Inspection on 09/06/06 for The Lodge Trust

This inspection was carried out on 9th June 2006.

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

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

Other inspections for this house

The Lodge Trust 23/11/05

The Lodge Trust 09/06/05

The Lodge Trust 08/03/05

The Lodge Trust 07/09/04

The Lodge Trust 22/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 The Lodge Trust Main Street Market Overton Rutland LE15 7PL Lead Inspector Mrs Kathy Jones Unannounced Inspection 9th June 2006 01:00 DS0000006460.V294487.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 DS0000006460.V294487.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. DS0000006460.V294487.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lodge Trust Address Main Street Market Overton Rutland LE15 7PL 01572 767234 01572 767503 admin@lodgetrust.org.uk 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) The Lodge Trust Ms Elizabeth Jane Irvine Care Home 25 Category(ies) of Learning disability (25), Learning disability over registration, with number 65 years of age (1) of places DS0000006460.V294487.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No further Service Users in the category of LD may be admitted when there is already a total of 25 Service Users accommodated in this Category. No further Service Users in the category of LD (E) may be admitted when there is already a total of 1 Service Users accommodated in this Category. 23rd November 2005 Date of last inspection Brief Description of the Service: The Lodge Trust is registered to accommodate up to twenty-five adults with learning disabilities. The Lodge Trust was established in 1984. The Lodge Trust is an Evangelical Christian Home. Residents who choose to live at the home make, as part of that choice, a decision to live by the Christian principles. The Lodge Trusts ethos is to promote and support all residents who are able to work to be involved in communal work at the Lodge Trust or work in the local area. Products produced by the residents are sold in the small shop on site. The home is in Market Overton, a small village in Rutland, in 21 acres of rural countryside and six miles from the county town of Oakham. Accommodation is provided in three houses, each with its own kitchen, dining room and sitting areas. The houses are close to the workshops and garden areas. Bedrooms are located on the ground and first floors of each house and close to bath/shower and toilet facilities. Rooms in one of the houses all have en-suite facilities. The following fees were confirmed by the responsible individual as being current at the time of the inspection on 9 June 2006: • Fees start at £457.89 per week with additional charges made for those people assessed as requiring additional staff time. The fees include personal care, accommodation and meals. There are no additional charges for day services. Chiropody and hairdressing services can be arranged and are charged separately. Other costs would include clothing and toiletries. DS0000006460.V294487.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All standards identified as ‘key’ standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. The review of evidence and pre-inspection planning was carried out over the period of half a day and involved reviewing the report of statutory inspections carried out in June and November 2005 and the service history, which details all contact with the home including notifications of events reported by the home and telephone calls. A pre-inspection questionnaire submitted by the registered manager, nineteen comment cards from relatives/visitors, one from a health professional and twenty two from residents’ were also reviewed. The information gathered assisted with planning the particular areas to be inspected during the visit. The unannounced inspection visit covered the afternoon of a weekday. The inspection was carried out by ‘case tracking’ which involves selecting residents’ and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The inspector spoke to ten residents’, some individually and some in a group. Observations were made of residents’ general well being, daily routines and interactions between staff and residents. The management of residents’ medication and monies were reviewed. Staff training was discussed with staff and two files for newly recruited staff were reviewed to check the adequacy of the recruitment process. Communal areas of the premises were viewed during discussions with residents’. Feedback on the inspection findings was given to the responsible individual throughout the inspection visit. What the service does well: One of the main strengths of the service is the support and encouragement residents’ have to increase their skills and to lead busy and fulfilling lives. The assessment process takes account of whether a prospective resident would be able to benefit from and contribute to the life of The Lodge Trust. Residents spoken to all felt that they had been given enough information prior to moving in to help them decide if it was the right place for them. All those spoken to felt it met their expectations and said they were happy. Before moving in DS0000006460.V294487.R01.S.doc Version 5.2 Page 6 residents’ know that the home is run on Christian principals and comments from residents’ and relatives confirm that this is important to them. One of the things that residents’ said they liked was that they were able to work from 9am to 5pm, “like other people”. Those spoken to were happy with their work placements, which are within The Lodge trust and include gardening, laundry, kitchen, cleaning, or working in the workshop producing goods for sale in the shop. Residents’ also attend local college courses and are encouraged to develop and use skills, some are working towards the Gateway Award, which is run in conjunction with the Duke of Edinburgh Award and is designed so that people can choose activities suitable for their particular abilities. Residents’ are as involved as possible in determining how their care, health and support needs are met and encouraged to be as independent as possible. Staff and residents are encouraged to raise concerns, which are taken seriously with action taken where necessary. Accommodation is in three houses, which are set in large grounds with immaculately, kept gardens providing pleasant and spacious areas where residents’ can spend time. The houses were clean and comfortable 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 DS0000006460.V294487.