Inspection on 04/12/08 for White Lodge

This inspection was carried out on 4th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

White Lodge 05/12/06

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: White Lodge 1 Mowbray Road South Shields Tyne And Wear NE33 3DH     The quality rating for this care home is:   one star adequate 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: Lee Bennett     Date: 1 9 1 2 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 27 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 27 Information about the care home Name of care home: Address: White Lodge 1 Mowbray Road South Shields Tyne And Wear NE33 3DH 01914553108 F/P01914553108 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Saint John of God Hospitaller Services Name of registered manager (if applicable) Mrs Brenda Brown Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home White Lodge is a home run by a national charity. 7 Over 65 0 care home 7 7 people can live here. It is a large house, set in it?s own garden. There are stairs to some parts of the home. Bathrooms and toilets are easy to get in and out of. Everyone has there own bedroom. Nobody has to share. There is a car here for people to use. This means people can get out and about. Care Homes for Adults (18-65 years) Page 4 of 27 Care Homes for Adults (18-65 years) Page 5 of 27 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: one star adequate 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: Before the visit we looked at: - Information we have received since the last visit in December 2006. - How the service dealt with any complaints & concerns since the last visit. - Any changes to how the home is run. - The providers view of how well they care for people. - The views of people who use the service & their relatives, staff & other professionals. Care Homes for Adults (18-65 years) Page 6 of 27 The Visit: An unannounced visit was made on the 19th December 2008. During the visit we: - Talked with people who use the service, their relatives, staff and the manager. - Observed life in the home. - Looked at information about the people who use the service & how well their needs are met. - Looked at other records, which must be kept. - Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. - Looked around parts of the building to make sure it was clean, safe & comfortable. - Checked what improvements had been made since the last visit. After the visit: We told the manager what we had found. Previous Requirements: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. 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 8 of 27 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 9 of 27 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. Detailed assessments of need are usually in place before a persons admission. This can make sure the home and the staff team can meet peoples identified needs. Evidence: Before a person moves to a care home they are entitled to have an assessment of their needs carried out, either by social services or a health care worker, such as a nurse assessor. Even when a person pays for their own care, they are still entitled to such an assessment. The manager of a care home must also obtain information about those people who would like to come here. This will include a copy of the assessment, and a summary care plan, which explains how each persons needs are to be addressed. This is to make sure their needs are looked at and then can be properly met. Most of the people living here have done so for some time now, with the last person moving here nearly two years ago. In the past we have found that before people moved here information was obtained from a social worker to ensure that their needs Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: could be properly met at the home. This is so the manager had sufficient information about each person, and could make a judgment about whether the staff had the right skills and the home was physically suitable for the people concerned. However, for the most recently placed person we could find no such evidence. It is not clear if such information was obtained, because the registered manager has now left the home. There are however copies of the homes own assessment documents, that indicate this persons needs were looked at by the homes manager to ensure they could meet their needs. Care Homes for Adults (18-65 years) Page 11 of 27 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. The people living here benefit from well planed care. This ensures that staff are clear about how each persons needs are to be met. Evidence: To help guide the care that staff offer to the people living here, a care plan file is compiled. All of the people living here have had one developed. These are all written up, evaluated and reviewed by the manager and a key worker; a member of staff who works with a named service user and takes a lead on the planning and delivery of care. Staff are currently working through these, writing these up into new formats and making sure they are up to date. The care files contain a broad range of information on each persons needs, and are written in a person centred way. The care practice that we observed reflected the guidance in the care plans. Closely linked to care planning arrangements are risk assessments. Again, these are written up by a key worker when there is an identified area of risk, either to the Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: service user, or to others by that persons behaviour or needs. They follow a standardised format, with an initial overview checklist, and then more detailed assessments where needed. These explain the area of risk, consider the benefits of certain risks being present, and outline how unnecessary risks are to be managed. Both care plans and risk assessments are a formal way of documenting decisions about important matters affecting a persons care and lifestyle. There are also occasional group meetings held. Most of the people living here are clearly able to express their views and (sometimes with guidance) come to decisions about the things that affect them. Some need staff to be more vigilant with areas such a facial gestures, behaviour and so on, as they can not state the views and feelings as well. The staff team know the people living here well, and are able to explain to us how each person communicates. Care Homes for Adults (18-65 years) Page 13 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are assisted to spend their time in an active and fulfilling way. This can help promote each persons sense of wellbeing. Evidence: On the two days of the inspection, several people living here were spending their time at council day services. The people living here told us about the activities they enjoy, and they all have very active lifestyles. As well as using formal day services, people go out regularly to venues such as discos, the pub, the cinema, local theaters, church, and so on. They also enjoy holidays abroad, and have a minibus to help get out and about. As well as going out and about or being occupied whilst in the home, contact with friends and relatives can affect the quality of life enjoyed by people. Most people living Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: here have regular family contact, and visitors are made welcome. As well as having rights to keep up family contacts and to lead a varied and fulfilling lifestyle, the people here retain rights around how they are helped, and what staff do when they put themselves at risk of harm. To help meet these rights there is some guidance in care plans and risk assessments. The information in these is largely up to date. Furthermore, staff were able to explain to us clearly the individual needs of each person living here, any risks they may face, and how these are managed. Meals form an important part of peoples daily routine and lifestyle, and are normally taken as a group as the people living here usually get on well. This is an important time for people to talk about their day, and share their experiences with staff. The dietary needs of each person are detailed in their care plans, and there is a record kept of meals planned and