Inspection on 15/04/05 for The Lodge

This inspection was carried out on 15th April 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

The Lodge 09/10/06

The Lodge 10/10/05

The Lodge 26/10/04

The Lodge 24/05/04

The Lodge 08/12/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 The Lodge Clayton Road Clayton, Newcastle Staffordshire ST5 4AD Lead Inspector Berwyn Babb Unannounced 15 April 2005 09.00 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. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Lodge Address Clayton Road Clayton Newcastle Staffordshire ST5 4AD 01782 616961 01782 254001 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) Choiced Housing Association Limited Mrs Dawn Patricia Hughes Care Home 4 LD PD PD(E) LD(E) Category(ies) of 4 registration, with number 4 of places 2 2 The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service Users admitted must have a Learning Disability or a Learning Disability and a Physical Disability. Date of last inspection 26 October 2004 Brief Description of the Service: The Lodge is a detached bungalow set in its own picturesque and well maintained grounds, located on a busy main road, which gives easy access by car or bus to the town of Newcastle-u-Lyme, approximately 11/2 miles away and a variety of local shops. It provides accommodation for four adults who have a learning difficulty, and sets out to be as domestic in character as circumstances allow. There is a small private car park. The home consists of two single and one shared bedroom, a large lounge, kitchen / diner, a shower with WC, and a fully adapted toilet / bathroom and a small laundry. The building is in a good internal and external state of repair and all furnishings and fittings are appropriate and in good condition. Choices have a commitment to the personalisation of residents’ bedrooms that reflects the individual’s special interests and hobbies. Redecoration and minor maintenance is carried out by the handyperson, and larger tasks are undertaken by outside contractors. Other privately owned properties, and a large comprehensive school close by do not intrude on residents’ privacy. The large storage shed mentioned in previous reports is now finished, and will provide much needed storage space for wheelchairs and specialist equipment for this home, and also provide some general storage space for the choices handy person. All areas of the home facilitate wheelchair access. The staff have worked hard to successfully create a domestic atmosphere. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector found this home to be well run on the most domestic style that was possible for a group of people with profound difficulties. The building was maintained to a good standard, and it was evident that the Person Centred Plans were the result of wide ranging and lengthy consultations and awareness of the residents. Staff interacted in an informal but dignified way with residents, and demonstrated great respect for their privacy, and were very positive about the inspection process. What the service does well: What has improved since the last inspection? The two requirements of the last report had both been met. An updated Statement of Purpose had been lodged with The Commission for Social Care Inspection to reflect improvements made in the service, and all external medications had been dated at the time of first use. The “Log cabin” in the car park had been completed and was providing valuable extra storage area, thus releasing room in the home for the enjoyment of residents. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 6 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. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.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 The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.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) 2 and 4 The evidence demonstrated that the home followed best practice in finding out what prospective residents wanted and needed, and ensured that they had sound opportunities for visit the home before moving in. EVIDENCE: There had been no new residents admitted in the past eighteen months, so these standards were checked against documentary evidence in care plans, and by questioning staff about procedures. The evidence showed that the admission procedure was a long process, with careful introduction of the prospective new resident, amounting almost to being a module in the assessment process itself. Records showed an introductory regime that started with a short visit, building up to overnight and extended stays. The home offers discretely specialised services, and records and discussion revealed the training is based on best practice recommended by The British Institute for Learning Disability. The manager and deputy care manager are both qualified L. D. nurses, and both have recently completed the N. V. Q. Level 4 in management and care. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.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, and 9 The evidence demonstrated that the care plans were robust and extremely detailed, and that risk assessments had been undertaken to enable activity to take place, not only to limit it. EVIDENCE: The inspector examined in detail the care plan [Individual Personal Profile] of the most recent person to be admitted, and this described all the strengths of the individual, as well as all the areas where he needed assistance to live a fulfilling life. There were protocols for various behaviours both current, and anticipated, and these were seen to be in line with British Institute for Learning Disability recommended best practice. The individual had expressed the desire to take up a position that might expose him to environmental hazards, and the risk assessments undertaken [and there were several], had focused on enabling him to meet his expressed need, and there was further evidence of the purchase of extra equipment to help facilitate this chosen activity. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 10 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, and 17 The evidence gathered showed extensive commitment to ensuring that maximum attention was given to enabling the individual ability of each resident in obtaining a valued and fulfilling lifestyle. EVIDENCE: None of the current residents would benefit from employment, but the care plan examined in depth demonstrated that opportunities for appropriate education and occupation of time were made available, and observation during the inspection revealed the lengths to which staff go to devise ways of enabling residents to feel valued in their lifestyle. There was evidence of how risk assessments, an educative program, and extra equipment had been put together to allow one gentleman to have independent access to the local shops, and of other occasions when he and other residents were assisted to access the town centre for shopping and other facilities. There was also documentary and anecdotal evidence of residents having a regular pattern of having meals at different establishments, according to their The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 11 own preference, and at the commencement of the inspection, one gentleman was in town with his key worker, who was enabling him to follow his passion for going to the cinema. A high proportion of residents are from former long stay National Health Learning Disability institutions, and as well as seeing visits and contacts recorded from family members, where these were known, there was evidence of the organisation working to enable residents to maintain relationships that had been established over many years, with former fellow patients, some of whom now inhabit other Choices homes in the Stoke on Trent and Newcastle area. From observation of peoples different times and make up of meals, and from documentary evidence in the care and menu plans, it was established that residents have very individualised diets according to choice and assessed medical need. Protocols were noted for monitoring that a resident did not choke, and that another has supplemented foods to ensure he maintains body weight. As in all Choices homes, there was a commitment to encourage healthy eating, and fresh fruit was in abundant supply, and residents were seen to help themselves to this as they chose. