Inspection on 06/09/05 for Stroud Lodge

This inspection was carried out on 6th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Stroud Lodge 16/04/07

Stroud Lodge 16/03/06

Stroud Lodge 21/02/05

Stroud Lodge 18/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 Stroud Lodge 319 Stroud Lodge Gloucester Glos GL1 5LG Lead Inspector Tanya Harding Announced 06 September 2005 09:10 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. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stroud Lodge Address 319 Stroud Road Gloucester Glos GL1 5LG 01452 306449 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) Orchard End Limited Mr Mark Luce Care Home 8 Category(ies) of Learning Disability (8) registration, with number of places Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Mr Mark Luce must commence NVQ Level 4 in Care and the Registered Manager`s Award in September 2005. This must be completed by September 2007 Date of last inspection 21/02/05 Brief Description of the Service: Stroud Lodge is a residential home for 8 adults with learning disabilities and challenging behaviour. The home is a large detached building, situated approximately one mile from the centre of Gloucester. The home is close to local amenities and within easy access to public transport. Accommodation is provided over three floors, with communal areas on the ground floor and bedrooms on the other floors. There is a garden for the residents’ use and a parking area at the back of the house. Stroud Lodge is part of Orchard End Ltd, a subsidiary of C.H.O.I.C.E. Ltd. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on one day in August, commencing at 9.10am and lasting about six hours. The new registered manager and the quality assurance co-ordinator supported the visit. There were six staff on duty. The inspector met with and greeted most of the service users and spoke to several staff. A number of comment cards were completed by the service users, their relatives and professionals who have contact with the home. All of the comments received from people outside of the home were very positive, providing evidence that staff have a good understanding of service users needs and promote open communication for the benefit of the residents. Comment cards completed by service users showed that people find staff approachable and feel well cared for. Other comments demonstrated that people have diverse preferences and feel that these are not always accommodated. The majority of the service users are self-advocating and exercise their right to raise concerns and complain on regular basis. This feedback forms part of the continual service review and improvement. The requirements from the last inspection have been addressed and no requirements are made in this report. The home continues to offer an excellent service which is person centred, empowering and inclusive. What the service does well: The home supports service users with a variety of complex behaviours and there are comprehensive records about the care needs and assessed risks. There is a system of ensuring that staff are aware of the assessed needs, routines and tendencies of each resident. There are good communication systems by which staff are alerted of any changes to care plans, which are regularly revised and updated to reflect any changes. Service users are aware of the support systems in place and have an active involvement in reviewing and evaluating these. This makes the care planning process more meaningful for each person. Service users at Stroud Lodge are supported to take risks, make decisions about all aspects of their care and support and take control of their lives with the necessary guidance. The home provides sufficient staff to enable people to have very flexible daily routines and regular access to the community. Service users can pursue their hobbies and interests. They are supported to maintain and develop relationships outside of the home and see their families as regularly as agreed. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 6 An excellent level of support and care has been provided for a person who has been considerably unwell. The home is supported by a committed management team, which has developed a robust system of self-audit and appraisal. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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 Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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 There is information available for prospective service users to make an informed choice about living at Stroud Lodge. EVIDENCE: The Statement of Purpose has been updated and a copy provided to the Commission. This reflects the management changes in the home and incorporates the necessary information about the service and facilities provided. The information about the number of bathrooms / toilets should be corrected to state that there are two communal bathrooms and three communal toilets. There have been no new admissions to the home since the last inspection. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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) 6,7,8,9 and 10 Care plans are comprehensive and reflect the needs and wishes of the service users. Service users are consulted about their care and are supported to make informed decisions, thus promoting independence and participation. Care records are stored appropriately in order to protect service users’ confidentiality. EVIDENCE: Service users are involved in decision-making with regards to the support they receive on daily basis. One person told the inspector that they were considering a move and the home was supporting the person to look at available options. The person was confident that they would be encouraged to speak to all of the necessary people and will be given time to decide on whether to go ahead with the move or not. Care plans and risk assessments seen on the day of the visit were comprehensive and provided a detailed overview of the support needed for each service user. There was a strong emphasis on promoting independence through self-advocacy, learning skills such as budgeting and accessing the community independently. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 10 Risk assessments for independent community access included details such as how the person is likely to react to different situations and how they can summon help if necessary, for example by having a mobile phone and an ID. The Organisation hopes to adopt the person-centred approach to care planning in the near future. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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) 12,13, 15, 16 and 17 Service users are supported to lead full and active lives. EVIDENCE: Service users are supported to access a variety of activities of their choice. These include educational, employment and recreational activities. On the day of the visit one person was setting out for a day trip to Weston supported one to one by a staff member. There was evidence that service users maintain regular contact with their families. The home supports people who want to visit their relatives even if it is a considerable distance away. The routines in the home are very flexible as directed by the service users. This means that people can structure their day as they want to and be confident that they will receive the necessary support when needed. One Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 12 person told the inspector that they had chosen to have a lie in and were planning to go out later on in the day. An observation was made of a service user planning their holiday. Staff member who was supporting the person listened to the person’s ideas and offered a number of options to the service user to help them make an informed choice. There are no restrictions on service users accessing any of the communal areas around the home and some service users go out from the home independently in line with the relevant risk assessment. Where restrictions are imposed, there is a clear documented process of how the decision was made, who was consulted and how the restriction is being monitored and reviewed. People who live in Stroud Lodge enjoy a service which is tailored around their needs and wishes. Where there is a potential conflict of interest or a difficult decision to make, service users have access to advocates. The home openly promotes involvement from the placing authorities and other outside professionals to ensure that service users receive the best possible support. Menu’s provided with the pre-inspection questionnaire show that meals are varied and cater for the individual likes and dislikes. Service users are consulted daily about meals and offered alternatives if required. Some service users enjoy making own drinks and snacks. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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) 18,19 and 21 Service users are supported with personal care as necessary and their physical and psychological needs are being met by the home. Service users who are unwell are supported sensitively and with respect for their wishes. EVIDENCE: Where support is necessary with personal care this is documented in care plans. Service users have a choice of which staff members support them with baths and other personal care tasks. Staff are aware of people’s psychological needs from the information provided on files and have guidance on how to respond to service users who may be upset, anxious or angry. People are supported with managing their behaviour through discussion and support from outside professionals. There was evidence of medication changes and monitoring. The staff team has developed a good value base, which promotes principles of ordinary living. This means that service users are able to build and maintain personal relationships and friendships with other service users and people outside of the home. Service users who experience problems with Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 14 relationships are supported sensitively with the home identifying potential risks and discussing these with the service users as necessary. Comments were received from the GP who supports the home. These provided evidence of good communication between the home and the surgery to ensure people’s health needs are addressed as necessary. The manager said that steps are being taken to negotiate with the local surgery a system by which all service users will get yearly check ups. The team has demonstrated a high level of commitment in supporting a person with an enduring illness. The service user and their relative were able to comment on the help they have received from the home and said that this has been excellent. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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 and 23 Service users are able to speak openly about their views, and any concerns they may have are listened to. There are robust systems in place to protect service users from financial abuse and from poor practices by staff. EVIDENCE: There are systems in place which enable service users to talk to staff members and the management team informally as well as formally, where necessary. The service users are fully aware that they can discuss their concerns and any other issues with chosen staff. They can also have their concerns recorded more formally on the complaints format. There is also a system of providing feedback to the service users both individually and collectively as appropriate. A record of all complaints raised is kept. This serves as an aid to monitoring the quality of the service and to picking up any re-current issues which may require further response. The Organisation has adult protection procedures which include guidance about referral to POVA. The new manager has demonstrated a good understanding of protection issues and of the disciplinary process. Financial records were examined for one person. The home keeps the necessary records of expenditure and bank statements. The team leaders check moneys held for service users daily to prevent any errors and minimise potential for misuse, with the manager also carrying out regular audits. In addition to this external financial audits are carried out by the personnel coordinator. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 16 Money for activities and public transport are provided from the activities budget and this minimises any possible confusion about who pays for what. Preventative measures have been taken to protect equipment which belongs to service users. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 17 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) EVIDENCE: The standards in this section were not assessed on this occasion. The Organisation has planned a programme of improvement, which will include an extension to make the kitchen bigger, alterations to the first and second floors to provide extra toilet and bathroom facilities, and possible relocation of the laundry room. There was evidence that these plans have been discussed with the service users. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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) 32, 33, 34, 35 and 36 Service users benefit from being supported by a competent staff team who are aware of their own roles and needs of the service users. Recruitment procedures are thorough and offer protection to service users from unsuitable staff being employed. EVIDENCE: Staff spoken with during the inspection demonstrated a good understanding of their roles and responsibilities. They had a good awareness of the assessed needs of the service users, and of their preferences. Staff felt it was important to enable service users to make own choices. Staff explained that there are systems by which changing needs such as deterioration in mobility, is monitored and responded to. There are staff meetings and for those who cannot attend, minutes of these are provided. There are between five and six staff on the morning shift and six / seven staff covering the afternoon shift. There are two waking night staff. The high ratios of staff allow greater flexibility for service users to be supported in the way they prefer. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 19 There have been some changes to the induction process for new staff. The manager now oversees the first six weeks of employment for all new staff. During this period supervision offered is more intense to ensure new staff settle into their roles and any problems or difficulties are sorted out quickly. Several staff files were examined and contained the necessary information and employment checks. Some minor omissions have already been picked up through the homes own audit and have now been corrected. The Organisation has employed an additional NVQ Assessor and with this it is envisaged that more staff can start NVQ training in compliance with the government target. Training for all staff is co-ordinated by the training manager and a training matrix was made available to the inspector for reference. This provided evidence of mandatory and specialist training attended by staff. Staff are being formally supervised by senior staff who have undergone the necessary training. A sample of supervisions was seen, but it was difficult to establish the quality of these sessions and whether the necessary areas such as development of staff practice were fully considered. A recommendation is made for the quality of supervision sessions to be improved in order to provide a more thorough record of appraisal. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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) 37,38,39 and 43 Service users benefit from a well run home and are supported by a competent and committed manager and an effective staff team. Service users’ views are listened to and underpin the ongoing process of service evaluation and improvement in the home. EVIDENCE: A new manager has been appointed since the last inspection. He has now completed the registration process with the Commission and has commenced NVQ4 and registered managers award in September 2005. The new manager was previously a deputy at Stroud Lodge and has a good knowledge of the service users. It was observed that he has an excellent rapport with staff and residents. Two service users commented that they felt the new manager was doing very well and was a good at their job. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 21 There is no formal system for obtaining feedback from the relatives and other people who support the home, although some feedback is received at reviews. Feedback received from comment cards returned by some relatives and professionals has been positive. The Organisation has a comprehensive system of self-audit and Regulation 26 visits are carried out regularly and are unannounced. The resulting reports provide a good overview of the service in the home and pick up on issues which may need further follow up. Feedback is sought from service users and staff and issues which are picked up are communicated to the manager of the home as well as to the Registered Provider. Where actions have been agreed, these clearly state who is responsible and the timescales. A senior management team and the Responsible Individual from C.H.O.I.C.E provide ongoing support to the home. The necessary certificates and insurances are in place and there were no concerns about the viability of the home at the time of the visit. Links have been developed between the Organisation and the CSCI which consist of regular monitoring meetings and other liaison. C.H.O.I.C.E now have an allocated Business Relationship Manager. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stroud Lodge Score 3 4 x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 4 x x x 3 D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 1 36 Good Practice Recommendations Information in the Statement of Purpose about the number of toilets and bathrooms should be clarified. Quality of supervision sessions should be improved to demostrate a more thorough appraisal of staff practice. Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 Page 24 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Stroud Lodge D51_D03_S55599_StroudLodge_V202474_060905_Stage4_A.doc Version 1.40 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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