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. DS0000006460.V294487.R01.S.doc Version 5.2 Page 8 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 DS0000006460.V294487.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 1, 2, 4 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The admission process provides assurances that residents’ can make an informed choice about entering the home and that their needs can be met. EVIDENCE: A group of residents’ told the inspector that before they moved to The Lodge Trust they came and stayed for an ‘assessment week’. This gave them the opportunity to see if they wanted to move in to the home and for staff to see if it would be right for them and they would be able to meet their needs. Residents’ felt that they had been given enough information to make a choice and that the home met with their expectations. The home has a statement of purpose, which provides written information about the service. It states that the basis for deciding if someone should come to live at The Lodge is that they would benefit from and contribute to the life of The Lodge Trust. DS0000006460.V294487.R01.S.doc Version 5.2 Page 10 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 the following standard(s): 6, 7, 9, Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Residents receive a good standard of care and support and are encouraged to make decisions about their lives. EVIDENCE: Questionnaires from residents’ and relatives confirm that they are happy with the overall care provided with many additional positive comments such as “we are more than satisfied with the ‘care’”. The care and support provided was discussed with six residents’ in a group and three individually. One resident agreed to discuss with the inspector in more detail how their care is planned and supported. Residents’ confirmed that they are aware of the content of their care files and are encouraged to be as involved as possible with drawing up their care plans with some residents’ writing some of their care notes. The discussion with a resident about their care and care file demonstrated that residents’ are in control of their care and decide how they wish staff to support them. The plans include ‘goals’ which DS0000006460.V294487.R01.S.doc Version 5.2 Page 11 residents’ wish to achieve and the support they need to do that. Care plans are reviewed every six months with a formal review annually. Residents’ are supported and encouraged to make decisions about their lives and express their views. One resident has been representing people with a learning disability regionally and has just been elected as a national representative. Discussion about the management of residents’ finances identified that work is being carried out to improve the systems to enable residents to have more control while ensuring they have any necessary support to manage their money effectively. A resident confirmed that staff recognise the need for residents’ to be able to take responsible risks and to have as much independence as possible. An example given was of a trip to a local town where staff had assisted them to the bus where they had then been able to travel independently to meet friends. DS0000006460.V294487.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Opportunities for personal development are provided and residents’ are encouraged to lead a busy and fulfilling life. EVIDENCE: A resident said that staff had supported their personal development and that their self esteem and self confidence had increased allowing them to take up new and interesting opportunities outside the home. Residents’ told the inspector that they have a very busy life and enjoy working from 9am to 5pm “like other people”. There is an expectation that all but the older retired residents’ are engaged in some kind of work. Residents and a relative advised that they are able to choose the type of work they do. Examples of the work include gardening, laundry, helping in the kitchen, cleaning or working in the workshop where various items such as notebooks, wooden chopping boards, garden pots, hot-pot stands and scarves are made for sale in the shop. DS0000006460.V294487.R01.S.doc Version 5.2 Page 13 Residents said that the majority of them attend various courses at local colleges and have opportunities to shop in local towns. A member of staff told the inspector that they are supporting residents in working towards achieving a Gateway Award at varying levels. The Gateway Award is run in conjunction with the Duke of Edinburgh Award and is designed so that people can choose activities suitable for their particular abilities. Participants develop new interests and skills in the main areas, which are hobbies, physical recreation, and practical service in the community, adventure challenge and lifestyle. People moving in to The Lodge are clear that the home is run on Christian principals and comments from relatives and discussions with residents confirm that this is important to them. Residents’ choose which local church to attend. Responses in questionnaires from visitors/relatives and discussion with a relative confirm that they are made welcome in the home and that visiting arrangements are flexible. One relative stated that they had visited the home announced and unannounced and that “the welcome and love is always the same”, another that there is a “family atmosphere”. Residents spoken to confirm that they are happy living at The Lodge and relatives report that after a home visit they are always pleased to go back and that they like living there. Residents said that they were going shopping on the evening of the inspection to one of the local towns. They usually go on a Saturday however this week they were all invited to and looking forward to the manager’s wedding which was due to take place the following day in the grounds of the home. Some residents were involved in preparations for the wedding, which included ensuring that the gardens were looking at their best. There is a set menu however residents said that alternatives are available and that there is plenty of food. They said they liked the food and that they are able to have drinks and snacks as and when they wish. DS0000006460.V294487.