Inspection on 06/11/08 for White Lodge

This inspection was carried out on 6th November 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

White Lodge 08/11/07

White Lodge 22/03/07

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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: White Lodge Southview Road Headley Down Hampshire GU35 8HY two star good service The quality rating for this care home is: 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: Damian Griffiths Date: 0 6 1 1 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: White Lodge Southview Road Headley Down Hampshire GU35 8HY 01428713877 F/P01428713877 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Omega Elifar Ltd Name of registered manager (if applicable) Mrs Nina Hall Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: 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). The maximum number of service users to be accommodated is 4. Date of last inspection 0 8 1 1 2 0 0 7 A bit about the care home White Lodge has undergone a major refurbishment and now offers a newly decorated and completely wheelchair accessible home currently for three service users with learning disabilities. The home is registered for four service users and the home was in negotiating with a fourth service user to join the home. The home is owned and managed by Omega Elifar Ltd who also have four other registered services in the area. The home is situated in quiet cul de sac in a semi-rural part of Hampshire between the villages of Grayshot and Headley. 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 How we did our inspection: This is what the inspector did when they were at the care home This key unannounced inspection took place over seven hours. The inspection was carried out by Damian Griffiths and the registered manager Mrs Nina Hall was available, representing the establishment, throughout the inspection. This was the homes first inspection since the completion of a major refurbishment and since the manager had acquired CSCI registration for this service. A full tour the premises took place and a number of documents and files, including all three service user care plans, staff recruitment files, quality assurance information and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. The Inspector would like to thank service users their relatives, care staff and the registered manager for their help and hospitality on the date inspection. Comments received during inspection and appearing in the homes AQAA are featured in this report and some words have been changed in respect of confidentiality. What the care home does well What has got better from the last inspection A quality rating of Adequate had been awarded to the home at the previous inspection due to there being no service users at the home. There were no requirements or recommendations made at the last key inspection. The home now offers service users good outcomes. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Damian Griffiths 33 Greycoat Street London SW1P 2QF 02079792000 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 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 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 . Service users had received a full assessment of their care needs prior to moving into the home to ensure their health safety and welfare would be provided. Evidence: The service users had received a variety of care need assessments prior to moving into the home from a range of social/healthcare practitioners in partnership with the homes manager. The three service users living at White Lodge had each received a pre admission assessment of their care needs in areas such as; personal care, health care, social care, physical disability and culture. The assessments took particular care to ensure that the service users views, likes and dislikes were recorded to ensure good outcomes for each service user. The home had completed an annual quality assurance assessment (AQAA) and submitted it to CSCI before the inspection. It stated that; as a company, we ensure that service user needs are comprehensively assessed prior to any admission being agreed. The home was in the process of assessing a fourth service user. 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 . Risk assessment and individual care planning ensured care staff were well informed about how to support service users independent life skills, choices and personal care support. Evidence: The three care plan folders sampled contained details of each service users care needs including; personal and family background, personal care, specific disability needs and what kind of support was needed to improve opportunities for socialisation at the home and within the local community. The AQAA summarised this stating; service users are actively encouraged to participate in, and are consulted, regarding all aspects of life in their home e.g. choosing weekly menu planned, supported to go shopping and choices regarding the home. Amongst the wealth of service user information to be found in the large care plan folders a personalised account completed by the service user and their key worker known as the ‘About Me’ handbook was fitted in one of the many plastic wallets contained in the folders. It gave a straightforward account of the service user’s care needs. Any new member of staff introduced to the home would understand a lot about the individual service user by reading this account. It contained a photograph of the service user and mix of illustrations and simple statements giving a clear indication about the service users preferences, for example; how I communicate, ,when I want a contention , my likes and dislikes, my personal care routines, what I can do and what help I need. Amongst information in the care plan folders careful assessment of the risks involved in Evidence: relation to supporting each service users health and social care activities