Inspection on 17/07/08 for The Lodge

This inspection was carried out on 17th July 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Lodge 23/01/08

The Lodge 01/05/07

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 09/11/2008.

CARE HOME ADULTS 18-65 The Lodge Swiss Drive Wordsley Dudley West Midlands DY8 5SL Lead Inspector Linda Elsaleh Unannounced Inspection 17 & 21st July 2008 2:00pm th The Lodge DS0000069615.V368150.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 The Lodge DS0000069615.V368150.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. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge Address Swiss Drive Wordsley Dudley West Midlands DY8 5SL 01384 484625 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) Select Health Care (2006) Limited Manager post vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Learning Disability (LD 3) The maximum number of service users to be accommodated is 3. 2. Date of last inspection 23rd January 2008 Brief Description of the Service: The Lodge is a 3 bedded purpose built bungalow owned and managed by the Select Healthcare Group. The home is located adjacent to Brierley Hill Road and on the same site as Swiss House residential home in Wordsley, set at the bottom of the drive. The Lodge accommodation is based on a single storey building. There are three single bedrooms with en-suite shower and WC. Communal facilities include a lounge/dining room, large bathroom and wellequipped kitchen/diner where service users are encouraged to participate in preparing and cooking their meals. There is patio and lawn area to the rear of the premises. The Lodge aims to create a homelike environment for the service users to enable them to lead as ordinary a life as possible and to have optimum control of their lives by promoting their right to privacy and dignity. The home has its own transport. The home should be contacted directly for up to date information about the fees charged for this service. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This unannounced inspection was carried out over two days in July 2008. The purpose was to assess the home’s performance against the key standards in the National Minimum Standards for Care Homes for Adults. The findings are based on the information received by us, the Commission for Social Care Inspection (CSCI), examination of relevant records and documents kept at the home and discussions with the manager, staff on duty and people who live in the home. We received comments from people who visit the home. One person told us their friend was settled and happy “…he receives lots of attention. It is a nice atmosphere”. Another person said the service, “enables clients to live as independently as possible”. Comments received from staff tell us they feel they are well supported. The atmosphere within the home was relaxed and friendly. A tour of the premises found it to be suitably furnished, clean and tidy. The requirement made at the previous inspection has been met. What the service does well: A stable and competent staff team provide care and support to the people who live in the home and are familiar with each persons care needs, routines and personal preferences. People are encouraged to express their views and make choices in their daily lives. Support is provided to enable them to develop their independent and social skills. The staff team respects the individual’s right to privacy and they are provided with a key to their bedroom. Good support is provided for individuals to access health care services. Advice and guidance is sought to ensure their individual health care needs are being appropriate met. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The home’s needs to review its referral and admission procedures and ensure an up to date assessment is carried out prior to admission to ensure the home is able to meet the person’s needs and personal preferences. The practice in the home for administering routine medication is good. However, individual protocols should be provided for “as required” medication to ensure a consistent approach is taken to administering this medication. The provision of community-based activities should be monitored more closely to ensure suitable staffing levels are available to meet changing needs and ensure people continue to be supported to enjoy regular outings. Suitable arrangements should be made to ensure a full review of each person’s care plans is held at least once every six months so they can be confident all their needs are being met. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 7 Regular audits should be carried out to ensure the information kept in people’s files are well maintained to reduce the risk of staff following plans that are out of date. Other records, such as staff training, should also be monitored to ensure training needs are being met in a timely manner. Improvements need to be made to the home’s quality assurance system to enable a comprehensive assessment of its own performance to take place. Its findings and plans for the further develop of the service should be published and made available to interested parties. An application for the registration of a suitably qualified and experienced manager should be forwarded to the commission. 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. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 8 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 The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 9 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, 2, 4 & 5 Quality in this outcome area is adequate. Information about the service is available at the home to enable people to make an informed choice about where to live. The current needs of people are not appropriately assessed prior to coming to live at the home. However, they are provided with opportunities to look round and meet with the people who live at the home and the staff. Two people who live in the home have been provided with an individual contract that informs them of their entitlements. However, one person has not been provided this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about the home is placed in the main reception area and includes a copy of the Service User Guide, a summary of the Mental Capacity Act and the most recent copy of the report by produced by CSCI (Commission for Social Care Inspection). The manager told us the Statement of Purpose had recently been updated. A copy was not available at the time of this visit. A The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 10 friend of one of the people living at the home told us the home had provided them with information about the service. The information we received from the home shows the Referral & Admission policy and Emergency Admission policy was last reviewed in May 2008. There has been one admission to the home since our last visit. We looked at this person’s file. The records show