDENCE: Care plans clearly identified residents weekly and daily programmes, there was evidence that residents access college courses such as sport, drama, media studies, cooking etc at the local college in Chesham. All residents attend a day centre at least four days a week. One resident disliked change and could not adapt to having a home day, which meant that the individual attended the centre five days a week. The home have worked closely with the individual who now has one day a month off and with the support of the key worker plans a day out, such as trips on a train etc. The home has planned their annual holiday for this year and they are all off to Croyde, Devon in July. The residents hold weekly meetings over the tea table which are minuted by the staff on duty, these clearly evidence discussions relating to holidays, trips out and weekly menus. The last recorded meeting was 11.5.05. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 12 All residents access the local facilities, which are a short walk away for the banks, post office, cinema, pubs and the wider community for clothes and food shopping such as Uxbridge, Slough and High Wycombe. Residents attend clubs such as gateway, Wednesday Club and church. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20,21 The home has a comprehensive medication policy and procedure in place, to ensure residents are safeguarded from misuse of medication. The home has communicated with residents and/or their families regarding individual’s wishes in relation to terminal illness and death, decisions are recorded in the care plans. This limits the traumatic decisions required at a stressful time and ensures that residents and their families wishes are adhered to. EVIDENCE: The medication in this home is stored in a separate room in locked medication cabinets. Boots the chemist, on a monthly basis, supplies all medication, Boots staff also audit the home systems every three months. All staff have received basic training in the safe handling and administration of medication. There were no errors or gaps evident on the MAR sheets. Individual residents records are very clear, to ensure there are no mistakes the home has placed a photograph of each resident at the front of their MAR sheets with the PRN protocols and GP permission to administer homely remedies. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 14 The home has consulted residents or their families/representatives in relation to personal wishes regarding terminal illness and death. Decisions are clearly recorded in individual care plans Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 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 standard(s) 22,23 A comprehensive complaints policy and procedure is in place to ensure residents and their families/representatives are listened to. The home has a policy in relation to Abuse Awareness but training for staff appears to be lacking therefore potentially putting residents at risk. EVIDENCE: The home has not received any complaints since the last inspection. All resident representatives have been given information regarding “how to make a complaint” and residents have Fremantle’s Feedback cards. The Commission for Social Care Inspection area office received a copy of a complaint about social services and the home from a family, which had evidently been resolved to the family’s satisfaction. The home/organisation has a Vulnerable Adult Protection policy in place, however there was no evidence to confirm whether staff had received up to date training, which is a requirement. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 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 standard(s) 24,27,28,30 In spite of some improvements, there are areas in the home that require attention, in order to provide residents with safe, comfortable surroundings. EVIDENCE: Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 17 The house has three floors with bedrooms being located on the ground and first floor. The home offers ample communal areas, a dining room, quiet room, and lounge. There is a large kitchen of a domestic nature, a laundry and a sluice room. The ground floor has three bedrooms a bathroom/shower room and two separate toilets. The first floor has eight bedrooms, two separate toilets (without a wash hand basin), a bathroom and a shower room. The room housing all the medication is located on this level. The third floor has a sleeping in room, an office and two toilets. The communal areas were inspected during this visit and in general were found to be homely, clean with no offensive odours detected. There were a number of areas that require attention and are as follows:• 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. Since the previous inspection the home has had a hand wash sink installed in the laundry. Apart from the improvements required the home was found to be well maintained and in good order. There is a homely ambience displaying an array of ornaments, pictures and residents personal items. There is ample room for residents to move around freely and they are able to find quiet areas. The garden is large and residents seem to enjoy the opportunities to play football, basketball etc. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Improvements were noted in the amount of training that staff have received, ensuring residents care is provided by competent staff. EVIDENCE: Training records were perused and the outcomes are as follows:• One NVQ assessor • 90 staff with NVQ level 2 or above • 9 out of 9 staff with a first aid qualification • 6 out of 9 staff with the manual handling certificate, 3 booked on a course in May 05. • 7 out of 9 staff have completed food hygiene training, the two that haven’t are night staff and it not applicable. • Medication training has been completed by the six staff who administer medication. • 8 out of 9 have completed the fire awareness training • All 9 have attended infection control training • The manager has enrolled on the RMA, which commenced in March 05. As previously reported there was no evidence to suggest that staff have received up to date training in relation to the protection of vulnerable adults. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) x No standards were assessed during this inspection. EVIDENCE: Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 20 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 3 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 2 2 x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 x x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stow Lodge Score x x 3 3 Standard No 37 38 39 40 41 42 43 Score x x x x x x x H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 21 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. 2. 3. Standard 6 23 24-30 Regulation 15(1)(2) Requirement Timescale for action 1.11.05 that care plans are developed with residents in a format suitable. 18(1) all staff to be trained in the 1.10.05 protection of vulnerable adults 23(2)(c-d) PREVIOUS TIMESCALE OF 15.9.05 15.1.05 NOT MET. That the environmental issues identified in the main body of the report are adhered too, in particular the shower room.. 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. Refer to Standard 9 Good Practice Recommendations it is recommended that evdence is available to support a number of the risk assessments in place. Stow Lodge H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 22 Commission for Social Care Inspection Cambridge House, 8 Bell Business Park, Smeaton Close, Aylesbury, Bucks, 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 H53_H02_Stow Lodge_S23026_UI_V227375_Stage 4_GG_ces.doc Version 1.30 Page 23 - 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. 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