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Residents’ receive a good level of care and support based on their individual needs and preferences, with health care services accessed as required. EVIDENCE: As identified under the section titled ‘individual needs and choices’ residents are in control of their care. A resident described how her care and support needs had been detailed in her care plan which demonstrated that the aim is to help residents be as independent as possible which includes personal care. A resident spoken to had full insight into her health care needs and confirmed that relevant health care and advice is available. All arrangements are carried out with her full knowledge. During a sample check of the management of residents’ medication it was apparent that residents’ are aware of their medication and involved in any discussions. A sample check of the medication system confirmed that there is a clear system in place for the management and recording of medication administered. No discrepancies were identified during a sample check. Advice DS0000006460.V294487.R01.S.doc Version 5.2 Page 15 was given in one instance to ensure that the General Practitioner is aware of herbal remedies taken and that the herbalist is aware of all prescribed medication. Information from health professional questionnaires confirms that they are very satisfied with the care provided, that staff communicate clearly with them and that they demonstrate a clear understanding of residents needs. DS0000006460.V294487.R01.S.doc Version 5.2 Page 16 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 the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. There are procedures for dealing with concerns and complaints which residents’ and relatives/visitors are aware of. Complaints are taken seriously and where necessary action is taken. EVIDENCE: The Commission for Social Care Inspection have received no complaints about the service since the last inspection. Review of the homes complaint log identified that staff and residents are encouraged to raise concerns, that they are taken seriously and that where appropriate action is taken. Residents’ had no concerns about how they are treated by staff though some concerns were raised about the behaviour of other residents’. Discussion with residents’ and staff during the inspection confirmed that residents’ speak to staff if they are not happy with anything and that when situations arise staff deal with the situation. Staff spoken to had no concerns about how residents’ were being treated and were aware of their responsibilities to act to protect residents’. DS0000006460.V294487.R01.S.doc Version 5.2 Page 17 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 the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The standard of the environment is good providing people with a clean, comfortable and homely place to live, which meets their needs. EVIDENCE: Residents’ accommodation is provided in three houses, each with its own kitchen, dining room and sitting areas. The garden house is the smallest house accommodating six of the older residents. This house has been purpose built and each room has en-suite facilities. The houses are close to the workshops and are surrounded by immaculately kept garden areas. The communal areas in all three houses were seen, all were clean and comfortable. Residents are able to move freely around the site and all said they were happy with their rooms and the facilities. DS0000006460.V294487.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. Staff training, recruitment procedures and staffing levels provide good care and protection for residents’. EVIDENCE: Staffing levels were discussed with the responsible individual who advised that these are tailored according to the assessed needs of residents’. Discussion with staff and residents’, and questionnaires from relatives confirm that there are enough staff to meet residents’ needs. Observations confirmed this was the case at the time of the inspection. Records reviewed for two recently recruited staff confirms that there is a thorough recruitment process in place, which includes obtaining references and a satisfactory criminal record bureau clearance prior to someone starting work in the home. A recently recruited member of staff confirmed that induction training specifically for working with people with a learning disability is provided for new staff. DS0000006460.V294487.R01.S.doc Version 5.2 Page 19 The pre-inspection questionnaire submitted by the registered manager identifies that 45 of staff have achieved a National Vocational Qualification (NVQ) at level 2, which is just slightly below the target of 50 in the National Minimum Standards. Additional pre-inspection information confirms that other staff are working towards NVQ2, which provides staff with a basic understanding of care. Some staff are also working towards NVQ 3. Additional training to meet residents’ needs has included autism, person centred planning and communication. A staff member confirmed that staff are supported in their work with residents’ and have a one to one supervision session every three weeks. DS0000006460.V294487.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using all the available evidence including a visit to the service. The management and organisation of the home is good promoting the interests and well being of residents’. EVIDENCE: The registered manager was not present at the time of the inspection however the pre-inspection information states that she has achieved a registered managers award. The findings of this inspection indicate that the home is well managed. Quality assurance systems were discussed with the responsible individual who described the process for reviewing the quality of the service. Regular ‘quality meetings’ are held with the managers of the various departments. They include discussion about any concerns, complaints or compliments and DS0000006460.V294487.R01.S.doc Version 5.2 Page 21 residents’ reviews. A staff satisfaction questionnaire has recently been sent out to gain their views. The pre-inspection questionnaire confirms that regular servicing and maintenance checks on the premises and equipment are carried out. For example servicing of the central heating system and fire equipment. Staff confirmed that they receive appropriate training in safe working practices such as health and safety, movement and handling and first aid. DS0000006460.V294487.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 3 2 3 3 X 4 3 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 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000006460.V294487.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000006460.V294487.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 DS0000006460.V294487.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. 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!