he visited the home with a friend on two occasions before a placement was agreed. His file contained details of observations made during his first visit, but no details were available about the second visit. The person’s friend, the manager and a member of staff told us this visit went well. The Care Management Assessment/Care Plan on the person’s file was dated April 2007. The manager told us discussions had taken place about the person’s care needs with the funding authority, staff at his previous home and his friend. A plan for responding to some identified behaviours has not been produced. We discussed with the manager need to follow robust assessment processes that includes obtaining an up to date assessment from a suitably qualified/trained person to enable the home to be confident it can meet the person’s needs. We looked at the contracts for two people living at the home. One resident’s contract/statement of terms & conditions is available in an easy to read, pictorial, format. However, a contract has not been completed for the person who has recently come to live at the home. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 11 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, 8 & 9 Quality in this outcome area is good. People who live in the home are involved in the home’s process for assessing their needs and identifying their personal goals. However, the service needs to ensure suitable arrangements are made for care plans to be reviewed regularly with the individual, their relatives/representatives and other significant people. This will ensure people are confident all their needs are being met. The service provides support to people to make informed decisions about their lives. Suitable arrangements are made to consult with them about all aspects of life in the home and enable them to participate in its day-to-day running. There are processes for assessing risks and identifying support and/or management strategies to assist people to follow an independent lifestyle as possible. This judgement has been made using available evidence including a visit to this service. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 12 EVIDENCE: We looked at the care plans, two in detail, for the people who live in the home. The plans give details of the individual’s personal, health and social care needs and how these are to be met. Plans are provided in pictorial formats. The manager told us the staff team are attending training in person-centre planning. Staff said they receive good information about people’s needs and guidance on how support is to be provided. The quality of the daily recordings on people’s files has improved. This provides key workers with more detailed information for their monthly monitoring of the individual care plans. The manager meets with the key worker to discuss progress and, where applicable, changes are made to the plans. An example of this is the concerns raised about a person’s behaviour. This was discussed with the relevant health care professionals and his care plan was revised. Discussions with staff and the information we looked at identify these concerns have reduced. The manager told us another meeting is being arranged to discuss the person’s progress. A health care professional told us the communication from the service is good and “…they will ask for support early and work at being pro-active before issues become serious and are always willing to try out suggests/ideas.” Whilst the home is working well in addressing areas of concern as they arise, there is no evidence to show arrangements are made with individuals, their relatives and/or representatives and other relevant people to review all aspects of their care at least once every six months. The manager told us the funding authority arranges for reviews to be held every twelve months. The records for two people show it has been over twelve months since the last full review took place. The home needs to introduce a system for arranging care plan reviews at least once every six months. This was discussed with the manager at the time of our last visit. During this visit we observed staff encouraging and supporting individuals to make choices about how they would like to spend their day. There are few limitations placed on people to make their own decisions. In such cases risk assessments are carried out and any restrictions are detailed in their care plan. For example, risk assessments identify that, at present, two people living in the home require support from two staff when going out to ensure their safety is fully protected at all times. People who live in the home continue to meet regularly with staff to discuss issues. The minutes we looked at of the most recent meetings show discussions have taken place about household matters, such as what new furnishings to purchase and about activities individuals would like to do participate in during the summer months. People do not always attend each The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 13 meeting. On such occasions staff will talk with the individual to ensure due consideration is given to their views. Two people’s files we looked at show the service has continued to carry out risk assessments and identify strategies for minimising risks. Risk assessments and strategies on the files we looked covered a range of areas specific to the individual, such as concern about a person’s health care and the dietary needs of another. A health care professional told us the service has “worked with me to resolve and reduce risks.” The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. People who live in the home are supported to follow their own choice of lifestyle. However, staffing levels in the home should be closely monitored to ensure these are sufficient to enable to people to regularly pursue and develop community-based interests and activities. Details of the support provided by the service to encourage people to follow their own routines and maintain contact with relatives are identified in the individual’s care plan. The home provides a varied and nutritious diet and people are able to participate in the planning and preparation stages for providing a meal and/or snack. This judgement has been made using available evidence including a visit to this service. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 15 EVIDENCE: We were told the college course which one person has been attending has finished and another course is being sought. One resident told us he does not like to go out much and prefers to spend time his bedroom. Another person spent the time during out visit either watching television or listening to music in the lounge with staff. The home keeps records of people’s progress in developing their independent skills. It shows the tasks they have carried out for themselves and where support has been provided. These form part of key workers’ monthly monitoring of people’s progress. Staff told us people are consulted on activity choices on an individual basis and at house meetings. There are activity plans, checklists and monitoring sheets available on people’s files. The records show activities have included visits to a cider museum, zoo and garden centre. One person told us he enjoyed the trip to the cider museum very much. The manager told us that at present three staff are on duty during the waking day. Staff said “they are restricted in the number of community-based activities they can offer at the moment because two people both need the support of two staff when outside the home”. They told us it is expected this level of support will be reduced for one person in the near future and will enable more community-based activities to take place. The manager needs to regularly monitor the provision of community-based activities to ensure sufficient staffing levels are available to support people to enjoy activities and outings outside the home. The people living in the home and the staff team have been through an emotional time recently. The manager told us that because of this no arrangements have been made for a summer holiday. However, now things were better discussions will take place about what kind of holiday individuals would like. The home welcomes people’s visitors at any reasonable time. Individuals are supported to maintain positive contact with family/friends, where applicable. All people living at the home are supported to access the services of an independent advocate. Records show people have regular contact with people who are important to them. Support is provided for people to follow their own routines such as when they get up and go to bed. Individual’s routines are included in their care plans. Daily recordings are kept that demonstrates the staff team provides positive support to people whose routines change. Staff spoke with sensitivity about the recent changes in one person’s routines and how they are supporting him through an unsettled period. Responses we received from visitors to the home show overall satisfaction with how the home responds to people’s different The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 16 needs. One person stated, “I feel real efforts are made to consider each person as an individual, each person pursues their own lifestyle.” Two people have a key to their bedroom. They told us staff respects their right to privacy and always knock on their doors before entering. One person told us he often re-arranges his furniture and is thinking of replacing his television. The possessions displayed in the two bedrooms we were invited to see reflects the individual’s personality and interests. A nutritional assessment is carried out for each person. The manager and a member of staff have recently attended training. Information about individual dietary needs, where applicable, and their likes and dislikes are recorded on their care plans. A 4-week pictorial menu is available and people are able to choose their meals on a daily basis. The home also provides alternative meals on request. A record is kept of the meals taken, for monitoring purposes, and advice is sought where any concerns are raised. People, who are able, are supported to prepare their own drinks and snacks. We observed two people making their own drinks. One of who was seen making several trips to the kitchen for snacks. Mealtimes are flexible to accommodate the people’s different routines and are usually taken in the lounge/dining room. One person said he prefers to take his meals in the kitchen or his bedroom. Staff told us he is has begun to occasionally join others for a meal in the lounge/dining room. The home does not employ catering staff. Basic food hygiene training is provided for the care staff. People are encouraged to help staff to prepare meals, depending on their individual abilities. A member of staff is on hand to ensure people who are making drinks and/or preparing their own snacks do so safely and follow good hygiene practices. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 17 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 & 21 Quality in this outcome area is good. The staff team are familiar with the personal and health care needs of individuals and provide support in accordance with their care plans and in the way they prefer. People are supported by the home to help cope with illness and death. The home has arrangements in place for managing medication on people’s behalf. To ensure their health and welfare are fully protected the home needs to produce protocols for administering medication that is prescribed, “as required”. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a team of male and female staff. This provides people who live in the home with a choice of whom they wish to support them with their personal care. Staff who we spoke to showed they are familiar with people’s individual needs and personal preferences as detailed in their care plans. Daily recordings are kept of the support provided. One person receives regular visits The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 18 from a community nurse. These visits are carried out in the privacy of the person’s bedroom. The home keeps records of all visits to/from health care professionals including telephone calls made on behalf of individuals. The home continues to work closely with the health care service. People are registered with local general practitioners (GP). The records show they have access to a wide range of health care professionals. GPs are consulted about arrangements for routine health care. Advice and guidance is sought to ensure physical and mental health care needs are appropriately met. The manager arranged for a representative from the health care service to visit and talk to staff about its priority health care screening programme. A member of the health care service told us, “I feel positive that staff are requesting various training sessions/workshops…” The home manages medication on behalf of all the people who live in the home. Two of the files we looked at had written consent to this. The medication policy and procedures were reviewed in May 2008. A sample of the signatures and initials of staff trained in the management and administration of medication is kept in the medication folder. There are suitable arrangements for storing medication. Records are kept of medication received by the home and returned to the pharmacist. The manager carries out monthly medication audits. The local pharmacist, who also carries out regular audits, has not raised any concerns about the home’s practice during her/his last visit. The last medication audit took place in May 2008. The records for one person show his medication was last reviewed in June 2008. The GP consulted with other health care professionals involved in the person’s care and with the staff at the home. We looked at the Medication Administration Records (MARS) sheets and daily recordings for one person who is prescribed “as required” medication. The daily records show decisions for when this medication is administered fluctuate between staff. There is no guidance for staff to follow. We discussed the need to produce detailed individual protocols for administering “as required” medication. This will ensure staff respond to symptoms/changes in the individual and ensure the staff team provide a consistent approach to the administering this medication. The recordings kept by the home will provide more accurate information for health care professionals who are responsible for reviewing the individual’s medication. As previously reported, the home has been through an emotional time recently. The manager has sought profession advice and support about coping with illness and death for people who live in the home and the staff team. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 19 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 & 23 Quality in this outcome area is good. People who live in the home feel their views are listened to and concerns are appropriately addressed. The home’s procedures and practices protect people from abuse and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaint procedures were reviewed in May 2008 and are produced in a pictorial format. Staff told us opportunities are provided to encourage people to express their views and report any concerns they may have. We have not received any complaints about the service. The manager confirmed no complaints had been made to the home. The home has system for recording the receipt, investigation and outcome of any complaints received by them. Two people told us the name of a person they would speak to if they had any concerns. Responses received to the surveys we sent tell us people are aware of the home’s complaints procedure, but had not had any cause to use it. They told us the staff team are easy to talk to and take the time to discuss any concerns or worries they may have. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 20 There have been no reported adult protection issues or referrals and no concerns have been raised during this visit. Policies and procedures for safeguarding vulnerable adults were reviewed in May 2008. The information is kept available for staff to access at any time. They are required to read and sign these procedures to confirm they understand them. We looked at the files for three staff. Two people’s files contained a record of attendance on an adult protection course. The third person’s training & development plan identified the need for training to be arranged. The home does not act as appointee for any of the people who live in the home. There are satisfactory arrangements for managing personal allowances on people’s behalf and supporting them to manage their own personal allowance, wherever possible. Records are kept of all transactions made on their behalf. We are kept informed of any event that adversely affects the wellbeing of the people who are living in the home. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 21 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 & 30 Quality in this outcome area is good. People who live in the home are provided with a homely and comfortable environment. Suitable procedures are available for staff to follow to ensure the home is clean and safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Lodge is a 3 bedded purpose built bungalow. A tour was made of the communal areas and garden. Information about the service is provided in the reception hall. This was in the process of being re-decorated when we visited. The lounge/dining room is suitably furnished and the patio doors lead out into the garden. The kitchen is suitably equipped and residents can choose to eat their meals here, if they wish. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 22 Since our last visit the office has been re-designated as the sleep-in room for staff. The manager told us this is a temporary arrangement and long-term plans are being considered to provide both office and sleep-in facilities. Single, en-suite bedrooms are provided for each resident. We were invited to see two people’s bedrooms. The manager told us the company had recently purchased some furniture for one person’s bedroom. Another person’s friend told us they had been involved in arranging his furniture and personal possessions to his liking. The home does not employ catering or domestic staff. A cleaning schedule and monitoring records are kept to ensure good standards of cleanliness are maintained. Suitable procedures are in place for infection control and a copy on displayed in the laundry. The records we looked at show that during the year three members of staff have attended infection control training. Regular checks are carried out on hot water outlets to ensure temperatures in en-suite facilities and communal bathrooms and toilets are maintained at a safe and comfortable temperature. The manager is advised to produce a planned annual maintenance and renewal programme for the premises to ensure good environmental standards continue to be provided for the people who live in the home. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 23 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, 33, 34, 35 & 36 Quality in this outcome area is good. A competent and trained staff team are provided to meet the needs of people who live in the home. People are protected from abuse by the home’s recruitment procedures. Suitable arrangements are in place to supervise and support staff to carry out their duties. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rotas show that at present three members of staff are on duty during the waking day. All three residents were at home during this visit. There were two members of staff and the manager on duty. The manager is rota-ed to provide 32 hours a week direct care and 16 hours a week are allocated for her to carry out her managerial duties. The staffing compliment for the home is identified as being a manager, seven care staff and a handy person. At the time of this visit there was one vacancy The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 24 in the care staff team. Information provided by the home show five staff hold a National Vocational Qualification. A senior member of the team is working towards Level 4. We looked at the recruitment records for two members of staff. Both files contained written references and satisfactory checks had been received fro the Criminal Records Bureau (CRB). The minor shortfalls identified during our previous visit have been addressed. The records show both staff members have been issued with a copy of their Contract of Employment, the General Social Care Council Code of Practice, job description, the company’s Staff Handbook and a copy of the home’s Complaints Procedures. A introduction to the home for new