Inspection on 30/08/05 for Titchfield Lodge

This inspection was carried out on 30th August 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

Titchfield Lodge 23/10/07

Titchfield Lodge 19/07/06

Titchfield Lodge 16/01/06

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Titchfield Lodge 66 Titchfield Park Road Titchfield Hampshire PO15 5RN Lead Inspector Craig Willis Unannounced 30.08.05 10:30 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. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Titchfield Lodge Address 66 Titchfiel Park Road 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) 01420 544118 01420 544118 Iliace Limited Mrs Sharon Walton CRH 4 Category(ies) of LD Learning Disability registration, with number of places Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection N/A Brief Description of the Service: Titchfield Lodge is registered to provide care and accomdation for four people with learning disabilities, between the age of 18 and 65. The accommodation is provided in a large detached house in Titchfield Park, approximately half a mile from local shops and transport links. Each service user has their own single bedroom and share the use of kitchen, lounge, conservatory and gardens. The home has a car which staff support service users to access. The home is managed by ILIACE, who have a number of similar services in Hampshire. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection of the year March 2005 to April 2006 and took place over 3 hours. The inspector met three of the service users, but due to their communication needs did not have direct conversations with them. The manager, two members of staff and the parent of a service user were spoken with during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to make sure service users are provided with a statement of terms and conditions of residence, which is relevant to their new home. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 6 New care plans and risk assessments relevant to their new home need to be developed for all service users. More structure is needed in the planning of leisure activities for service users, to ensure they meet their needs. Staff need to be provided with medication training, to ensure they are able to operate the medication systems safely. The manager needs to provide staff with formal one to one and group meetings to ensure that staff receive the support they need. The manager needs to obtain the gas and electric safety certificates for the home. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 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 Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 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) 2, 4 and 5 The home has a good assessment system, which gives staff information about the aspirations and needs of service users. Service users and their families are supported to visit the service prior to moving in, although failure to supply terms and conditions of residency may leave them unaware of their rights. EVIDENCE: The inspector viewed the files of all four service users. Each service user has a comprehensive needs assessment, which was completed when they first moved into a home run by ILIACE, prior to moving to Titchfield Lodge. These assessments had been reviewed each year. The assessments included health, communication, educational and social needs and an assessment of risks that service users face. Prior to the move to Titchfield Lodge, service users were supported to visit the home and transition meetings were held with service users’, family members and care managers. The manager reported that the previous placement of one service user has been kept open as it was agreed that the move to the new home might not work. A review of the placement for this service user was due to be held the day after the inspection. None of the service users had a copy of the terms and conditions of residency for Titchfield Lodge. The manager agreed that she would ensure each service user was supplied with this document. This will be followed up at the next inspection. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 9 Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 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 standard(s) 6 and 9 Service users did not have up to date care plans and risk assessments specific to their new home. The home could not therefore demonstrate that the needs of all service users were being met. EVIDENCE: All four service users had care plans and risk assessments available, although they all related to their previous placement at other ILIACE homes. The manager reported that she planned to update all of these documents and make them relevant to the service provided at Titchfield Lodge. The manager also reported that it was possible that one service user would return to their previous placement as it was thought they had not settled in well to the new home. Staff spoken with said that they were aware of the care plans and felt that they were generally good. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 17 Meaningful activities are planned and provided during weekdays, which should be extended to evenings and weekends. Dietary needs of service users are well catered for with a balanced and varied selection of food available EVIDENCE: Service users are supported to take part in a range of educational activities through ILIACE’s day activities programme, including the use of a local outdoor activity centre. The parent of one service user expressed the need for more structured leisure activities at the weekends and in the evenings. The manager reported that activity plans were being reviewed as part of the review of the placement and action would be taken to introduce more structured activities for service users. This will be followed up at the next inspection. The home had a planned menu, which took into account the recorded likes and dislikes of service users. The menu provided a varied and balanced diet and staff reported that alternative meals were available if requested. The kitchen was well stocked with good quality food. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 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) 19 and 20 The health needs of service users are met with evidence of access to a range of NHS services. Service users’ needs were being met by adequate medication systems. The provision of formal training for all staff will ensure these needs continue to be met. EVIDENCE: Records indicated that service users were supported to attend a range of health services, including GP, dentist, chiropodist and optician. The records contained details of any advice given by the practitioner. All of the service users are provided with support to take any prescribed medication. Medication is stored in a locked cabinet in the office. The manager reported that a larger cabinet was being ordered, to make it easier to store the required medication. Records of medication administered to service users were fully completed and guidelines were in place for the administration of ‘as required’ medication. Two of the staff administering medication had been trained by their previous employer and two had received in-house training from the manager. The manager reported that the ILIACE medication training was planned for all staff. This will be followed up at the next inspection. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 13 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) 23 The home has good systems in place to protect service users from abuse. EVIDENCE: The home had a copy of ILIACE’s adult protection policy and the adult protection procedure followed by the local authority. Staff spoken with demonstrated a good understanding of signs of possible abuse and action they should take if abuse was suspected or reported. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 14 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 and 30 The home is clean, safe and well maintained which provides service users with a pleasant, comfortable environment. EVIDENCE: The home is well furnished, with good quality domestic fixtures and fittings throughout. On the day of the inspection the parent of one service user was painting a mural on the conservatory wall. Sufficient communal space was provided in the lounge, dining room and conservatory to meet the needs of service users. The home was clean and hygienic with suitable laundry facilities provided in a utility room. Procedures were in place to prevent soiled laundry being taken through the kitchen whilst food was being eaten or prepared. The home had consulted the Environmental Health Officer on developing these procedures prior to their registration. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 15 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) 33 and 36 Service users are supported by sufficient staff, although there are poor staff support and supervision systems in place. EVIDENCE: The home has two full time staff vacancies, although the manager reported that one person had been recruited and was due to start the following week. The manager also reported that an advert had also been placed for the remaining post and was interviewing short listed candidates the following week. The home has a staff rota in place, indicating that there was a minimum of two staff on duty at any time during the day, with additional staff for particular events where additional support was required. Staff vacancies were being covered from within the team and through the use of agency staff. The home operates a shift leader system, to ensure that new staff are working along more experienced staff. The manager reported that she had not yet started to provide formal, one to one supervision for staff. One member of staff spoken with said that they did not feel they received enough support, particularly as they had been getting to know a new group of service users. Another member of staff spoken with said they felt well supported, although said she had not met with the manager for formal supervision. The manager also reported that staff meetings had not yet Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 16 been held, although one was planned for the following week, and will be held every two months. This will be followed up at the next inspection. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 17 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) 42 The system for maintaining the health, safety and welfare of service users is satisfactory. EVIDENCE: The home’s fire alarm system and extinguishers were checked regularly by the maintenance team of ILIACE and records were made of the checks. Fire safety training had been provided to staff. The home had information on chemicals used, which were stored in locked cupboards. Food was suitably stored and daily checks of the fridge and freezer were recorded. Hot water taps were fitted with thermostats to prevent scalding. The manager reported that the gas and electrical safety certificates had not been received from the builders, following the completion of works prior to the home opening. This will be followed up at the next inspection. Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 18 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 x 3 x 3 2 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Titchfield Lodge Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 19 N/A 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. 2. 3. Standard 36 Regulation 18 (2) Requirement The registered person must ensure that all staff are provided with formal supervision. Timescale for action 31/10/05 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 Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 20 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Titchfield Lodge H54 S63468 Titchfield Lodge V243830 300805.doc Version 1.40 Page 21 - 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. 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