Inspection on 29/01/07 for The Lodge (Bru-ley Homes Limited)

This inspection was carried out on 29th January 2007.

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 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 (Bru-ley Homes Limited) 03/11/05

The Lodge (Bru-ley Homes Limited) 20/12/04

The Lodge (Bru-ley Homes Limited) 16/09/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 The Lodge (Bru-ley Homes Limited) Lodge Lane Kynnersley Telford Shropshire TF6 6DX Lead Inspector Sue Woods Key Unannounced Inspection 29th January 2007 10:00 The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.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 (Bru-ley Homes Limited) DS0000020569.V292588.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 (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge (Bru-ley Homes Limited) Address Lodge Lane Kynnersley Telford Shropshire TF6 6DX 01952 677083 F/P 01952 677083 Bruce.Wheeldon@btinternet.com 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) Mr. Bruce Wheeldon Mrs Shirley Wheeldon Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.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 Lodge is registered with the Commission for Social Care Inspection (CSCI) to provide accommodation and personal care for a maximum of three people with learning disabilities. At the time of this inspection there were two service users living at the home with Mr and Mrs Wheeldon and their granddaughter. There are no plans for anyone else to move into the home. Mrs Shirley Wheeldon assumes management responsibilities. The Lodge is a Duke of Sutherland Cottage set in the rural village of Kynnersley, near Telford. Consultation with service users takes the form of regular observations and detailed care and support plans that identify and review likes and dislikes. Quality assurance questionnaires are sent out to family members annually. Current fees for the service are £1200 per week. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of The Lodge took place on 29th January 2007 between 10.00 am and 12.45 pm. The inspector returned to the home on 01/02/07 to review medication arrangements. The inspection reviewed all 22 key standards and information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. As part of the fieldwork activity the inspector met both service users however due to their complex needs was unable to directly obtain their views in relation to the quality of the service they receive. Interactions were observed and additional evidence was obtained through speaking with the proprietors and reviewing photographs and care plans. Other records reviewed reflected health and safety monitoring within the home and support received by the two permanent staff members and the minimally used relief staff team. What the service does well: The Lodge operates as a family home. Service users are treated as part of an extended ‘family’. As they have lived there for a number of years proprietors and staff know the individual needs of each service user very well and thus are able to meet these needs effectively. Person centred care and support plans identify likes and dislikes while risk assessments ensure that support is given in a safe manner. Service users benefit from supported family contact and involvement and enjoy a healthy and balanced diet. The home is very well maintained with a planned programme of routine maintenance and redecoration. Staffing is minimal but sufficient to meet the support needs of service users. Training opportunities are good. The management team work well together and the health, safety and welfare of service users is promoted and protected to a high standard. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 6 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 summary of this inspection report can be made available in other formats on request. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.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 The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.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): Standard 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place that would enable the successful admission of a new service user to the home. EVIDENCE: There have been no new admissions to the home for a number of years and although the home is registered for three the proprietors have no plans to admit any further service users. The judgement made at the time of the last inspection will therefore be carried forward. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Person centred care and support plans enable staff to offer service users choice and assist with decision making as well as delivering care in a way that they prefer. Risk assessments ensure that support is given in a safe manner. EVIDENCE: One of the two care files was reviewed at the time of this inspection. It was found to contain a detailed care and support plan and a comprehensive section relating to health care support needs. Plans are well set out and include all health issues, communication, community activity, daily living, personal care and leisure and recreational activities. They focus on aims, objectives and realistic goals for the service users in the months ahead. Discussions with the proprietors demonstrated their in depth knowledge of both service users and this is seen as a strength of the service. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 10 Service users access the community on a regular basis. It was evident through observations, examining records and discussions with the proprietors that they respect service users rights and provide opportunities for decision-making as appropriate. Risk assessments support activities. Records reflect that assessments have been recently reviewed (01/01/07) The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 11 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): Standards 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are enabled to participate in the community-based activities that they enjoy allowing them a good quality of life. Service users benefit from supported family contact and involvement Service users benefit from a balanced and varied diet EVIDENCE: At the time of the inspection one service user was out shopping with the manager and the deputy manager and one service user was at home doing a gardening project with the proprietor. Records suggest that activities are planned daily to correspond with individual goals and needs. The manager identified that as well as planning activities they also enjoyed days out to make The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 12 the most of the weather and to support individual preferences. For example the proprietor reflected that both service users look forward to the annual game fair and the manager spoke of being members of the national trust which enabled them to take advantage of local countryside walks. Family contact is promoted and encouraged with regular visits and telephone contact. Over the years the proprietors have developed a close working relationship with the families of both service users. The four weekly menu was seen by the inspector and looked to provide a balanced and nutritious diet. There was a well-stocked fruit bowl in the kitchen. The proprietor identified that one service in particular enjoys his food having snacks throughout the morning with his regular cups of tea. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 13 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): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Well-developed personal care and support plans enable staff to meet the needs of service users. Service users may have been at risk from unsafe and inappropriate dispensing arrangements for medication however safeguards implemented since the inspection have improved safety and practice. EVIDENCE: The manager demonstrated an in depth knowledge of the care and support needs of both service users. The male proprietor supported the personal care needs of the male service user at the time of the inspection. The manager reported that both service users are currently enjoying good health and receive regular input from the consultant psychiatrist, local dentist and chiropodist. Records reflected this. The medication arrangements were reviewed for both service users on 29/01/07 and again on 01/02/07. Medication is locked in a designated cupboard in the kitchen. Following discussions on 01/02/07 the manager The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 14 purchased a thermometer that reads maximum and minimum temperatures to comply with optimum storage guidelines. It was found that one particular medication is being added to the dispensing boxes after collection from the chemist. The manager stated that this practice would stop with immediate effect. Discussions with the manager and the deputy manager on 01/02/07 identified that there were issues in relation to how medication is received into the home from the chemist. Since the inspection this has also been addressed and resolved with the local pharmacist. PRN protocols were reviewed January 2007 by the manager. Records of seizures are kept. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 15 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): Standard 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home safeguards service users by ensuring that robust policies and procedures in relation to concerns, complaints and protection are implemented within the home. EVIDENCE: At the time of previous inspections of The Lodge these standards had been met. There have been no changes to policies and procedures and there have been no complaints made about the service. Both the manager and the deputy manager have attended adult protection training and have identified refresher dates to attend in the near future. The home works closely with the families of both service users to ensure that service users needs and wishes are addressed. Detailed review notes reflected this. The inspector reviewed financial records of one service user and found that receipts are kept and withdrawals and deposits are logged. These records were not reviewed in detail as the manager was not present at the time but receipts seen reflected that the service user regularly buys sweets and clothes. Gift receipts were available to support Christmas spending. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 16 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): Standard 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Lodge is run as a ‘family’ home and the high standard of accommodation enables service users to feel relaxed and comfortable. EVIDENCE: The inspector saw all downstairs rooms at the time of the inspection and the recently erected garden room that is being used as an activities room during warmer weather. The room was well equipped and photos shown to the inspector reflected that it had been well used last year. The Lodge is a family home and decoration reflects this. The kitchen was seen to be clean and tidy and the gardens are very well maintained. Service users enjoy the wild life that visits the patio kitchen garden area. Plans to improve the environment this coming year includes the redecoration of the hall, stairs and landing area as well as building a new porch. Since the time of the last inspection the kitchen has been refurbished and new carpets have been fitted throughout. A new suite was purchased for the The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 17 lounge. The proprietor and a service user are putting up a new perimeter fence. The home has carried out a fire risk assessment. Three monthly risk assessments were available for review although had yet to be signed by the manager. The deputy manager has prompted her to do so. Portable fire fighting equipment is tested weekly and records support this. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 18 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): Standards 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well trained and supported staff team enabling their needs to be effectively met within the home. EVIDENCE: Staffing at The Lodge is minimal with the proprietors providing the majority of the personal care and support. The home has a deputy manager and one support worker who is based at the home. Additional support is bought in as and when required from a nearby care home that used to be owned by the proprietors and who shared close links with service users over a number of years. Relief staff are used infrequently. Records on site at the time of the inspection reflected that the manager carried out supervision / appraisal for all staff in January 2007. Records seen were very similar and it is recommended that such records should reflect individual goals and achievements and be signed also by the staff member. Forthcoming staff training dates have been recorded on the homes calendar. Fire safety training has been booked for march 2007 and the manager and deputy manager are currently awaiting a new date to update their infection control training refresher. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 19 There have been no new staff appointed to the home since the time of the last inspection therefore staff files were not reviewed on this occasion. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 20 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): Standards 37, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed by a competent manager and staff team who have implemented and maintained systems to safeguard service users. EVIDENCE: The Lodge operates as a very well managed ‘family home’ and service users have lived there for many years. Health and safety checks are carried out regularly. Records seen at the time of the inspection reflected this. Fridge temperature checks take place daily and had already been carried out on the day of the inspection. There have been no accidents at the home sine the time of the last inspection of the home. Fire alarms are tested weekly and the manager has developed and implemented a Fire Safety risk assessment. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 21 The last quality assurance questionnaire for the home took place in December 2006. Feedback about the home was very positive although it was reported that the families preferred the informal way of sharing information with proprietors and staff that they have known for many years. It was agreed that perhaps the process could be attached to the formal review process for the future. The quality assurance asks relates if they are aware of the complaints procedure. He home achieved Investors in people Status in 2005 and this is valid for three years. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 22 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 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 3 34 X 35 3 36 3 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 X 12 4 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 4 X 3 X X 3 X The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13 (2) Requirement The home must stop the secondary dispensing of medication with immediate effect and follow up issues identified in this report in relation to the storage and receipt of medication from the chemist. Timescale for action 09/02/07 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 YA36 Good Practice Recommendations It is recommended that the manger personalise supervision records and require staff to sign them. The Lodge (Bru-ley Homes Limited) DS0000020569.V292588.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 (Bru-ley Homes Limited) DS0000020569.V292588.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. 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