CARE HOME ADULTS 18-65
Sycamore Lodge 501 Slade Road Erdington Birmingham West Midlands B23 7JG Lead Inspector
Brenda O`Neill Unannounced Inspection 7th February 2006 02:00 Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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 Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sycamore Lodge Address 501 Slade Road Erdington Birmingham West Midlands B23 7JG 0121 377 6280 0121 377 6280 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) Mind in Birmingham Valerie Parker Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Residents must be aged under 65 years That four named people, who are over 65 years of age can be accommodated and cared for in this Home. 13th September 2005 Date of last inspection Brief Description of the Service: Sycamore Lodge is a three-storey home consisting of two semi-detached properties, which have been converted into one home. All bedrooms are single and arranged over all three levels of the home. The accommodation on the top floor of the home is in the form of flatlets, with separate kitchens, bathrooms, bedrooms and communal lounge. These flatlets are provided for residents with higher levels of independence who may be en route to more independent living. There are two large lounges on the ground floor of the home, one smoking and one non - smoking; there is also a large dining area. The home also has a main kitchen and a training kitchen for use of residents under supervision of the staff and the homes cook/trainer. There is a wellestablished side and rear garden equipped with garden furniture and a green house. The home is conveniently located for local shops, churches, and college and leisure facilities. There are several bus routes running past the home providing easy access to Erdington and the city centre. Focus Housing Association owns the building, and the care and support is provided by Mind in Birmingham. The home views itself as a rehabilitation service, although there is no pressure placed upon residents to move on until they feel they have developed the necessary skills. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took part over one afternoon in February 2006. This was the second of the two statutory visits to the home for 2005/2006. To get a full overview of all the standards assessed this inspection year this report should be read in conjunction with the report written following the inspection on September 13th 2005. During this visit the communal areas were viewed, two resident files were sampled as well as other care and health and safety documentation. The inspector spoke with the manager, three staff members and six of the twelve residents. What the service does well:
This home had a very welcoming atmosphere and the residents greeted the inspector warmly. Throughout the course of the inspection it was very apparent that there very good relationships between the staff and the residents and that the residents were very much at ease in the company of the staff. Throughout the course of the inspection it was evident residents were encouraged to make decisions about their lives within the bounds of their risk assessments. Residents were fully involved in drawing up their care plans and risk assessments. The manager and staff encouraged and enabled the residents to have contact with their families and friends. Where family involvement had broken down the manager was keen to try and re-establish links. There was good documented evidence of the health care needs of the residents being met both in terms of their mental and physical health. Staff demonstrated a good understanding of the mental health needs of the residents and of how to manage residents who were unwell. Where resident’s mental health had relapsed there was good documentation of the involvement of other professionals and of how it was being monitored. The home was very well managed and had a very stable staff team which was very good for the continuity of care of the residents. The premises provided residents with a comfortable and spacious home in which to live. The health and safety of the residents and staff was well managed and no requirements were made in relation to this following this inspection. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 6 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. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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 Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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): EVIDENCE: Standards 2, 3 and 4 were assessed at the previous inspection and found to be met. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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, 9 The care planning system was good but staff needed to ensure that what support was to be offered was detailed for all identified needs to ensure consistency for the residents. Risk assessments needed to be specific about the actions to be taken by staff. Residents made decisions about their every day lives wherever possible. EVIDENCE: Two resident’s files were sampled and both included an Essential Lifestyle Plan (ELP). Both residents had been fully involved in drawing up their ELP and it was written from their perspective and included their short and long term goals, what they enjoyed/preferred/disliked and a section that included what other people needed to know to be successful in supporting them. There was also a section for unresolved issues or issues of disagreement between staff and the resident. One of the ELPs did not have all the sections completed and neither of those seen included enough detail about the support that staff were to offer. Statements in the ELPs included such things as ‘I need support when I go out’, ‘I need support with tidying my room’ but there was no detail as to what support staff were to offer. The ELPs clearly reflected what the residents thought were their support needs but it was evident from the daily records, discussions with the manager and the monthly evaluation sheets that the
Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 10 residents were receiving a lot more support than was documented. The plans needed to have clear, specific details of how staff were to meet any identified needs and all support needs needed to be included in the plans. Risk assessment were included in both files for such things as self harm, aggression and violence and physical mobility. These included specific known triggers and a risk management plan. In the main these were well detailed but some did not include enough specific detail, for example, ‘offer support’ and ‘make aware of changes’ but did not specify what support or what changes. Throughout the course of the inspection it was evident residents were encouraged to make decisions about their lives within the bounds of their risk assessments. All the residents managed their own finances, had keys to the front door of the home and their bedrooms. Residents were seen to come and go as they wished throughout the course of the inspection. Their wishes to remain in their rooms on occasions were respected by staff and if they wished to go out and needed staff support this was offered. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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): 15 Appropriate personal and family relationships were encouraged and enabled by staff at the home. EVIDENCE: There was documented evidence that staff encouraged and welcomed appropriate family involvement in the lives of the residents. Some of the residents regularly went out to see relatives and several had visits at the home. One of the residents commented about going to church every week with a relative and another commented about her weekends staying with relatives on a regular basis. Some of the residents had personal friendships and spoke of their friends being able to visit the home. One of the residents also commented about how he kept in touch with relatives by post. The manager discussed with the inspector how the staff at the home were trying to reestablish family contact for one of the residents as there had been some issues. Standards 12, 13, 14, 16 and 17 were assessed at the previous inspection and all found to be met.
Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 12 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): 19, 21 The residents’ needs in relation to their mental and physical health were being met. EVIDENCE: There was good documentation on the daily records and monthly evaluation sheets of all the health care appointments that the residents had attended including, G.Ps, dentists, chiropody and optician. One of the residents spoke of his ongoing dental treatment and was also attending the doctors on the day of the inspection as he had been unwell. Staff demonstrated during the inspection how they monitored one of the residents who had stayed in her room as she was unwell and how they contacted the hospital for the appropriate advice as the individual was a diabetic and they were concerned as she was not eating her usual diet. The inspector was informed of the advice they had been given and this was seen to be carried out. Discussions with the manager and staff evidenced that they were well aware of when any of the residents’ mental health was relapsing. There was documented evidence that when this occurred the appropriate professional help was sought and if necessary residents were admitted to hospital for a while. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 13 One of the residents at the home had recently been admitted to hospital for an ongoing illness and had died the day before the inspection. All the residents had been told and staff were very aware of how this might affect the mental health of some of the residents particularly those she was closer to and they were monitoring the situation closely. The manager was aware of the individual’s wishes and was ensuring these were carried out. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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): EVIDENCE: These standards were assessed at the previous inspection and apart from a minor requirement, which has been brought forward to this report, were met. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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): 24, 28, 30 The home provided residents with a comfortable, spacious and homely place to live that was generally well maintained. EVIDENCE: Since the last inspection the former office had been changed to a large bedroom as the resident who occupied this room could not manage the stairs and needed a ground floor room. The office had been moved to a smaller room between the entrance hall and the lounge. Although this bedroom was not viewed the resident who occupied it was very happy with it. Only the ground floor communal areas were seen during this inspection. The home had two lounges one smoking and one non-smoking and a large dining room. Most of the areas had been redecorated at the last inspection and the non-smoking lounge had had all new furniture. All the rooms were comfortable and appeared to meet the needs of the residents. It was noted that the furniture in the smoking lounge was quite dirty but this was in hand and due to be cleaned. The requirement made in relation to adequate ventilation being fitted in the smoking lounge at the last inspection had been met with the installation of extractor fans. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 16 An ongoing problem at the home had been keeping the carpet in the entrance hall clean as it is the main thoroughfare for the residents and any visitors to the home. This was in the process of being rectified as new flooring was on order that was easier to clean. On the day of the inspection scaffolding was being erected at the front of the home as the windows were to be double-glazed. It was hoped this would add to the security of the home and also reduce the energy bills. The home had also had intruder alarms fitted to all external doors since the last inspection as there had been an incident with an intruder. The alarms were used at night to alert staff who were sleeping in and would also alert them to any residents who go out at inappropriate times. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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): 33, 34 Adequate staffing levels were being maintained by a stable staff team who had a good understanding of the residents’ needs. EVIDENCE: The staff team at the home was very stable and some of the staff had worked there for a considerable amount of time. Staffing levels appeared adequate for the needs of the residents at the time of the inspection. There were generally two care officers on shift with the manager’s hours being supernumery to this during the week. When fully staffed there were occasions when there were three care officers on shift. Staff transferring from another of the organisations homes had filled any vacant posts. The home also employed a cook and domestic assistant. Without exception all the residents spoken with were very positive in their comments about the staff and the support they were offered. Throughout the inspection it was clear that the residents were very comfortable in the presence of the staff and that staff were aware of their needs. No new staff had been employed at the home any vacancies had been filled by staff redeployed from another of the organisation’s homes and therefore would not have gone through the recruitment process again. The inspector had seen the employment records for the staff already in post which were all in order. It
Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 18 was also known to the inspector that the organisation had a robust recruitment procedure. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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): 37, 42, 43 The manager ensured the smooth running of the home in a competent manner. The health and safety of the residents and staff was well managed. EVIDENCE: This was a well run home and the manager demonstrated a good knowledge of the needs of the residents in her care throughout the inspection. She was undertaking the care component of the NVQ level 4. She had very good relationships with the residents and they were very comfortable in her presence. No issues were raised during this inspection in relation to health and safety. The fire book evidenced all the appropriate in house checks were being carried out and there was evidence that the fire alarms and extinguishers had been serviced. A recent fire drill had taken place. The manager received regular support and supervision from her line manager and copies of the Regulation 26 visit reports made by her were available for inspection.
Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 20 The home accommodated four residents over the age of 65 however the manager had informed CSCI and the registration of the home had been varied to allow this. The residents themselves were well and appeared to be receiving all the support they needed. Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X 3 2 X X X X 3 3 Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1) Requirement All residents must have a plan of care that details all their support needs and how these are to be met. (Previous time scale of 01/11/05 not met.) Risk assessments for the residents must detail the type of support to be given to the residents. (Previous time scale of 01/11/05 not met.) The responsible individual for the organisation must ensure that the adult protection procedure is in line with the multi agency guidelines. (Previous time scale of 01/11/05 not assessed for compliance at this visit.) When vacated the small bedroom measuring only 8 square metres must not be used as a bedroom for residents. (Ongoing requirement until room vacated.) Induction and foundation training must be carried out within the time scales specified by the Sector Skills Council.
DS0000016876.V280485.R01.S.doc Timescale for action 01/04/06 2. YA9 13(4)(c) 01/04/06 3. YA23 13(6) 01/04/06 4. YA25 23(2)(a) 01/12/06 5. YA35 18(1)(c) 01/04/06 Sycamore Lodge Version 5.1 Page 23 6. YA37 9(2)(b)(i) (Previous time scale of 01/11/05 not assessed for compliance at this visit.) The manager must be qualified to NVQ level 4 in care and management by 2005. (Previous time scale of 31/12/05 not met.) 01/06/06 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 Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Sycamore Lodge DS0000016876.V280485.R01.S.doc Version 5.1 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!
