Inspection on 18/10/06 for The Lodge

This inspection was carried out on 18th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Lodge 28/10/08

The Lodge 09/11/05

The Lodge 19/04/05

The Lodge 26/10/04

The Lodge 17/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 The Lodge 21 Roundshead Drive, Off Jiggs Lane Warfield Bracknell Berkshire RG42 3RZ Lead Inspector Kerry Kingston Unannounced Inspection 18th October 2006 10:15 The Lodge DS0000011048.V310453.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 DS0000011048.V310453.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 DS0000011048.V310453.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge Address 21 Roundshead Drive, Off Jiggs Lane Warfield Bracknell Berkshire RG42 3RZ 01344 424982 01344 424982 lichunrong@hotmail.com londonroad@tiscali.co.uk Milbury Care Services Limited Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Chunrong (Heather) Li Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users should not be admitted over 65 years of age. Date of last inspection 9th November 2005 Brief Description of the Service: The Lodge is situated close to the Bracknell town centre and local amenities. The home provides care and accommodation for up to 5 Service Users with learning and associated physical disabilities. The current Service Users are all males. The Service Users all have single bedrooms; there are 3 bedrooms located on the ground floor and 2 bedrooms on the first floor. There are bathroom facilities located on the ground and first floor. The home has a lounge with dining area, large kitchen with dining area, conservatory and a large secluded garden. There is some off road parking available to the front of the property. The fees are £1,140 - £1,449 per week. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on the 18th October between the hours of 10.15 am and 4.15pm. The purpose of the visit was to collect information to inform the key inspection report. Information for this inspection was collected by means of an Annual Quality Assurance Assessment, completed by the manager of the service and service user surveys, completed by service users with assistance from their key workers (five of the five surveys were returned) prior to the visit. On the day of the visit the inspector toured the building, observed care practice, spoke to three service users, staff and the manager. Service user care plans and other records were looked at. This is a small home and on the day of the visit there were three service users at home for different parts of the day. What the service does well: 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. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 6 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 DS0000011048.V310453.R01.S.doc Version 5.2 Page 7 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): 2 and 5 The quality in this outcome area is good. Service users have been in the home for some years and are still appropriately placed. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: The home was opened in 1997, all the service users moved in from hospital. Full medical and social assessments were completed at the time. Annual reviews are done and changing needs are looked at to ensure that the home is able to meet the changing needs of the service users. The service users are assessed, currently, as appropriately placed in the home. Two service users spoken to said ‘it’s a nice place to live’. Each service user has a written statement of terms and conditions, produced in a user-friendly format. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 8 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 and 9 The quality in this outcome area is good. The home ensures it meets the individual needs of service users, respects their choices (as far as is practicable) and properly risk assesses to ensure service users are able to pursue as independent a lifestyle as possible. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: All service users have a comprehensive care plan which look at all areas of care including individual support requirements, likes/dislikes preferences, communication plan, finances, religion/cultural issues, healthy eating, activities, mobility, relationships and emotions. The service user with a physical disability has an en-suite facility and all necessary equipment to meet his specific needs. The home work closely with the ‘Psychological service for people with learning disabilities’ to try to meet any mental health or behavioural needs that service users may have. They accesses all necessary ‘other professionals’ to ensure that the service users are receiving the best possible care. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 9 The home holds occasional resident meetings and the discussions about the home and what is happening within it are minuted. One service user spoken to said we ‘can make all the decisions about what we want to do during the day and what time we go to bed and get up’. Two service users were observed being offered choices about what they wanted to eat for lunch, if they wanted to go out, where they wanted to go and how they wanted to get there. Five of the five service user surveys noted that they could choose what to do each day. Service users choices and preferences are clearly noted on care plans. Daily notes lack details of how service users make choices and preferences known, on a daily basis, as they are a very brief note form of recording, this is under review by manager. The manager described how service users are involved in interviewing new staff, at least one service user sits on the interviewing panel and contributes fully to the discussion about the applicants suitability to work in the home. Risk assessments are comprehensive and up –to-date. Care plans specifically note any cultural religious or diversity needs and these are individually addressed as necessary. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16and 17. The quality in this outcome area is good. The home supports service users to achieve an enjoyable and positive lifestyle. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: Information received from the service, noted updated activity schedules, two service users started attending college in October (not yet added to the activity schedule on display in the home) and one service user began attending music therapy sessions. Two service users described their activities and what they liked to do. Both said that they have enough to do and can choose what they want to do. One service user was observed being encouraged and persuaded to attend activities as he has a motivation issue, whilst the home do not attempt to force service users to comply the staff use their skill to keep service users busy and motivated. The service users have been on an annual holiday, one person goes on holiday with a specialist holiday company, rather than with others from the home. On the day of the visit two service users were at home, three were accessing external activities, one with a member of staff. One service user chose not to go anywhere as he was going out in the evening The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 11 and two went into the local community with a staff member during the afternoon. The manager stated that there are now more drivers on the staff team and taxis can be used, but they are expensive. The home is within easy walking distance of town centre. Review notes detail activities and any development plans to improve these. Daily notes do not always record outings and activities as they are in note type form, which provide few details of the daily life of the service user. The Manager is reviewing the recording system. Four of the five service users noted on the surveys that staff always treat them well, one said that staff usually treated them well. One service user spoken to said staff ‘treat you well’. One service user was observed interacting in a relaxed manner with staff and he appeared to be very comfortable and confident to make requests, ask questions and make his choices known. Very positive interactions between staff and service users were noted throughout the course of the visit. Four of the five service users have family involvement and one service user said that his family visited him at the home and ‘they are made welcome and happy to visit me here.’ The manager discussed an incident where a family member had said that they did not feel the manager was available enough and described the steps she had taken to address this (this was not noted in the complaints/concerns book which may have been appropriate). The menus are balanced and nutritious, Service users were observed choosing their food. One service user said that the ‘food was usually good but some staff are better cooks than others. If you don’t like something you can have something else.’ The pre inspection information stated that the menu had been changed with service user involvement, this was confirmed by one service user spoken to. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 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): 18,19 and 20 The quality in this outcome area is good. The home offers good support to ensure service users are able to meet their personal care needs and offer excellent support to ensure that their health care needs are met. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: Service users care plans detail preferences and choices, how people like to be supported and what their particular likes and dislikes are. There is also a communication passport on some files to ensure staff and service users are able to understand each other. The pre-inspection information received notes mental and physical health improvements for some service users this is evidenced within the excellent health records. One service user has regular mental health reviews and any recommendations made are acted upon. One service users’ health has improved since the cause of his serious chest infections has been identified and dealt with. All health and medical support needed is accessed, one care plan noted appropriate contact with the G.P, chiropodist, audiologist, optician, dentist also recording hospital appointments and referrals. There are good links with the primary health care team, the psychiatric service and the Psychological service for people with learning The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 13 disabilities (they help with any behavioural issues or programmes. The home also has access to a dietician as necessary. All service users health needs are reviewed regularly and action is taken very quickly if there is any concern about a service users physical or mental health. Medication is administered by staff and is safely stored, one minor recording error was noted and rectified immediately. A list of staff competent to administer medication is kept, these staff are trained and assessed as competent by the manager or a senior staff member. Special training is given if staff are asked to administer any specific procedures for example, artificial feeding, one service user is fed through a gastric tube and staff have specific training to ensure this is done safely, very detailed guidelines are kept in the home. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 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): 22 and 23 The quality in this outcome area is good. The home has a proper complaints procedure and ensures that service users are protected from all forms of abuse. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: The home has a complaints policy and procedure and adheres to the joint procedures for the protection of vulnerable adults. The home has recorded no complaints since the last inspection and the Commission for Social Care Inspection have received no information regarding complaints or notifications of any vulnerable adults concerns. Three of the five service user surveys noted that they always know how to make complaints (two were not completed). One service user, spoken to, confirmed that he would know how to make a complaint, he said it was ‘discussed at resident meetings sometimes and he I can talk to any of the staff if I have a problem.’ Staff training records showed that training for the protection of vulnerable adults is a regular feature in the training programme and most of the staff have completed it. A staff member spoken to was able to fully describe action that he would take to protect a service user, if necessary. The home has robust systems to protect service users finances, the sample of account books, receipts and cash seen were accurately completed. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 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): 24,25 and 30 The quality in this outcome area is adequate. The home is kept clean and hygienic and it is comfortable and homely, but there remain some outstanding maintenance issues that require immediate attention. