Inspection on 04/10/06 for The Lodge

This inspection was carried out on 4th October 2006.

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 03/11/05

The Lodge 07/12/04

The Lodge 15/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

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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 Lodge (The) (Chaldon) The Lodge Rook Lane Chaldon Surrey CR3 5AB Lead Inspector Kenneth Dunn Unannounced Inspection 4th October 2006 10:00 Lodge (The) (Chaldon) DS0000013703.V317106.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 Lodge (The) (Chaldon) DS0000013703.V317106.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. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lodge (The) (Chaldon) Address The Lodge Rook Lane Chaldon Surrey CR3 5AB 01883 383838 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) Surrey and Borders Partnership NHS Trust Mrs Kim Susan Mott Care Home 2 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (1) of places Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: The establishment is currently registered in the name of Chaldon Lodge. The premises comprise self-contained building and is one of a group of small care homes belonging to Surrey and Boarders NHS Trust and set in rural Surrey in the village of Chaldon. The Lodge is situated in a residential area on the outskirts of the village. Service provision is for residential care for adults with learning disabilities. Accommodation is on two levels and domestic in scale providing single bedrooms, lounge, therapy room, dining/kitchen facilities, utility room and accessible bathing and toilet facilities. There is an enclosed garden and there is ample parking facilities at the far end of the garden. The home is situated near to all community amenities and relevant support services. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours on the 4th of October 2006 and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2006 to March 2007. For the purposes of this inspection the inspector has reviewed and audited all of the key core standards for younger adults only. On the day of the inspection the manager and deputy manager was off duty and the inspection was facilitated by care staff who demonstrated a sound knowledge and understanding of both service users and in addition how the home operates. Both service users have extremely complex needs and use mostly non-verbal communication, they also become unsettled and uncomfortable with people they do not know. In order to minimise any distress caused, the inspectors did not feel it appropriate to carry out in depth interviews with the service users. Instead, observations of interactions and service user responses have been recorded in this report. The care plans / Person Centred Plans (PCP’s) for both of the service users were inspected and the on-duty staff were spoken with during the inspection. The inspectors would like to thank the, staff and service users for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? The further development of the life skills of both service users has improved, but particularly one of the service users who had previously had a very restricted social network. The improvement to this one service user is so far as community activities has been enhanced greatly, and now affords the Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 6 service user a greater scope and possibility for social interaction within the general community. 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 summary of this inspection report can be made available in other formats on request. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 9 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has in place a detailed and informative statement of purpose and a well designed service users’ guide. Both of these documents are used in conjunction with the policies and procedure in operation at The Lodge for the carrying out detailed assessments on potential service users. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 10 EVIDENCE: Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 11 The statement of purpose and the service user guide have been designed to be open and allow the reader to understand the concept of care offered at The Lodge. Both documents are written in clear a concise English and follow current good practise guidelines. The Lodge offers a very specialised environment and was designed for two specific service users, who have both got profound learning disabilities and have little or no concept of language either written or verbal. The manager has not therefore translated either document into a format more suitable for service users with learning disabilities as it was felt that this would be disingenuous as neither service users could access the documents and make use of them. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 12 The care plans or Person Centred Plans (PCP’s) sampled they were based on comprehensive care manager needs assessments. The home is able to demonstrate their capacity to meet the assessed needs of both of the service users. Details of the likes and dislikes were clear and self explanatory, both PCP’s demonstrated a full knowledge of the service users and the levels of care needed for them to achieve as active a life style as they can function in. The PCP’s are reviewed annually and evidence seen supported that this has been the case at this service. The member of staff on duty stated that if it is deemed necessary the PCP’s could be reviewed more frequently if a change in behaviour is detected. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 13 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 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff have an excellent understanding of the support needs of the service users. This positive relationship, which has been developed has enabled the service users to expand their experiences and allowed them to enjoy life out with the confines of the care home. EVIDENCE: Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 14 The care plans or PCP’s sampled were found to be comprehensive and included details of care reviews and a social and medical history. Risk assessments are also on file. Challenging behaviour patterns are also identified and there are clear instructions for the staff to follow to manage the service users challenging behaviours. The staff group endeavour to encourage the service users to assist with making food and drink and some limited duties around the home. The service users benefit from a nutrition and varied diet and there are written evidence to demonstrate the involvement of a dietician in the designing and structuring of meals. Risk assessments seen are comprehensive and provided the reader with a clear basic picture of the service users. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 15 Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 16 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): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Lodge successfully promotes the independence of the service users and offers opportunities for them both to become part of the wider community in which they live. They are supported and enabled to maintain and develop appropriate personal and family relationships. Meals are well-balanced and varied. Appropriate systems are in place to ensure that service users’ rights are respected. EVIDENCE: The care plans PCP’s sampled detailed the service users known and previous preferences for leisure activities. The staff were gradually introducing new activities and experiences, both inside and outside the home and are monitoring and documenting the individual service users reactions and indicated preferences. A member of staff informed the inspector that they have had some considerable success with one of the service users, who previously had some considerable degree of agoraphobia and as a result had a very limited social environment, which basically consisted of the service and the grounds. The service user supported by staff is now regularly enjoying Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 17 outings and trips to the shops with one to one assistance or with the other service user and the staff. During this inspection the service users were observed to have free movement around the home and could access all areas without restrictions being placed upon them. They were comfortable with the inspection process and made several visits into the office to see what was happening and interact with the staff member involved in the inspection and to engage with the inspector. As was previously stated the home offers a wide verity of meals based upon the service users known likes and dislikes and in addition making full use of the guidelines established by a dietician. