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Inspection on 04/11/08 for The Lodge Dovercourt

Also see our care home review for The Lodge Dovercourt for more information

This inspection was carried out on 4th November 2008.

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

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Lodge Dovercourt 16/18 Beach Road Dovercourt Harwich Essex CO12 3RP The quality rating for this care home is: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ray Finney Date: 0 4 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 32 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: The Lodge Dovercourt 16/18 Beach Road Dovercourt Harwich Essex CO12 3RP 01255503678 NA thelodgecarehome@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Nowranee Sookun Name of registered manager (if applicable) Mrs Nowranee Sookun Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 learning disability Additional conditions: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 8 persons) Date of last inspection 0 8 1 1 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home The Lodge is a pleasant property situated in Dovercourt, close to the seafront promenade and within walking distance of the shops. Accommodation is in single rooms, one of which is on the ground floor. Communal areas include a lounge and a dining room with patio doors leading on to the enclosed rear garden. There are two bathrooms with toilets and additional separate toilets on the ground and first floor. The home is owned and managed by Mrs Sookun, who takes a hands on approach to running the home. Charges to stay at the home are variable depending upon the particular support needs of each individual. Information about the home, including the Statement of Purpose and Service User Guide can be obtained by contacting the manager. Care Homes for Adults (18-65 years) Page 5 of 32 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home We looked at lots of different evidence for this report. We looked at paperwork like care plans, staff files and menus. The manager sent us information called an Annual Quality Assurance Assessment or AQAA. This gave us information about how they run the home. We visited the home on 4th November 2008. We looked around the home. Care Homes for Adults (18-65 years) Page 7 of 32 We talked to people living in the home and staff. We looked to see if people were happy with what goes on in the home. What the care home does well Care Homes for Adults (18-65 years) Page 8 of 32 Listens to people and helps them to do the things they want to do. Cares for people well and looks after their health. Helps people keep in touch with their families and friends. What has got better from the last inspection Care Homes for Adults (18-65 years) Page 9 of 32 Some of the paperwork has got better. There has been redecorating, some new windows and new carpets. What the care home could do better. Care Homes for Adults (18-65 years) Page 10 of 32 Where drugs are stored could be better. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Ray Finney CSCI CPC1 Capital Park Fulbourn Cambridge CB21 5XE If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 11 of 32 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 32 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Through the comprehensive admission process people choosing to live at The Lodge can be confident that their needs will be met. Evidence: The manager stated in the AQAA that in the past twelve months they have updated the Statement of Purpose and the homes Service User Guide. Through discussion, the manager was able to demonstrate a good awareness of the importance of carrying out a thorough pre-admission assessment of the needs of anyone wishing to move in to the service, so that they can ensure they will be able to meet those needs. The manager stated in the AQAA, Service users visit the home prior to admission. The number of visits is flexible depending on the needs of the prospective service user. For example one service user spent a weekend at the home prior to coming to live here whereas another had several day visits. Individual records examined on the day of the inspection all contained comprehensive Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: assessments of peoples individual needs. The background information in the records examined included information relating to peoples mental health, healthcare needs, fitness and nutrition. The pre-admission needs assessment covered mobility, continence, personal care, dressing and cultural needs. Other areas assessed include language and communication, behaviour, education, occupation and leisure, family contact and preferred environment. Through discussion the manager demonstrated an in-depth knowledge of peoples assessed needs around health, personal care and social and emotional needs. Care Homes for Adults (18-65 years) Page 14 of 32 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in The Lodge receive good quality care based on their assessed and identified needs. Evidence: The manager stated in the AQAA that what they do well is, develop individualised and detailed care plans which are subject to change and review depending on the developing needs of the service users. The care plans for all the people currently living in The Lodge were examined. Care plans contained ample details to ensure staff have the information they need to provide consistent care for the people living in the home. This is especially relevant for people with autism, who can feel particularly anxious about changes to their routine or if things are done in a different