Inspection on 16/10/08 for Victoria Lodge

This inspection was carried out on 16th October 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.

Other inspections for this house

Victoria Lodge 17/04/08

Victoria Lodge 30/07/07

Victoria Lodge 13/09/06

Victoria Lodge 15/11/05

Victoria Lodge 10/05/05

Victoria Lodge 13/12/04

Victoria Lodge 14/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Victoria Lodge 59 Victoria Drive Bognor Regis West Sussex PO21 2TQ     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: Liz Palmer     Date: 1 6 1 0 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. that people have said are important to them: They reflect the things 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. Care Homes for Adults (18-65 years) Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 23 Information about the care home Name of care home: Address: Victoria Lodge 59 Victoria Drive Bognor Regis West Sussex PO21 2TQ 01491579270 01491579738 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Victoria Lodge Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD). Date of last inspection Brief description of the care home Victoria Lodge is a care home for younger adults (18-65) who have learning disabilities. The home is registered for six service users. The home is in a residential area in Bognor Regis. The building is detached and has surrounding gardens. There is an annex to the house that is currently used as an activities room. The service aims are to assist residents to develop independent living. The weekly fees range from #1378.00 to #21760.00. Care Homes for Adults (18-65 years) Page 4 of 23 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 peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took six hours. The manager of the home and the organisations operations manager assisted. Three residents were met, two were spoken to about living in the home. One member of staff was interviewed, two others were met. We used the homes Annual quality Assurance Assessment (AQAA), their improvement plan and the last report to help make our judgements about the home. Care Homes for Adults (18-65 years) Page 5 of 23 What the care home does well: What has improved since the last inspection? What they could do better: 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 6 of 23 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 7 of 23 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. People who use the service can be assured that their individual needs and aspirations would be assessed prior to moving to the home. Evidence: No new residents have moved into the home since the last inspection. This standard was assessed and met at the last inspection and there have been no changes to the procedure. There are currently two vacancies in the home. The manager stated they are not in a hurry to fill them but would rather have a period of stability. Care Homes for Adults (18-65 years) Page 8 of 23 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. Improvements to the care planning process ensures that people who use the service have individual care plans and risk assessments that are detailed and clear. People are able to participate in the decision making in the home and in making choices about how they lead their lives. Evidence: Three care plans were looked at. Improvements have been made since the last inspection and the plans are more person centred and specific in the detail. They were clear, specific to the individual and kept under regular review. There was evidence that people who use the service are involved in this process, as are their relatives, care managers and other relevant professionals. Information such as important relationships likes and dislikes and how to support individuals are written in the plans. Communication needs are detailed for individuals to ensure that those supporting them can understand their needs and wishes. There are behavioural support plans in place, for those who need them. These include triggers, proactive strategies and Care Homes for Adults (18-65 years) Page 9 of 23 Evidence: specific dos and donts which focus on dignity and respect. There is a protocol for when 1:1 support is required and a system in place to monitor this. One person required to have 1:1 support was observed receiving this during the inspection. When spoken to they confirmed they receive this. The requirement made at the last inspection regarding care plans needing more detail has been met. The requirement specifically asked for details of dealing with emergency neurological conditions, this related to an individual who no longer lives in the home. Also included are emotional and health needs and evidence of concerns being followed up was seen. People who use the service are supported to take risks and risk assessments are in place and regularly reviewed. Risk assessments are drawn up on an individual basis and the emphasis on independence and positive outcomes supports people to achieve their goals and aspirations. Examples promoting independence and supporting individuality were seen in the care plans. People said they were able to choose how they spend their time and care plans reflect this. Care Homes for Adults (18-65 years) Page 10 of 23 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 who use the service are supported to access a range of educational, social and community activities. Healthy and varied meals are provided with the preferences of people who use the service taken into account. Evidence: From the three care plans looked at talking to staff and talking to service users it is evident that people are supported to make choices about how they spend their time. They are supported to access a range of activities, based on the preferences, needs and choices. Suitable staffing is provided to enable those who like going out to be able to do this on a daily basis. Some attend college, go swimming, shopping and pursue their hobbies with the support of the homes vehicle. Care plans detail peoples preferences and their regular social activities. Such as attending church on Sundays for one person. Each person has a weekly planner which sets out their daily goals and Care Homes for Adults (18-65 years) Page 11 of 23 Evidence: records their acheivements. Evidence was seen to show that people are supported to do the things they like and pursue their hobbies. People are supported to use the local shops, pubs, cafes and restaurants. Evidence in care plans showed that people are supported to keep in touch with their families. Some are supported to use the telephone and individual arrangements are in place for this. The AQAA states that healthy and varied meals are provided and people said they enjoyed the meals and some liked helping with the cooking. Details of specific dietary needs are recorded in care plans as well as individual needs and preferences. Meals and meal times are flexible. The kitchen was in the process of being refurbished during the inspection and systems were in place for people to eat out during this period. One person spoken to said they had particularly enjoyed this. A record of what people eat each day is kept. Care Homes for Adults (18-65 years) Page 12 of 23 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 who use the service are supported to maintain their health and receive personal care in a way that meets their individual needs and preferences.They are protected by the homes policies and procedures for storing, recording and administering medication. Records of medication reviews with GPs and psychiatrists, where necessary were seen. Evidence: The individual needs and preferences of people who use the service regarding their health and personal care are recorded in their care plans. Care plans and daily