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 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 standard(s) 18 and 20 The evidence gather during this inspection indicated close attention being given to the healthcare needs of resident’s. EVIDENCE: Residents were seen to be approached by staff in a sensitive and dignified way when preparing to assist or prompt them with personal care tasks. One resident told the inspector that they all had different routines during the day, some having afternoon naps, others going to bed in the early evening or sitting up to watch television. Another resident indicated that he would like a bath that afternoon, rather than at the time previously arranged, and the staff on duty were able to respond to his personal choice in this matter. Care plans demonstrated input from specialist support service, both directly with clients, and for advice to staff. None of the current residents at The Lodge manage or administer their own medication. A trawl through the Medication Administration Records did not reveal any areas of concern, all doses were appropriately recorded as given, refused, or for some other reason not administered, and a sample audit of one section of the storage cassettes was similarly positive. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 13 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 The evidence taken from a staff interview convinced the inspector that detailed knowledge of each resident enabled those working in the home to determine whether a resident wished to complain, and then help him to do so. The inspector also detected a deeply held concern to ensure that residents were kept safe from abuse or exploitation. EVIDENCE: A member of staff who undertook a more formal interview spoke of knowing the usual demeanour of those residents who could not speak for themselves, and being able to respond to any change in this to enquire whether anything was wrong, or whether they were being abused. She listed facial expression, body positioning, withdrawing from someone, or into their private room, and other more personally specific changes in behaviour as triggers that would alert she and her colleagues to there being something wrong. Additionally, the inspector was able to reference the complaints procedure which had been produced in different formats, to make it more accessible to residents. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 14 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, 29, and 30. The Lodge is a well maintained bungalow that had structural alterations to make it well suited to the needs of people for whom it is registered. It benefits from belonging to an organisation with its own maintenance department that quickly responds to all but the most major needs. EVIDENCE: The Lodge is a spacious bungalow with two single and one shared bedroom, and adequate compensatory communal space. There is a large kitchen/dining room where residents were observed to locate themselves when not in their own rooms. This area has a good view of the entrance and of the main road, and people passing by. The car park can also be viewed from here, and this leads to a large shed that has been clad with half timbers to resemble a chalet. This acts not only as a storage area for the home, but is the depot for the maintenance team, thus providing much interest with the various to-ing and fro-ing [the team also provides placements for therapeutic earnings for more able men from other homes, and their arrival on the premises was observed to be an occasion that sparked much good natured interaction with the men resident in the home]. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 15 Before registration, the bathrooms in this home had been altered to meet the requirements of the proposed service users, and meet current specifications. The provision of adaptations post registration has been on the basis of the need of a particular individual, and the care plans demonstrated that these had been assessed and provided via the appropriate professionals. The home was clean and infection control policies were in place, and a service engineer was attending to a need that had been identified with the gas boiler as this inspection took place. There was a separate laundry room, and hand washing facilities were seen located at convenient positions throughout the home. During the inspection care staff were observed to use appropriate protective for the tasks they were undertaking. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 16 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, and 34. The evidence confirmed that staff looking after the residents of The Lodge are suitably trained and qualified to carry out their duties. EVIDENCE: The inspector discussed with two members of care staff their qualifications, experience, and training, and was impressed that these fitted them to undertake their role within the home, and were based on current best practice. All training offered by Choices is based on The British Institute for Learning Disability aims and objectives, and was confirmed to be of a high standard. 4 of the current pool of 7 carers have already completed N. V. Q. level 2, and another is presently undertaking this training. It was established that there is a closely knit staff team, with vacancies covered where possible by existing staff, or by bank staff known to the residents. The provision of a male member of staff can be arranged through this pool of carers, but none of the current residents have objected to receiving care from a female. The inspector undertook a more formal interview with one member of staff who assured him that all the recruitment, induction, and training procedures of Choices were aimed at preserving the safety of individuals resident in their homes, and in line with all current legislation. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 17 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, 39, and 42 The evidence gathered supported the notion that this home benefits from good management structures that in turn benefit service users in that it provides them with a well run home. EVIDENCE: Both the registered manager and her deputy have obtained the N. V. Q. level 4 in management and care, and were given an enviable C. V. by other members of care staff to whom the inspector spoke. The Personal Centred Plans reviewed by the inspector contained adequate evidence of quality control being undertaken as a continuous process of assessment and review. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 18 The inspector was able to observe numerous instances of good health and safety practice, some of which are listed below: • • • • • • • • • • • • • Containment of Substances Hazardous to Health notices in large type displayed in prominent places Regular fire training All staff having Emergency First Aid certificates Regular Food Hygiene training, and all staff having the certificate Use of protective aprons and gloves for all tasks where infection control was an issue Infection control questionnaire used every six months Up to date Gas servicing Up to date Legionella testing Testing water temperature control systems every night Use of floating thermometers to test bath water Recording the meaning of non verbal behaviour for individual residents Secure locks on all external doors Alarms and censor switched exterior lights to protect the grounds from intruders. The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x 3 3 3 4 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 4 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Lodge Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 4 x E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 20 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. Refer to Standard Good Practice Recommendations The Lodge E51-E09 S5016 The Lodge V222325 150405 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside, Stafford ST18 0ES 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. 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