Inspection on 28/11/06 for Sunny Lodge

This inspection was carried out on 28th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sunny Lodge 31/10/07

Sunny Lodge 02/12/05

Sunny Lodge 08/08/05

Sunny Lodge 28/02/05

Sunny Lodge 14/09/04

Sunny Lodge 19/01/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Sunny Lodge 132 The Commons Prettygate Colchester Essex CO3 4NR Lead Inspector Ray Finney Key Unannounced Inspection 28th November 2006 10:00 Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunny Lodge Address 132 The Commons Prettygate Colchester Essex CO3 4NR 01206 571419 01206 866136 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) Mrs Dewantee Balgobin Mrs Dewantee Balgobin Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd December 2005 Brief Description of the Service: Sunny Lodge is a four-bedroom bungalow situated in a residential area of Colchester, close to local amenities and public transport. There are parking facilities to the front of the property and at the back there is a garden that is mostly laid to lawn. Sunny Lodge provides accommodation and care for four people with learning disabilities. The service supports service users to live in an ordinary home environment that reflects their individual needs. Information about the service may be obtained by contacting the manager. The home charges between £1,104.81 and £1,263.22 a week for the service they provide. This information was given to the Commission in April 2006. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to compile this report. Documentary evidence was examined, such as training records, menus, service users’ care plans and staff files. A visit to the home took place on 28th November 2006; this included a tour of the premises, discussions with service users and members of staff and observations of interactions between service users and members of staff. One service user said they ‘like it here’. On the day of the inspector’s visit the atmosphere in the home was welcoming and, as the manager was away, the inspector was given every assistance from senior care staff. What the service does well: What has improved since the last inspection? What they could do better: Although overall record keeping is very good and meets required standards, the system for recording medication uses a number of different record books, Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 6 which makes following an audit trail quite complex. The home could consider looking at the system to see if it could be improved. 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. The summary of this inspection report can be made available in other formats on request. Sunny Lodge DS0000017948.V319779.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 Sunny Lodge DS0000017948.V319779.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have the information they need to make an informed choice about where to live. The home ensures service users are admitted on the basis of a full assessment. EVIDENCE: There have been no changes to the Service Users’ Guide and the Statement of Purpose since the last inspection. As previously reported these documents contain all the information required to meet the National Minimum Standard, including the aims and objectives of the home. Service users’ records examined contain copies of the Service User Guide and the Statement of Purpose. Although there have been no new admissions to the home for some time, there is a process in place for assessing service users’ needs before admission. Records examined show that full assessments of need are in place; each area of need identified in the assessment has a ‘strategy of care’. As previously reported assessments are reviewed and changes in needs are reflected in the care plans. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs and goals are reflected in their Individual Plans. Service users are supported to make decisions about their lives and are supported to take risks within the limitations of their capacity to understand. EVIDENCE: A sample of three service users’ care plans that were examined on the day of the inspection visit all contain detailed, comprehensive information. Each area of need identified in the service user’s assessment has a ‘strategy of care’, which identifies in full what the need is, the care objective and details of ‘how we care’. The information in ‘how we care’ is clear and contains sufficient detail to ensure staff understand protocols to be followed. Care plans cover dressing, behaviour, personal hygiene, activities, finance, self-image, daily routines, smoking, continence independence, shopping, safety, diet and health. There are strategies in place for dealing with aggressive or difficult behaviour. Records examined show that care plans are reviewed monthly and service Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 10 users have monthly meetings with their key workers. Files examined contain daily progress reports. Service users in the home are very vocal and able to make their wishes known. On the day of the inspection visit service users were seen to be making choices. A senior carer spoken with confirmed that service user meetings are held approximately monthly so that they can discuss their wishes and views on the service; minutes of these meetings were available. Staff spoken with said that some service users have family support when making choices and records examined also show family involvement. Observations of interactions between staff and service users show that staff encourage service users to make choices and take part in the running of the home. In particular the inspector observed that staff were very patient and calm and they listened to service users and responded appropriately. As previously reported, care plans identify how service users are supported to be as independent as possible within their daily lives. Service users’ records examined show that risk assessments are in place and the care plans relate to the initial assessment of risk. Risk assessments identify risks both within and outside the home and there are strategies in place for minimising risks. Records examined show evidence that risk assessments are reviewed regularly. A sample of service users’ records contains risk assessments around holidays and outings, manual handling/moving, behaviour and hygiene. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to take part in a range of age, peer and culturally related activities and are part of the local community. Service users are supported to maintain appropriate relationships. The home ensures service users’ rights are protected. Service users are offered a varied and healthy diet that they enjoy. EVIDENCE: Records examined contain evidence of supported employment opportunities that were accessed by one service user. However, the service user no longer chooses to go and the placement has ceased. Currently service users living in the home are not able to access paid employment because of their complex needs, but the home supports service users to take part in a range of activities. Records contain evidence of how the home supports service users to Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 12 develop skills around independence, such as ‘travelling skills’ – awareness of buses, times, fares and routes – and learning to manage money. A sample of service user records examined contains details of how service users access community facilities, such as the library and Aqua Springs. One service user spoken with enjoyed visiting the gym. Staff spoken with said that a trip to the theatre to see a pantomime and have a Christmas meal is planned. Service users’ records contain daily activity charts showing a variety of activities including swimming, walking, reading, listening to music and watching television. On the day of the inspection visit service users were ‘in and out’ during the course of the day shopping, going to the bank or going to various activities. The home ensures family links are maintained and this is well documented in the files that were examined. One service user told the inspector about keeping in touch with their parents by phone. Staff explained that one service user regularly visits a relative who lives locally and the relative takes and active part in supporting the service user with decision making. Observations on the day of the inspection visit show that service users are encouraged to be involved in the day-to-day running of the home. Staff spoken with confirm that service users are encouraged to participate in daily routines such as washing up, dusting and polishing. Records examined contain evidence of involvement in daily routines. Menus examined show that the home offers a variety of nutritious food. The small size of the home and the domestic nature of the premises ensure that service users individual wishes around meals are taken into account. Discussion with members of staff confirm that individual likes and choices are catered for. The kitchen/dining area is homely and clean. On a tour of the premises food stocks were examined and salads, fresh fruit and vegetables are available. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures service users receive personal support in the way they require and their physical and emotional needs are met. Service users are protected by the home’s policies and procedures for dealing with medicines. Service users can expect their wishes to be met around aging, illness and death. EVIDENCE: Care plans examined contain details of the way service users prefer to have personal care carried out. Interactions observed during the inspection visit indicate that staff treat service users with dignity and respect. The home operates a key worker system and members of staff spoken with are able to demonstrate an awareness of service users’ preferences. On the day of the inspection visit service users were seen to be able to tell staff what they want and like; all were very vocal about their wishes. Service users’ records that were examined contain health information including G.P. appointments, input from Consultants, weight charts, opticians and dental Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 14 clinic appointments. Each service user has a Health Information File containing a Health Action Plan that clearly records any issues the service user may have with their health. There is also evidence that the home supports service users to improve their health; health promotion literature and a strategy for helping reduce smoking was examined. There is evidence in care plans of medication reviews with the consultant. The home operates a monitored dose system for medication. There are currently no service users living in the home with the capacity to self medicate. Medication is stored appropriately in a locked cupboard, which has separate shelves, clearly labelled with pictures, for each service user. Medicine Administration Record (MAR) sheets were examined on the day of the inspection visit and are completed appropriately. The home maintains a set of books for recording processes around medication, including a book for recording when medication is commenced, a book for recording PRN (as required) medication and a book documenting returns, which is stamped and signed by the pharmacy. Records show that staff receive training provided by the monitored dose provider. The home has a very good training pack with pictures and symbols to support people with LD understand the processes and feelings around death and dying. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident their views are listened to and acted on. Arrangements are in place to help protect service users from abuse, neglect and self-harm. EVIDENCE: The home has a complaints Policy & Procedure in place that contains all the relevant information to meet the National Minimum Standard. Service user records examined contain information about the complaints procedure. As previously reported, service user meetings take place and issues raised are acted on. There is suitable documentation in place for recording complaints, although there have been no complaints since the last inspection. Records examined show that the home has policies in place for the Protection of Vulnerable Adults (POVA). As part of the recruitment process, the home carries out Criminal Records Bureau (CRB) enhanced disclosure checks to ensure the protection of service users. Training records examined indicate that staff have POVA training and staff spoken with demonstrate an awareness of their responsibilities around protection. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall service users live in a homely, comfortable and safe environment and they can expect the home to be clean and hygienic. The home ensures service users’ bedrooms promote their independence. Toilets and bathrooms meet the needs of service users. EVIDENCE: During a tour of the premises, the inspector observed that the home is comfortable and well maintained. The furnishings throughout the home are domestic in nature. Service users’ bedrooms are decorated to individual tastes and there is ample evidence of personal possessions. Since the last inspection the home has installed a cordless phone that can be used by service users so that they can make and receive personal calls in the privacy of their own rooms. One service user has their own mobile phone. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 17 Since the last inspection repairs have been carried out to the woodwork in one of the bathrooms. Bathrooms are clean and meet the needs of the service users living in the home. A tour of the premises showed that the home has a very good standard of cleanliness. There are no unpleasant odours throughout the home. The laundry facilities are domestic in nature and appropriate for the size of the home. Staff spoken with said that service users are encouraged to help with domestic routines. Staff records examined contain evidence that staff receive training around infection control. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall service users are supported by competent and qualified staff who receive appropriate training. Service users are protected by the home’s recruitment policy and procedures. Service users benefit from well-supported and supervised staff. EVIDENCE: Overall the staff team are competent and qualified to carry out their roles. Records examined show that 50 of care staff have completed a National Vocational Qualification (NVQ) at level 2 or above and 3 out of 6 carers have LDAF (Learning Disabilities Awards Framework) training. As at the last inspection, the home has a robust recruitment process in place to ensure the protection of service users. A sample of staff files examined contain all the required documentation including an application form, two written references, appropriate evidence of identification (ID), photographs and enhanced Criminal Record Bureau (CRB) checks. Staff confirm they are Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 19 given copies of the General Social Care Council (GSCC) Code of Practice and a copy was seen to be displayed prominently in the office area. Staff records examined show that the home has a good training and development system. The staff training planner shows that training includes Fire Safety, Communication, Managing Violence, Manual Handling, Communication, Death & Bereavement and Health & Safety. A sample of staff records examined also contains evidence of recent training around epilepsy, Protection of Vulnerable Adults (POVA), Infection Control, care planning and reflective practice. Staff spoken with feel that training is good. Records examined show that supervisions take place regularly and staff spoken with said that they feel well supported. Staff files contain evidence that staff receive induction training. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and had policies and procedures in place to safeguard the rights of the service users. Overall service users views are taken into account through the Quality Assurance process. The home ensures the health, safety and welfare of service users are promoted and protected. EVIDENCE: The registered manager has a number of years management experience and holds a City & Guilds NVQ Registered Managers (Adults) qualification and a Level 4 award in care. The home has a range of policies that the manager implements to ensure the home is well run in the interests of service users. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 21 The home has a quality assurance system in place. Records examined show that views of service users and other interested parties are sought through surveys. Evidence was seen that the manager has taken this information and formed a development plan for the home. Service user audit forms completed in August 2006 contain positive comments including “I like it here” and “Happy”. The home has appropriate policies and procedures in place around Health & Safety and a monthly H&S audit is carried out. Records examined confirm that fire evacuation drills are held monthly. COSHH (Control of Substances Hazardous to Health) assessments are in place. Health & Safety records examined show that Portable Appliance Testing has been carried out and a Gas Certificate is in place. Records were seen of daily temperature checks on water and fridge. There is evidence of recent review of the home’s Fire Risk Assessment and the H&S at Work Assessment and Employee Risk Assessment around trips and falls. Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Sunny Lodge DS0000017948.V319779.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!