way to what they like. The care plans contain detailed steps relating to how the person needs and wants to be supported and the level of prompting or staff input that is required. Through discussions on the day of the inspection, it was evident that the manager has a Care Homes for Adults (18-65 years) Page 15 of 32 Evidence: comprehensive knowledge of peoples individual needs. The manager explained that she has completed a training course around Person Centered Planning that has enabled her to develop meaningful care plans that identify not just peoples needs but their individual wishes and aspirations. A healthcare professional who completed a survey for the homes quality assurance process stated that what the home does well is, person centred care plans promoting development of skills and promotion of independence. Completed surveys received by us from relatives were complimentary about the care their relatives receive. One person commented, They are very Person centred and caring and another stated, They take into account each individuals personal needs and encourage them to try and do more for themselves. One persons Person Centered Plan was examined in detail and was completed with a high level of detailed information about the people in their life, what is important to them, what makes sense to them and what doesnt make sense. There is an excellent communication plan that records what is happening, what the person does, what we think this means and what we should do. There is also a document that records in detail what the person likes and this is written using a computer programme called Widget that produces graphics so that the information can be more easily understood by the individual. On the day of the inspection we observed good communication between staff and people living in the home. The manager explained the importance of understanding autism and how this affects peoples individual communication needs. A relative who completed a quality assurance survey for the home stated, communication skills have improved 100 per cent since being at the Lodge. We observed people being encouraged to make choices about what they wanted to do and when they wanted to do it. It was evident from observations that people living in the home are listened to and their wishes and opinions are valued. One person spoken with was able to describe how they spend their time and what they choose to do. Records examined contained a range of risk assessments with comprehensive, detailed information. The risk assessments identify the hazard, who is at risk, existing controls to limit the risk and what further action may be necessary. The risk assessments are about enabling people to continue to do things in a safer way rather than imposing any restriction on the person. Risk assessments cover a range of activities including cooking, swimming, walking or rambling, cycling, horse riding and trampolining. A relative who completed a survey stated, My [relative] seems much happier and contented since living at The Lodge and I am very pleased with the progress [they have] made. Care Homes for Adults (18-65 years) Page 16 of 32 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in The Lodge can expect to enjoy a lifestyle that meets their wishes and interests. Evidence: No one living in The Lodge has the capacity either through their learning disability or their behaviour to hold down paid employment. However, the service supports people to participate in a range of meaningful actvities, including college courses. The manager stated in the AQAA, All service users attend a college, two attend courses at the local community college and one attends a specialist centre in Colchester. On the day of the inspection, records examined contained evidence that people take part in music and dance courses and pottery. There is a social diary that confirms that people keep busy on a daily basis according to their individual needs and wishes. The manager stated in the AQAA, All service users have an individualised timetable Care Homes for Adults (18-65 years) Page 17 of 32 Evidence: which incorporates their interests. Each persons file has an individual timetable for activities and there is an activity planner on the wall with velcro backed graphics so that people can see what the planned activities for each individual are during that day. One person also has a folder with laminated pages that breaks down the day into times so that they can see what they will be doing through the course of the day. This person was seen to consult this and appeared reassured when they knew what they would be doing throughout the day. Records show that people take part in a wide range of activities including swimming, sewing, line dancing, massage, music, woodwork, art and basketball. A social care professional who completed a survey for the homes quality assurance process stated that there is, a varied and interesting timetable of activities of [their] choice which are appropriate to [their] needs and abilities. People were also seen to be taking part in activities in the home including a giant Connect Four game. The manager explained that this was particularly useful for one person to maintain mobility and improve posture by stretching and manipulating the giant counters into the frame. A person living in the home who completed a survey for us stated, I like the things I do at the Lodge, walking, swimming, gym, going to the cafe. Records also confirm that people access a range of community facilities including church, restaurants and pubs and visits to a social club. One person has an interest in trains and takes regular