staff includes an outline of the daily routines, access to care plans, receiving visitors and telephone calls and layout of building. The manager told us they are required to complete the Skills for Care Common Induction and Foundation training workbook. The home has improved its arrangements for providing training for staff. The records show this year’s programme has included training in producing communication passports and managing challenging, as well as other training courses included in different sections of this report. We were informed plans are being made for staff to attend a makaton workshop and equality & diversity training. Staff we spoke to said they were provided with good training opportunities. We noted some gaps in the training records. This was brought to the attention of the manager. Training records should be kept up to date to ensure training needs are being met in a timely manner. Each member of staff receives regular planned supervision. Records are kept of each session. Since our last visit the manager has begun a programme of annual appraisals. This includes identifying training and development needs. We looked at the staff meeting minutes. These are held on a regular basis and discussions about people’s care needs, practice issues, policies & procedures and training. A member of staff told us “Staff meetings gives us time to discuss service users’ progress as a team”. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 25 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, 41 & 42 Quality in this outcome area is good. People who live in the home have benefited from improvements made to service. An application for the manager to be registered should be made to demonstrate commitment to providing people with a well run home. The quality system should be improved to ensure people continue to be confident that their views underpin the home’s self-monitoring and development of the service. Records kept by the home should be maintained in good order to ensure people’s best interests are fully safeguarded. Suitable health and safety procedures are available and training is provided to staff to ensure the safety of people who live in the home is fully protected. This judgement has been made using available evidence including a visit to this service. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 26 EVIDENCE: We have not yet received an application for the registration of the manager. The manager has made progress in developing different aspects of the service since she took up post last year. She is working towards achieving the NVQ Level 4. She told us feels well support by her area manager and the staff team. The information and records kept on people’s files are not well organised. For example, we found discontinued care plans and current plans filed at random. This increases the risk of staff following out of date plans. It is advisable for staff to be provided with guidance on how files are to be maintained and a system introduced for regular auditing of the files. The home still does not have its own fully comprehensive quality assurance system. However, there continues to be evidence that people who live in the home are consulted about the day to day running of the home and surveys have been sent by the home to relatives and representatives requesting their views on the home’s performance. The area manager continues to carry out monthly monitoring of the home’s performance and forwards us a copy of her report. The company also carries out quality audits. The findings of these visits should be included in the home’s system for monitoring its own performance. Each year the home should publish its findings and plans for developing the service. Environment risk assessments are carried out by the home to ensure people live in a home that is safe. Regular checks are carried on appliances and equipment. The home reports no accidents or incidents have occurred since our last visit that affects the wellbeing of the people who live in the home. The records we looked at show training in health & safety issues, such as basic first aid and moving & lifting, are provided to staff. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 27 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 2 2 1 3 X 4 3 5 2 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 2 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 2 2 X 3 X The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 28 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. 1. Standard YA2 Regulation 14(1) Requirement The home must follow robust procedures before agreeing a placement. This must include obtaining up to date assessments carried out by a suitably qualified/trained person to ensure the home is able to meet the person’s needs. Timescale for action 31/10/08 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 YA1 YA5 Good Practice Recommendations A copy of the Statement of Purpose should be kept available in the home and accessible to all interested parties. An individual written contract/statement of terms & conditions should be provided to each person and/or their relative/representative. The fees and service agreed should be included in the contract. The home should make arrangements for care plans to be reviewed at least once every six months with the individual, their relative/representative and other DS0000069615.V368150.R01.S.doc Version 5.2 Page 29 3. YA6 The Lodge 4. 5. YA13 YA20 6. YA24 7. 8. 9. YA35 YA37 YA39 10. YA40 significant people. Monitoring of community-based activities should include the availability of sufficient staffing levels to ensure people are able to enjoy regular outings. Individual protocols should be produced to provide staff with guidance about when “as required” medication should be administered. This will ensure the person receives a consistent approach to meeting his health care needs. A planned annual maintenance and renewal programme should be produced for the up keep of the premises to ensure good environmental standards continue to be provided for people who live in the home. Training records for staff should be updated to ensure their training needs are being met in a timely manner. An application for the registration of a suitably qualified and experienced manager should be forwarded to the commission. A comprehensive quality assurance system should be fully implemented for the home to assess its own performance. The findings and a plan for the development of the service should be published each year. Regular audits should take place to ensure people’s files are well maintained and guidance produced on how records and information are to be kept to reduce the risk of discontinued plans being followed by staff. The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 The Lodge DS0000069615.V368150.R01.S.doc Version 5.2 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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