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 18 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 & 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The privacy, dignity and independence of the service users is paramount to the service the respect offered the service users is very dignified. Sound policies and practices are in place for the administration and management of medications. EVIDENCE: Both service users were already dressed and waiting to go out when the inspector arrived to start the inspection. The service users were well dressed in appropriate clothing at the time of the inspection. In the course of the inspection both service users were given assistance with their personal care the support was discreet and carried out in the privacy of the service users bedrooms or the bathroom with the doors closed. The service users were observed to be relaxed and comfortable with the staff on duty. The PCP’s sampled provided evidence that service users’ healthcare needs are being effectively met. There is clear written evidence within the individual service users PCP’s that they are registered with a local GP and referrals to other health care professionals are obtained, as necessary, from the GP surgery. The inspector was also advised that a nutritionalist/dietician was regularly involved in the care of the service users. The inspector was informed that the Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 19 current menus are based on the service users’ previous likes and dislikes. The member of staff involved in the inspection process also stated that they try to introduce new foods on a regular bases in order to give the service users new experiences. The staff member also stated that in the event of one of the service users not wanting the meal that was offered to them there is always an alternative on offer. The service follows a well devised medication policy and the procedures in operation safeguard the service user from mediation errors. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 20 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. This judgement has been made using available evidence including a visit to this service. All required policies and procedures are in place to ensure that service users are safeguarded from harm or abuse. The service Users are well protected by the organisation training policies and procedures with regard to the protection of vulnerable adults. EVIDENCE: There have been no complaints since the last inspection. The home has a complaints procedure in place in line with Community Integrated Care policies and procedures. The service has an adult abuse policy in place. Staff had received training in the protection of vulnerable adults. The Local Authority multi-agency procedures for protecting vulnerable adults were in place at the service. Lodge (The) (Chaldon) DS0000013703.V317106.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. This judgement has been made using available evidence including a visit to this service. The standard of the environment within this home is good; it currently meets the collective and individual needs of both service users, providing a homely place to live. EVIDENCE: The location of the home is suitable for its stated purpose; it is accessible, safe and well maintained, meeting service users’ individual and collective needs in a comfortable and homely way. Standards of cleanliness and hygiene were high throughout the home and no malodours were evident. The home’s communal areas are spacious and are decorated and furnished to a very good standard. No safety hazards were evident within the communal and private space areas. Toilet and bathing facilities were of a very good standard and afforded adequate privacy for the service users. Service Users bedrooms were decorated and furnished to a very good standard and had been personalised by the service users. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 22 Lodge (The) (Chaldon) DS0000013703.V317106.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): Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 24 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All interactions observed between staff and service users evidenced a high degree of respect and skill in working with both individuals. Staffing is kept under review and provided to meet the needs of the service users at all times. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 25 The home has a comprehensive staff training programme which incorporates all areas needed to ensure, as far as reasonably possible, that service users are in protected and in safe hands at all times. EVIDENCE: Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 26 The trust has a proven commitment to staff training all members of staff have an individual training file and are regularly required to undertake retraining or additional training. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 27 It was pleasing to note that staff have a good understanding of the service users needs, they were respectful and demonstrated a good rapport with the each individual. Staff rotas indicated that the service is appropriately staffed at all times with additional staff available if or when a need arises. Staff recruitment files are up dated and contain all the relevant documents as detailed in Schedule 2 of The Care Homes Regulations 2001. All staff has had a criminal record bureau (CRB) check and Protection of Vulnerable Adult (POVA) check prior to starting work in the home. Staff supervision was undertaken on a regular basis, and staff are provided with a copy. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 28 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users and staff all benefit from the management approach in operation at The Lodge it provides an open, positive and inclusive atmosphere. The health and welfare of all service users and staff are safeguarded by the implementation and adherence of very user-friendly policies and procedures. EVIDENCE: Although verbal communication was difficult with the service users in at the time of inspection, body language and behaviours suggested that the service users were happy with the way the home was run. All interactions observed between the staff and the service users during the process of this inspection demonstrated to positive way the service users are regarded and inclusive atmosphere that has been developed to further benefit the service users. Various systems are in place to ensure that the staff are able to obtain the service users’ views on all issues concerning their life at the home. The main Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 29 method used is by careful monitoring and observation of the individual service user’s reactions and actions in all situations. All required written policies and procedures are in place at the home. All necessary health and safety checks are carried out by the manager of the home with documentary evidence inspected of routine fire practices and evacuations, fire, gas and electrical safety certificates. Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 30 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 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 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 31 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Lodge (The) (Chaldon) DS0000013703.V317106.R01.S.doc Version 5.2 Page 33 - 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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