monthly train trips out. It is evident from photographs that the person derives great pleasure from this activity. The manager described a staged introduction to the local swimming pool over the course of a number of weeks for one person. Eventually a short swimming session was successful and the manager said that, although the effort required in the planning and preparation took a lot of work, the outcome for the person was really worthwhile and just to enjoy a short session in the swimming pool was a great achievement for this individual. Similarly there was evidence in records examined of detailed planning and slow induction to horseriding for another person. The manager and staff team should be commended for their efforts and skills in enabling these activities to take place. A boat trip that had taken place earlier in the year had a planning document that made good use of symbols so that people could understand and be part of the planning process. A relative who completed a survey stated, Staff try hard to enhance quality of experience with trips and short holidays in keeping with our [relatives] tolerance levels. There is ample evidence of how people are supported to maintain family links and fiendships. The manager stated in the AQAA, Service users are encouraged to maintain contact with family and friends. One service user has friends from Jigsaw Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: over for dinner on a regular basis. One person spoken with said they invited friends from the club they attend to come for tea. Care plans examined contained information relating to important dates such as relatives birthdays and anniversaries. One person has a calendar in their room to record planned visits to the family home. There is also a chart with velcro backed graphics of a telephone to reassure one person of the times when family are going to telephone. Family members also keep in touch via email and one of the people living in the home now understands about this kind of communication and the manager helps them to respond to emails received from family. A relative who completed a quality assurance survey stated they were, very pleased with the efficient and friendly atmosphere and the support [my relative] receives. One persons Person Centred Plan received very positive and supportive comments from their relatives. The manager stated in the AQAA, All support staff are taught the importance of consistency in routines in order to maximise and promote the independence of service users. Through discussions the manager explained that people are encouraged to be more independent and to take part in household routines. There are laminated placemats with symbols of where to put the knife, fork, spoon and plate so that people are able to lay the table. Records examined had detailed instructions around how people are to be encouraged and supported to strip their beds, clean their room or hang out washing. This is a small home where the cooking arrangements are domestic in nature and meals are planned daily acccording to what people want. On the day of the inspection dinner was toad in the hole with potatoes and fresh vegetables. There were plenty of fresh vegetables and fruit available and records examined show that a range of nutritious home cooked food is provided. On a tour of the premises, food stocks were seen to be plentiful and of good quality. One person spoken with said they like the food. The manager explained that food is important to people, not just to remain healthy but for quality of life. The manager was able to demonstrate how people with autism who have obsessions about certain foods have slowly been encouraged to widen the range of food that they will accept. Care Homes for Adults (18-65 years) Page 19 of 32 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People using the service can expect their personal and healthcare needs to be identified and provided with the support to ensure these needs are met as they would wish. Evidence: It is evident from discussions with the manager and the care plans examined that the ethos of the home is to promote and encourage independence. The bathing care plan for one person gives step by step details about what the person likes. There is a small measuring cup with a line marked on it so that the person is able to measure an appropriate amount of bubblebath into the bath independently and there is a line on the bath so that they know when to turn the taps off. The input required from staff is to help the person check the water temperature, but again this is done with the individual rather than for them. There is a similar level of step by step plans relating to areas such as morning routines. These detailed plans for how people want to be supported with personal care are particularly important to people with autism, for whom consistency and routine are essential to ensure they maintain emotional wellbeing. The manager stated in the AQAA, Service users physical and emotional needs are Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: regularly assessed and medical visits take place in private. Appropriate arrangements are made with medical professionals when service users need to attend the doctor or dentist. Care plans contain evidence of how the home meets peoples healthcare needs. Individual records examined contain ample evidence of input from a range of healthcare professionals including chiropodist, doctor, dentist, optician, clinical nurse specialist for sensory impairment, psychology, consultants and occupational therapy as well as social workers and advocates. Records confirm that annual care reviews