Inspection on 05/05/05 for The Lodge, Plymouth

This inspection was carried out on 5th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Lodge, Plymouth 18/01/07

The Lodge, Plymouth 01/02/06

The Lodge, Plymouth 09/11/04

The Lodge, Plymouth 15/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Lodge The Mencap Centre 207 Outland Road Plymouth PL2 3PF Lead Inspector Kim Fowler Announced 5 May 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Lodge Address The Mencap Centre, 207 Outland Road, Plymouth, Devon, PL2 3PF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 773333 01752 796299 Plymouth Society for Mentally Handicapped Children & Adults Mrs Ann Martin Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users with a learning disability some of whom may have a physical disability 2. Age 18-65yrs Date of last inspection Brief Description of the Service: The Lodge is a care home providing personal care and accommodation for three people with learning disabilities. It is owned by the Plymouth Mencap Society, which is a voluntary organisation, affiliated to the Royal Mencap Society. This home is located in the residential area of Peverell, close to shops, pubs, the post office and other amenities. The home was opened in 1995 and consists of a two-storey building situated on the site of the Plymouth Mencap Society, where there is also another care home and a day centre owned and managed by the Society. All the home’s bedrooms are single, on the 1st floor and none of them have en suite facilities. On the ground floor there are separate lounge and dining rooms. The home has an attractive patio and garden accessible to all the service users, shared with the other facilities on the site.The home is staffed 24 hours a day and has sleep in staff at night. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours and was a planned Announced Inspection. A full tour of the building took place as well as staff and care records were looked at. The 3 service users were spoken with during the inspection and 3 staff members a service user well as the Registered Manager. The CSCI received 3 Relative/Visitor Feedback cards and 3 Service users Feedback cards. What the service does well: What has improved since the last inspection? What they could do better: The inspector felt that the home could expand the recording of the controlled drugs for the service user who carries drugs with him at all times. Please contact the provider for advice of actions taken in response to this The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1/2/3/5. Service users can be confident that The Lodge provides information on the Statement of Purpose and Service Users Guide enabling them to make an informed choice of care home. EVIDENCE: The home has a Statement of Purpose and Service User Guide both seen and read during this inspection. Evident from these copies was that the home has reviewed and updated both documents. The Service User Guide has been produced using a combination of photographs, symbols and writing. The has had no new admission since the last inspection but the home produced as evidence the pre-admission questionnaire to be completed if the need arises. Case tracking provided evidence for one service user who had a pre-admission questionnaire completed held on file. This file also contained the Local Authority assessment and Care Plan. These document provided all the relevant information required to meet this standard. Relative/Visitors Feedback Cards were received from three relatives of the service users living in the home. All 3 relative were satisfied with the care offered. Case tracking provided evidence that the Service User plans and staff records seen indicated that the home had the capacity to meet the needs of individual needs. The contracts seen in individual service users files were from the local authority and individual contract. Both contained the terms and conditions of occupancy and were all signed by each service user. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6/7/8/9 Service users are encouraged to make decisions about their own lives. EVIDENCE: Care plans were seen for all 3 service users in the home. These care plans were comprehensive and complete in detail. All service users have a key worker. Each file contained a Care Managers completed assessment. The home has use of an advocate when needed and service users in the home are encouraged to make decisions about every day issues including menus and food. The manager informed the inspector that the service users are involved in choosing meals and one service user will plan and makes a shopping list. Another service user is involved in the shopping. There is also a timetable on daily household chores that is in sign to assist service users. Case tracking provided evidence in individual file on who and how the service users money is managed. The service users money was checked during this inspection and was well documented and recorded. The home has individual risk assessments for Service Users. These risk assessments relating to hot surfaces have been reviewed and updated as required from the last inspection. The homes individual Risk Assessments seen during this inspection cover all aspects of service users life. Including inside the home and activities outside of the home. These include medication, epilepsy, horse riding, behaviour, infection control and many household tasks. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11/12/13/14/15/16/17 Service users can be confident that the home will provide support for them to access the local community and many leisure activities. EVIDENCE: One service user informed the inspector that they were going to their day service on the day of the inspection and another had already gone. The inspector also saw one service user going out to a horse riding session. The manager informed the inspector that one service users does some educational classes at their day centre and scrap book was seen as evidence of all the activities on e service user is involved in. All service users are encouraged to go out and help with the shopping for the house and the home has regular planned trips out to cafes, pubs and other local attractions. The homes rota was seen as evidence that the staff are able to work flexi hours to assist service user participating in the community. Service users are supported to maintain family contacts through either visit home or via phone calls. This information was confirmed by the 3 Relative/Visitor Feedback cards sent to the CSCI. One card confirmed that one service user went home 2-3 times a week. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 11 From observations made on the day of the inspection the service users are respected and service users were asked before their rooms were inspected. The service users in the home have locks on their bedrooms doors and all are offered keys. All service users have unrestricted access to the house and garden. There is menu is designed to includes meals that individuals enjoy or request. If one service users does not like a particular meal a alternative is offered. The home caters for specific dietary needs for example diabetes and any special requirements are recorded into individual files. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18/19/20 The home continues to provide excellent personal support for service users in the home. EVIDENCE: From discussion with staff all service users are offered personal care in private and case tracking provided evidence that the service users preferences about how their personal care is carried out is clearly recorded into individual files. Case tracking also provided evidence that one service users attended the local A&E department for head injury. The completed accident form was seen as was the follow up incident form and treatment carried out. The home has a excellent record of all medical appointments each service user attends. One service user has diabetes and the home has regular contact with the Diabetic Nurse at the GP surgery. Further case tracking provided additional information that one service users has had a recent operation and document was the full details of this appointment. The manager informed the inspector that the home is due to have medication training update in July 2005. The Pharmacist 12 monthly assessment form was seen as evidence to confirm the visit. The previous requirement carried over from the last inspection, on medication, has been completed and the risk assessment was seen in place. The risk assessment for the staff to carry out blood sugar levels was in situ as was a letter from the District Nurse confirming the staff training managing insulin. On the medication file was a Medical Alert notice for all staff on a needle stick The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 13 injury. The home has a clear system in place for the procedure of disposal of all needles. The controlled drugs and the procedure for the administration of these drugs was seen and checked during this inspection. The inspector recommended that the home expand the recording of the controlled drugs for the service users who carries drugs with him at all times. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22/23 Service users can be confident that their complaints or concerns will be listened to and acted upon. EVIDENCE: The home has a complaints procedure, and has produced a complaints leaflet in pictures and symbols. The CSCI received completed feedback questionnaires from each service users in the home. Each service user was assisted with the completion of these forms by the homes advocate. These forms completed agreed that each service users is aware that the home has a complaints procedure in place and all service users expressed they were happy in the home. The manager showed as evidence, the certificates received, that most staff had completed the Adult Protection course. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24/25/26/27/28/29/30 The home continues to maintain a suitable environment for its stated purpose. EVIDENCE: The premises were accessible to all the service users, clean, comfortable, well furnished and decorated. The home meets the required standard in overall living space. Rooms are regular redecorated and any furnishings or fittings are replaced when needed. And the home has a designated budget for ongoing maintenance work. Plymouth Mencap also employs a maintenance person for everyday work. Two of the rooms are below 10 sq m and the manager informed the inspector that the two occupants spent very little time in their rooms. Each service users bedroom was decorated individually and reflected the personality of the person whose room it was including many personal possession’s. All bedrooms contained wash hand basins. There was one bathroom, with a toilet, on the 1st floor, and a separate toilet on the ground floor. Both the bathroom and toilet were lockable but could be opened in an emergency. The inspector was informed that both rooms had had thermostatically controlled valves fitted. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 16 Outside of the front of the home is a private paved area where there is ample seating, pots and hanging baskets that are well maintained. The kitchen and laundry facilities were found to be domestic in character and communal areas exceeded 4.1 sq m per service user. There was a bedroom for use by staff when sleeping in and where staff could also store belongings. All area where found to be well decorated and comfortably furnished. None of the service users in the home required any specific aids or adaptations but grab rails were fitted for the safety of service users. Most doors have ‘Hold open’ devices fitted. The premises were found to be clean, hygienic and free from offensive odours. Laundry facilities were located in the same room as the ground floor toilet and found to be satisfactory. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31/32/33/34/35/36/ Staff training is promoted and supported enabling service users to receive the best possible service. EVIDENCE: From discussions with the manager and the staff and from observation it was clear that staff were aware of their duties and responsibilities. The home has job descriptions for all posts. The home is part of Plymouth Mencap and has access to support and advice from within the organisation. The observation of the staff during the inspection provided evidence that the staff are skilled in working with this service users group. The records of staff training included not only basic training such as food hygiene but also a range of courses relating to understanding the needs of people with a learning disability. Most staff have gained the NVQ2 or above. The homes staff rotas sent to the CSCI provided evidence that the home has sufficient staff on duty. One staff member sleeps in each night. Observation during the inspection show that there are sufficient staff to assist service users lead a active live within the home and in the community. The home also has a on call system providing out of hour cover. Staff files were seen and showed to be in good order. There was a application form, references and evidence of the home taking identification for CRB checks and POVA checks for the file seen in detail. The staffs training file was seen as evidence and recorded was the regular training included training on LDAF. The home has also received Fire Safety training this week and two staff have attended the Person Centred Planning course, this was confirmed by one staff member spoken with. Evidence was seen of regular recorded and signed supervision carried out. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37/39/40/41/42/43 The management of this home is very good and ensures that records are effectively maintained and staff are well trained and above all the service users are happy and their needs are met. EVIDENCE: The Registered Manager, Ann Martin, was present during the inspection as was Linda Strong who will become the Registered Manager on completion of the CSCI Registered Managers process. Linda is near completion of the NVQ 4 in care and due to start the Registered Managers award in September. The home has regular contact with families and is able to discuss quality assurance information on a 1to1 bases. The quality assurance policy was seen in place and the blank questionnaires were seen that the home send to relative and representatives and stakeholders. All 3 service users returned completed Feedback cards to the CSCI. The homes advocate assisted each service users in the completion of these forms. The service users are consulted informally through discussion and formally through meetings and any action required is The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 19 rcorded into care plans. The home has a comprehensive Policy and Procedure file in place. Staff are required to read and then sign to say they have read each policy and procedure. All the records seen during this Inspection were in good order, well maintained and up to date. Records are kept secure. Risk assessments were seen in place in relation to hot surfaces and in particular for service users who have epilepsy. The home has reviewed these completed risk assessments. Thermostatically Controlled Valves have been fitted throughout the home and the inspector was informed that a new boiler had also been fitted. The pre-inspection questionnaire shows that that regular checks and maintenance is carried out on all equipment and services in the home. The home’s staff training record show that the staff have received appropriate training including Manual Handling, food hygiene and first aid. The home produced a Finance and Business plan as evidence. The home insurance certificate was seen in situ and all lines of accountability is clear clearly understood by service users and staff. Monthly Provider visits were being documented and copies sent to the CSCI. The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 4 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 4 3 4 Standard No 11 12 13 14 15 16 17 3 3 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 4 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Lodge Score 3 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 3 4 3 3 D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 21 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 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. 1. Refer to Standard Good Practice Recommendations The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Lodge D52-D04 S3445 The Lodge V214982 190505 Stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!