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: The home is clean and hygienic, very homely and reflects service users personal tastes. Some carpets (hallway and dining area) are very stained but there is provision for their replacement in the budget for this year. There were areas of repair to the home, which resulted in requirements from last inspection, four of the specific areas of repair remain outstanding: • Awaiting part for boiler – old boiler difficulty in locating part (9/02/06 timescale) • Damp in service users bedroom – floor replaced as rotten, trench outside wall dug awaiting walls drying out - there remains a most unpleasant smell in the room, the service user agreed that the smell was ‘not nice.’ The bedding and clothing are not affected by the damp but immediate attention needs to be given to trying to improve smell and locating the source of the problem. A lot The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 16 of work has been done to try to resolve this problem but more needs to be done quickly. • The parking area still floods no action ahs been taken to resolve this. (Timescale 09/02/06) • A ceiling needs repair in a bedroom …the contractors have been to see what needs doing but have not affected the repair yet. (Timescale 09/02/06) One service user survey noted that they would like the bathroom decorated, the downstairs bathroom floor needs to be sealed and the area is a bit ‘tired’ looking. One service user has a hospital bed which includes ‘cotsides’ the manager said that this was not necessary for the care of the individual, she was advised to assess the suitability and safety of the bed or replace it. One service user said he would like to be able to access the garden from the French windows in his bedrooms but there is a ‘high lip’ across doorway that prevents him from self-propelling his wheelchair into the garden, the providers are aware of his issue. The home keeps a maintenance log but it is not always clear when repairs have been completed. Replacements and repairs are included on the annual development plan and are budgeted for but the home appears to be expensive to properly maintain. Four of the five service user surveys said that the home is always clean and fresh. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 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): 32,33,34 and 35 The quality in this outcome area is good. The home has a well-trained, competent staff team who are safely recruited and able to effectively meet the needs of the service users. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: The rotas are completed with staff’s full names. There are a minimum of two staff per shift and extra staff are rota’d on duty to ensure service users are able to attend any special functions or activities. Service users surveys noted (5/5) that they are able to do what they want anytime of the day. One service user, spoken to, said that staff are always available to help him and staff were observed spending 1:1 time with service users and attending activities either on a 1:1 or 2:1 basis. Staff and the manager felt that the staffing levels were adequate to meet the needs of the current group of service users. Staff files showed that the proper information is collected prior to staff beginning to work in the home. There was some discussion with the manager about ensuring the references were useful, as some referees of one staff member had only known them for a few months. Staff training profiles showed that staff had received good basic training and new staff have access to the Learning Disability Award Framework and to National Vocational training. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 18 There are ten staff, three have completed N.V.Q. 2 or above and two are to begin the training this year. Staff felt there are good training opportunities, training records are very well kept. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 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): 37,39 and 43. The quality in this outcome area is good. The home is well managed, the quality of the care is reviewed regularly and the manager makes every effort to ensure that the staff and service users are as safe as possible. This judgement has been made using the available evidence, including a visit to the service. EVIDENCE: The manager was appointed in April 06, she is registered with the Commission for Social Care Inspection, has a nursing qualification and has completed the Registered Managers Award. The manager is aware of all her responsibilities and works hard to ensure the home is well run. The provider has a comprehensive annual quality audit system which culminates in an annual review meeting, held September 06 this year. The annual service review meeting produces an annual report and an annual development plan, which includes replacement and maintenance issues. Service user surveys/questionnaires, family questionnaires and other professionals’ questionnaires inform the annual review process. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 20 The last written Quality Assurance annual report available in the home, is dated 2004. Regulation 26 visits are completed regularly by the service manager. Health and safety records are accurate and up-to-date, all Health and Safety checks are up to date and staff Health and Safety training is updated on a regular basis. Hold open devices for fire doors are now fitted, as necessary. The fire officer visited on the 6th July 06 and he made no recommendations or requirements. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 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 3 3 X 4 X 5 3 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 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X X 3 The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 22 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 YA24 Regulation 23(2) Requirement Part of the front of the central heating boiler is missing and needs replacing. In another bedroom there are damp patches by the sink, bay window and outside wall. The parking area floods when it rains. A ceiling needs repair in another bedroom. (Outstanding requirement 09/02/06) 2. YA24 23.2 (f) To assess the possibility of providing a service user direct access to the garden from his bedroom. 01/03/07 Timescale for action 10/12/06 3. YA24 23.2 (b) To deal with the damp which 01/12/06 causes unacceptable odours in a service users bedroom. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 23 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 YA12 Good Practice Recommendations To record all activities and outings participated in by service users. The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 The Lodge DS0000011048.V310453.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!