and medication reviews are taking place. Through discussions the manager was able to demonstrate that she has an extensive knowledge of peoples healthcare needs. Through consultation with relevant health and social care professionals they ensure that peoples changing needs are met. Surveys received from health and social care professionals as part of the homes quality assurance process were examined and contained positive comments about the standard of care provided including, I am more than satisfied with the way the Lodge is run and an autism specific approach is used. The manager stated in the AQAA, medication is appropriately recorded and when changes are made to medication they are confirmed in their file. Strategies are in place for the management of PRN medication for one service user. The manager was able to demonstrate a good awareness of peoples needs around medication. The storage and recording of medication was examined. Records examined contained management strategies for the use of medication that has been prescribed to be taken as required rather than on a daily basis. This is sometimes rreferred to as on a PRN basis. There is a rationale for when this medication should be used, what behaviours or signs are present that indicate that PRN medication is necessary, what the effects are and what is the desired outcome for the individual. Medicines Administration Record (MAR) sheets examined were all completed appropriately and the manager was able to demonstrate a good awareness of the importance of following robust procedures around the administration and recording of medication. Medication is stored in a cupboard that has two locks on it. However, it is sited in the kitchen and is not of metal construction. There were no controlled drugs in use at the time of the inspection and, although the manager was able to demonstrate a good understanding of requirements around the storage of controlled drugs, the home does not have a controlled drugs cupboard should anyone be prescribed medication requiring this type of secure storage. The lockable cupboard where drugs are stored would not meet current requirements around the storage of controlled drugs. Care Homes for Adults (18-65 years) Page 21 of 32 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service can be confident that their concerns about how they are treated are listened to and acted upon as stated in the complaints and safeguarding procedures. Evidence: The Lodge continues to have an appropriate process in place for dealing with concerns and complaints. The manager stated in the AQAA, We respond to issues raised by srevice users and those concerned with their welfare. No major complaints have been recorded since the last inspection and minor concerns are dealt with as and when they arise. It is evident from discussions with the manager that she is aware of their responsibilities around dealing with concerns and complaints appropriately. The manager explained that minor concerns that have been dealt with are then discussed at a staff meeting to ensure everyone is aware of the issue and are aware of what they should do. When asked if they knew what to do if they had any concerns, someone living in the home who completed a survey stated, Tell the staff I am unhappy and they will help me sort things out. The manager stated in the AQAA, Staff have the appropriate checks carried out prior Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: to appointment and receive training in the protection of vulnerable adults. Personnel records contain evidence that people undergo Criminal Record Bureau (CRB) enhanced checks before commencing work. A sample of staff training records examined contained evidence that staff recently attended a safeguarding training workshop delivered by the Essex Safeguarding Adults Board. Care Homes for Adults (18-65 years) Page 23 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can enjoy living in an environment that suits their lifestyle and which is well maintained and clean. Evidence: The manager stated in the AQAA, the home is quiet, calm and clean and what they do well is provide, a comfortable and safe environment. A tour of the premises showed that The Lodge is homely and has a domestic feel. The carpets in communal areas have recently been replaced and the lounge and dining rooms were comfortable. Peoples bedrooms are bright and airy and contain good quality furnishings. Individual rooms reflect peoples interests and tastes and there is ample evidence of personal possessions. One person living in the home who completed a survey stated, I like my bedroom. A tour of the premises confirmed that there was a good standard of cleanliness including in the bathrooms and toilets. There were no unpleasant odours throughout the home. The laundry contains domestic machines which are suitable for the small size of the Care Homes for Adults (18-65 years) Page 24 of 32 Evidence: home. Liquid soap and paper towels are available throughout the home in toilet areas and in the laundry so staff are able to follow good practices around infection control. A relative who completed a survey commented, The Lodge is spotlessly clean. Care Homes for Adults (18-65 years) Page 25 of 32 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in the home can be confident they are cared for by a competent staff team who can meet their needs and who have been employed following thorough recruitment checks to ensure people are protected. Evidence: Information provided in the AQAA dataset states that out of a total care staff team of seven, four people have a National Vocational Qualification (NVQ) at level 2 or