records show that people get the support they need and that staff respond to any indication that the persons health or well being is effected. Evidence in care plans shows that emotional and psychological needs are considered individually and the home has good links with other professionals who can offer advice and support. People spoken to said their privacy is respected and they feel safe and well cared for in the home. Care Homes for Adults (18-65 years) Page 13 of 23 Evidence: Each person is supported to maintain their health and well being by being registered with a local General Practitioner (GP), opticians, dentist and chiropodist. Support is given to attend appointments and records are kept of this. Evidence seen showed that the home will contact GPs if they have any concerns and action is communicated to staff to ensure everyone is aware of any new procedures or changes to medication. A requirement was made at the last inspection for staff to receive training in administering insulin by injection. Records showed this has been achieved for most of the staff. One member of staff was receiving his training the following day. Staff are trained and deemed competent by a community nurse. Only trained staff are permitted to administer. Medication was seen to be safely stored, for example, insulin is stored in a locked fridge. A lockable cupboard is provided for other medication. Procedures and records for this were sampled and found to be secure and accurate. The home has guidelines in place and where appropriate individual protocols are in place. Care Homes for Adults (18-65 years) Page 14 of 23 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. Improvements to the procedure for complaints means people can expect to have their complaints dealt with. People are protected by the policy and procedures relating to safeguarding. Evidence: A new easy read complaints policy has been produced by the home. There is also a new protocol for handling complaints which is monitored and overseen by the operational manager. Clear guidelines for managing complaints within given timescales were seen. The complaints log was looked at and seen to contain one complaint which was responded to in a timely and suitable manner, according to the homes procedure. This meets the requirement made at the last inspection. When asked about complaining, the two residents asked named staff they would talk to. We also made a requirement regarding referring incidents to social services and notifying us by way of a Regulation 37 notice. Records showed this is now being done and a discussion with the manager and one staff member showed that they are now clear about the procedures to follow. An example of an alert made in June was given and showed how they had implemented the procedure appropriately. This has now been signed off by social services and there are no ongoing safeguarding issues. Care Homes for Adults (18-65 years) Page 15 of 23 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 who use the service have a clean, homely and safe environment to live in. Improvements to the kitchen and other areas of the home, once completed will make it more safe, homely and comfortable. Evidence: During the inspection the kitchen, lounge, dining room, office, bedrooms and bathrooms were seen. Major refurbishment has been undertaken since the last inspection. The program for this, once complete will be over and above what we required at the last inspection. Three bedrooms were seen. Each bedroom has an en suite toilet with a wash hand basin. One en suite facility also has a bath. Bedrooms have been personalised according to the individual tastes of residents with posters, stereos, televisions and other personal items. One resident described how much she liked her bedroom. At the last inspection we made a requirement regarding the restriction of movement for residents. We asked for these areas to be risk assessed and reasons for restrictions to be recorded. This was seen to be met. Care Homes for Adults (18-65 years) Page 16 of 23 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. A trained and competent and staff team ensures the smooth running of the service. Evidence: The homes AQAA states that a standardised training programme is provided to all staff. The manager ensures that all staff receive mandatory training, such as, Health and Safety, Manual Handling, Fire, Food Hygiene and First Aid. New staff receive a Skills for Care standard induction programme. The member of staff spoken to during the inspection was confident and competent. They said they enjoyed their work and showed sound knowledge of the individual needs of people who use the service. They spoke about people in a sensitive and positive manner. People who use the service said they liked the staff and got on well with them. Three new staff have been employed at the home since the last inspection and their files were seen to contain all the required documentation, including, an application form, two written references and a Criminal Record Bureau check. The AQAA states that regular supervision takes place and this was confirmed by the member of staff spoken to. The rota showed that sufficient numbers of staff are deployed to provide the appropriate support for people. For example, when a 1:1 or 2:1 ratio is required it was seen to be provided for individuals. Care Homes for Adults (18-65 years) Page 17 of 23 Care Homes for Adults (18-65 years) Page 18 of 23 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 well run. Residents can be assured the home is run in their best interests. Evidence: The home has appointed a permanent manager, with experience, as required by us at the last inspection. She started working in August and has implemented positive changes to the home. She will be applying for registration with us. The new manager, supported by the operations manager has made many improvements since her appointment. All the areas outlined for improvement by us have been addressed. Where the timescale has not been met this is because they have gone further than we asked, for example, having a new kitchen installed where we asked for improvements to the existing kitchen. The operations manager has kept us informed at all stages of the work and continues to do so. Since the inspection we have had confirmation that the kitchen is completed and working well. Residents are consulted about all aspects of living in the home and where their view is not possible to gain, improvements and changes are made in their best interests. Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: Surveys are due to go out in January 2009 to all stakeholders and the home tells us they will act on the feedback they receive. Risk assessments are in place to promote the health and safety of residents. Staff receive suitable training and notices around the home promote health and hygiene. We made a requirement for the manual fire alarm to be tested on a weekly basis. The records showed that this had been started but was now overdue. This must be monitored to ensure the health and safety of residents and staff. A test was done on the day and all was reported to in working order. Care Homes for Adults (18-65 years) Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R 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 21 of 23 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 Requirement 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 Requirement 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 Care Homes for Adults (18-65 years) Page 22 of 23 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 © (2009) 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. Care Homes for Adults (18-65 years) Page 23 of 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!