Inspection on 19/04/05 for The Lodge

This inspection was carried out on 19th 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 28/10/08

The Lodge 18/10/06

The Lodge 09/11/05

The Lodge 26/10/04

The Lodge 17/06/04

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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 RG42 3RZ Lead Inspector Jill Chapman Unannounced 19th April 2005 11.50 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service The Lodge Address 21 Roundshead Drive, Off Jiggs Lane, Warfield, Bracknell, RG42 3RZ 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) 01344 424982 Milbury Care Services Ltd Ms Maria Rodriguez CRH Care Home 5 Category(ies) of LD 5 registration, with number of places The Lodge Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26.10.04 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 Lodge Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on a weekday, over a four-hour period. The communal areas of the home were seen and the inspector spoke with three staff and three residents. Records and policies were sampled and staff practice was observed. A requirement about providing guidance for staff on what to do if hot water temperatures are too high and not safe for residents has been carried out. A requirement about the monitoring of the records of service users money to make sure they are accurate has also been carried out. A recommendation about training for staff to carry out a special feeding process (PEG) has been carried out. This was a generally positive inspection, which showed that residents are well looked after and that they enjoy a fulfilling lifestyle. What the service does well: What has improved since the last inspection? A new boiler and washing machine have been installed since the last visit. The Lodge Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Lodge Version 1.10 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 Version 1.10 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, 3, 4 and 5. There is a procedure in place, which helps residents decide whether to come and live in the home and whether the home can meet their needs. Service agreements help residents know their rights and what is expected of them. EVIDENCE: There have been no recent admissions to the home but there is a procedure in place. This shows that needs would be assessed and that residents can have visits to the home to help them decide if they want to live there. Current service users came from hospital some years ago and staff confirmed they visited before transferring. Residents have service agreements and these were sampled. Milbury staff should sign these. The Lodge Version 1.10 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) 6,7,9 and 10. There is good information on how staff can meet residents needs, care plans and risk assessments are reviewed. Residents are asked about their likes and dislikes and day-to-day routines. Records show that residents have a right to confidentiality. EVIDENCE: Care plans were sampled and these had been reviewed as part of the annual review. It is recommended that individual care plans have the date of the review added to demonstrate this. Care plans were detailed and there is good pictorial information on file, to help residents understand these. Shift records demonstrate care given. There is very clear information about residents likes and dislikes on files sampled. It was observed that they were consulted routinely about daily choices, such as activities and food. Risk assessments were sampled and these were relevant and detailed. They are reviewed at the annual review but it is recommended that the review date be entered on each one. There is a statement of confidentiality on each residents file sampled. Staff confirmed that confidentiality is covered in induction training. The Lodge Version 1.10 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) 11,12,13,14,15,16 and17. Residents are supported to develop their skills and to access community resources. They enjoy varied activities and holidays. They are supported to maintain family contact and have an age appropriate lifestyle. Residents’ mostly benefit from respectful and attentive support from staff. (A shortfall is referred to in standard 32.) Residents receive a healthy diet and special dietary and feeding needs are met. EVIDENCE: Files sampled showed that there are care plans in place for self-help skills, communication, religious and social needs. Two residents attend Day Centre, two have Day Opportunity support and a third said he is ‘retired’ and chooses his routine. Residents told of their involvement in local community resources and of the many activities they enjoy. Residents have holidays booked to Cornwall and Spain. One resident showed photos and souvenirs from his recent holiday to France. Staff told how they help residents to keep in contact with families and friends and residents confirmed this. Records show that privacy is respected and generally staff interaction with residents was positive. (A shortfall is referred to in standard 32.) The Lodge Version 1.10 Page 11 The arrangements for food were seen and show that residents have a balanced diet and that they can make choices. It is recommended that more detail is added to the record of food to show what vegetables are given with the meal. One resident has special feeding arrangements and staff have been trained in this process. The Lodge Version 1.10 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) 18,19 and 20 Residents’ health needs are well met and staff help them get specialist help from healthcare professionals. Guidelines for residents who have behaviours that challenge help protect residents and staff. The system for medication ensures residents safety. EVIDENCE: Care is well documented in care plans and guidelines. Cross gender risk assessments are in place to help protect residents and give them choice. Healthcare needs are well documented and care plans show how these are met. Health professionals are consulted for specific needs. There are healthcare monitoring charts and guidelines in place. Behaviour guidelines are in place where appropriate and professional advice is sought. The arrangements for storage and administrations of medication were seen and were satisfactory. Staff are trained to give medication and stock is checked for accuracy. The Lodge Version 1.10 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. There are procedures in place to help protect service users and for them to complain if they are unhappy with their care. Staff should be aware of where the complaints record is kept in case they receive a complaint. EVIDENCE: There is a complaints procedure in place but a shortfall is that the complaints record could not be found. CSCI has not received any complaints about the home. There is a Milbury procedure for the protection of vulnerable adults, a whistle blowing policy and a copy of the local procedure. Staff confirmed they have received training on the protection of vulnerable adults. The Lodge Version 1.10 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) These standards were not inspected on this visit. EVIDENCE: The Lodge Version 1.10 Page 15 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 and 33. There appear to be enough staff on shift to meet the needs of the residents. They receive good support from the majority of the staff. There is suitable training provided to help staff meet resident’s needs. EVIDENCE: Staff Rotas were sampled and show that there are two staff on shift in the daytime and one waking night and one sleep in staff. Three staff were spoken to and they confirmed that they had received induction, core training and training to meet the needs of the service users. There is a programme of NVQ training in place. Staff conduct observed during the inspection was mostly positive. Concerns regarding the performance of one staff, which resulted in residents being ignored, were fed back to the manager. There is no formal shift leader system when the manager or senior staff are not on duty. It is recommended that this be developed. The Lodge Version 1.10 Page 16 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) 42 and 43. Residents’ money is kept safe and most aspects of their safety are well managed. The use of door wedges needs review in accordance with the advice from the Fire Officer, to make sure safety for residents is not compromised. EVIDENCE: Risk Assessments and Health and Safety records were sampled and these demonstrated that the needs of residents were met. Two fire doors are routinely held open to help residents with mobility problems. The Fire Safety Officer was consulted and has given guidance on this matter. Residents’ cash accounts were checked and were generally satisfactory except one receipt had not been entered in the record. Guidance for staff about what to do if hot water temperatures pose a risk to residents, needs to be transferred to the new book. The Lodge Version 1.10 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 The Lodge x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 3 x x x Version 1.10 Page 18 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 3 The Lodge Version 1.10 Page 19 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. 2. 3. Standard 22 32.2 42 Regulation 22 18(1)a 23(4) Requirement That staff know where the complaints record is kept Review the competency and conduct of one staff member. The Fire Safety Officer should be consulted about the most appropriate method of holding fire doors open and any recommendation carried out. Timescale for action 19-05-05 19-06-05 19-05-05 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. 3. 4. Refer to Standard 6&9 17 32 N/A Good Practice Recommendations That review dates are added to care plans and risk assessments. It is recommended that more detail is added to the record of food to show what vegetables are given with the meal. It is recommended that a shift leader system is developed for when the manager or senior staff are not on duty. N/A The Lodge Version 1.10 Page 20 Commission for Social Care Inspection 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 Version 1.10 Page 21 - 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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