above. As at last inspection there continues to be a robust recruitment process in place. Through discussion the manager was able to demonstrate an awareness of the importance of ensuring good practices around recruitment so that people are safeguarded by being cared for by staff who have been thoroughly vetted before starting work. A sample of staff files examined contained all the documentation required by regulation, including appropriate proofs of identity, two written references and Criminal Records Bureau (CRB) enhanced disclosure checks. Although all the information required by regulation was available in the files sampled, they could have been better organised. This was discussed with the manager, who said that she has concentrated on ensuring service user records were of a high standard and recognises that personnel records could be reviewed. Care Homes for Adults (18-65 years) Page 26 of 32 Evidence: There is a comprehensive three month induction programme using the Common Induction Standards. When staff are employed they receive the General Social Care Council (GSCC) Code of Practice guidelines. Completed surveys received by us contained positive comments about the staff team. One relative stated, The staff are very caring and a person living in the home said, The staff are kind. On the day of the inspection, we observed good interactions between staff and people living in the home. The manager stated in the AQAA, Staff are trained in autism awareness and attend training in dealing with challenging behaviour. Each member of staff has a Personal Development Plan in place. Evidence was seen that staff have received a range of training including Fire Training, Emergency First Aid, Manual Handling Awareness, Infection Control, Health and Safety, Basic Food Hygiene, Nutrition and Diet, and Tackling Aggressive and Violent behaviour. Staff have also had specialist training relevent to the people living in the home. Autism Anglia recently delivered staff training on Basic Autism Awareness. Personnel records contained evidence that staff have formal supervisions every eight weeks that are appropriately recorded. Regular staff meetings also take place and minutes were examined. Care Homes for Adults (18-65 years) Page 27 of 32 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is appropriately managed in the interests of people living there. Evidence: The manager stated in the AQAA that what they do well is, ensure the home is run to the best of our ability with the interests of service users being paramount. Through discussions the manager was able to demonstrate a good awareness of her responsibilities around managing a registered care service. Information requested by us including the Annual Quality Assurance Assessment (AQAA) was returned as required and was completed with a good range of information about the home. As documented throughout this report, information provided in the AQAA was found to be accurate and supported by other evidence. The manager also demonstrated a comprehensive knowledge of issues relating to people with learning disabilities and, in particular, to the special needs of the people who have behaviours relating on autism. She also showed an enthusiasm and a commitment to providing a good service. During the course of the day we observed good, skilled interactions between the manager and people living in the home and also with staff. Two completed surveys Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: from members of staff indicated that they receive the support they need to do their jobs. However, one person indicated that they could have more positive feedback rather than being told what they are doing wrong. Positive comments were received about the management and staff of the home from relatives who completed surveys. One person said, I personally think they do a fantastic job and need no improvement. The manager stated in the AQAA, service users see that their opinions are taken seriously as when they raise an issue it is acted upon. There is a quality assurance process in place that has been further developed since the last inspection. The manager has produced surveys for relatives, advocates, health and social care professionals. Surveys for people living in the home were produced using symbols to make them easier to understand and they were completed with the assistance of relatives or advocates. Information discussed at staff meetings is also taken into account. The manager has collated the information into a report and identified actions, including better use of the communication book and handover system. The Lodge has a range of policies and procedures in place relating to health and safety. The manager stated in the AQAA, Regular health and safety checks are carried out. A sample of health and safety records examined were all in good order, including servicing of fire equipment and an up to date gas certificate. There is a comprehensive fire risk assessment in place. Records examined confirm that fire alarms and emergency lighting are tested monthly. Personnel records contain evidence that staff received received fire training including practical demonstrations. Care Homes for Adults (18-65 years) Page 29 of 32 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 30 of 32 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 An appropriate facility for the storage of controlled drugs should be available in the event that someone living in the home may be prescribed medication that requires this level of secure storage. Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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