provided. Where help and prompting is needed staff were able to explain the help they offer, with clear guidance also being available in each persons care plan file. This is so staff follow good practice guidelines, as this can often have important health implications for the people living here. Care Homes for Adults (18-65 years) Page 15 of 27 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. Each individuals personal care and healthcare needs are well supported by systems that ensure privacy is respected and that health and welfare is monitored and maintained. Evidence: The people living here have their personal and healthcare needs outlined within their case files. Their needs are supported and met, where appropriate, in private. Specialist support and input has been sought and obtained where necessary, and multidisciplinary input (such as that from the Physio Therapist, or dietitian) is made available. As well as making sure healthcare advice is sought, the staff in the team help the people living here to access healthcare treatment. This is so people get the help and healthcare they need to keep well. The results of healthcare visits and routine monitoring is recorded within each persons care file. This can help ensure that staff follow any advice and guidance that has been made by the healthcare professional. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: Linked to these health and personal care arrangements is the support given with medication. Due to their levels of need, the people living here are not able to administer their own medicines, and designated staff will help in this area. Most of the staff here have had medication administration training (basic skills course). This has been suplemented by in-house guidance. The medicines themselves are stored in a locked cupboard to keep them safe. There is only a small amount of loose stock, the rest being held in a monitored dosage system. This is where tablets are placed into a blister pack system by the pharmacist. Once given out staff write down who has had what medicine on printed administration records. A check of some of the medicines used here was carried out by us. All of the medicines we looked at were properly accounted for. Care Homes for Adults (18-65 years) Page 17 of 27 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. Clear systems help protect people from neglect, abuse and self-harm. Evidence: A clear, written complaints procedure is available at the home. There have been no complaints reported to us since the last inspection. Some of the people living here are aware of how to raise concerns and complaints, both in the home and to external agencies, such as Social Services and ourselves. Others, due to their communication needs, cannot make direct comments on the quality of care they receive. Staff have therefore to be mindful of each persons behaviour, gestures, and body language to gauge how they feel. The staff here have also received training on adult safeguarding and abuse awareness matters. Both the care providers and the local councils adult protection procedures are available here for staff to refer to. Care Homes for Adults (18-65 years) Page 18 of 27 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. White Lodge provides a homely and comfotable environment, with adaptations to meet peoples current and changing needs. Evidence: White Lodge is an adapted, terraced house, that allows for relatively easy access for people who are physically frail or disabled to the ground and first floors only. As there are stairs and a split level landing some areas are not accessible for some of the people here. Nevertheless, everyone has access to the shared living rooms, and everyone can access a bathroom or shower and toilets. Overall the home is domestic in style, and each persons bedroom has been personalised to suite their tastes. The home is clean throughout and there is good odour control. White Lodge is a comforable home, and the people living here appear relaxed and at ease in their surroundings. Care Homes for Adults (18-65 years) Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living here are supported by a qualified, but recently not well trained or supervised staff team. Evidence: There have been four new staff members recruited here since the last inspection. We were not able to see the staffing recruitment records for one member of staff as this could not be located. For the other three workers there was evidence that preemployment checks were carried out, including checks for criminal convictions, against the Protection of Vulnerable Adults List, and reference checks from previous employers. For one worker the references were given as first names only, and not requested from the manager. The last employers reference was from a relief manager who the applicant went out with socially. There was no evidence that the validity of references was checked for this person. Overall staffing levels and team members have remained reasonably stable and at the time of the inspection, eight out of the nine support staff (and deputy manager) were qualified to NVQ level 2 in care [or higher]. From our sample of three workers, only one member of staff had received any training over the past year. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: Training is one of the topics discussed at each staff members supervision session. These are one to one meetings that are held between a staff member and manager to discuss their performance, training needs, personnel and personal matters. Actions are agreed where necessary. These have not occurred on a regular basis, and some staff have not had a documented one to one supervision since 2006. Care Homes for Adults (18-65 years) Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements have been diluted, although quality and health and safety matters are still checked. This can help ensure the service remains focused on the needs and safety of the people who live here. Evidence: White Lodge was until recently overseen, on a full time basis, by the registered manager. However, at the time of the inspection the registered manager had moved elsewhere, and the temporary manager was overseeing this and two other care homes. We have not been formally notified of this. The part time manager is qualified to NVQ level 4 in care and has also obtained an NVQ in management. We found that staff are not regularly supervised. More senior managers will carry out periodic inspections to check on the quality of care here. To make sure quality and safety are assured periodic checks on the building are carried out, water and fridge / freezer temperatures are monitored, and working practices that could present a risk are looked at. Safe ways of working (for instance by the use of lifting aids) are then Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: introduced. Chemical information sheets are also obtained to inform staff of what to do if they have an accident with a chemical product. We did not see any hazards to the health, safety or welfare of the people living here. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 1 34 19 Recruitment records for all 03/04/2009 staff must be made available for inspection. This is so we can be assured all staff are recruited safely. 2 34 19 Employment references must include those from an applicants most recent employer (not collegue). This is to ensure impartial information is obtained on potential staff. 03/04/2009 3 36 18 Staff must be formally supervised on regular occasions. This is so their performance, and other care and work related issues can be assessed and discussed. 03/04/2009 4 37 38 The CSCI must be notified of 03/04/2009 all matters affecting the day to day management of the home. Care Homes for Adults (18-65 years) Page 25 of 27 This is so we can be assured that the home is being well managed. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 35 37 Staff should receive a minimum of five days paid training each year (pro rata for part time staff). A full time manager should be employed here. Care Homes for Adults (18-65 years) Page 26 of 27 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). 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