had been recorded and confirming the homes AQAA statement; risk assessment in place for all service users to minimise the risk of harm ensuring that they are supported to take risks as part of an independent lifestyle. The documentation of risk was easy to read and contained on one page detailing the area support needed, goals, how the success be measured and the method of recording. A daily, weekly and monthly evaluation of actions taken was available on the same page and signed by the key worker. There was a need to update one service user’s handbooks because it did not contain their preferred nickname being used by care staff. Care staff advised that the care folder would be updated to include the nickname. The large care plan folders were worn and falling apart and it was quite difficult to locate specific information. The manager advised that that the folders were going to be replaced and the organisation of information reviewed. It is recommended that the information contained in the, ‘About Me’ handbook, should be given more prominence, made more accessible and easier to read. Please see the recommendation section of this report. 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 . Service users have access to the local community and the opportunity to do the things they wanted to do. The home had ensured that the service user’s right to choose was respected, independence promoted and wholesome and nutritious food was provided to ensure their health and well-being. Evidence: Records were in place showing that service users have visited local theatres and arts centres and participated in music and movement sessions. A full range of activities was available. Each service user had recorded in their care plan folders a range of interests and methods of measuring the success of each activity intended. Six monthly reviews were being completed and details were available to show that areas such as; community presence and participation, choice and independence were being considered. Evidence was in place supporting the homes AQAA statement; all staff encourage and support service users to access a wide range of individual and group activities including cultural, educational and recreational. A service user and their relatives were attending a six monthly review with the local authority social care practitioner at the time of the inspection. The service user was fully involved with the proceedings that were observed to be relaxed and informative. The relatives stayed for lunch with the service user afterwards. The family were made to feel welcome throughout their stay. When consulted during lunch the relative stated that their relative was; much more independent and described how the service user had developed and improved since being at the home; doing much more for Evidence: themselves. Other comments included; he/she looks much healthier, the home is clean and tidy and the care here is very good. Care staff respected service user’s privacy and dignity and were observed always knocking on doors before entering a room and addressing service users in the way they preferred, as stated in the previous section, using the service users nickname. Service users received a four-week menu plan listing wholesome and nutritious food. Care staff had been fully trained to ensure that service users with special needs were able to maintain a healthy and nutritious diet. A variety of nutritional and wholesome food was listed in the homes records including fresh fruit and vegetables. Potential dangers to the service users had been assessed for risk and care staff had received training in how to safely intervene when necessary. 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 . Comprehensive care need assessments ensured that community practitioners were able to carry out healthcare checkups in a way that promoted the best interests of the service user. Prescribe medicines were safely dispensed and recorded ensuring the service users ongoing health, safety and well-being. Evidence: The homes AQAA stated in the section titled; what we do well; regular and general health checks, accessing other health professionals as and when appropriate. The service user’s handbook, as described in the previous section, contained all the information care staff required to understand what the service user’s likes and dislikes were and how they prefer to receive their healthcare support. Details of appointments with practitioners as stated in the homes AQAA this section titled; How We Have Improved in the Last 12 Months; liaised with relevant professional bodies to enhance the lives of service users of e.g. Learning Disability Team for medication and behavioural support; Dentist and GP for regular checkup appointments and dietician for advice on balanced diet and healthy lifestyles, were contained in the care plan folders. Details of service users prescribed medication needs had been recorded in the care plan including details of each particular to medication the service user was currently prescribed. Service users seek help from the care staff to ensure the prescribed medication was given as directed by their GP. All medication given by care staff had been recorded in the Medical Administration Records (MAR) completed according to the homes medication policy that can also be found in the staff handbook and the staff induction programme. 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 . The homes complaints system was accessible and understood by relatives and advocates. Safeguarding practices were practiced by care staff that were committed to providing a safe environment for service users. Evidence: Relatives consulted at the home confirmed that they had spoken to the manager in the past and were confident that the manager would listen to any further complaints if necessary. This confirmed the homes statement made in their AQAA that; service users visit family on regular basis where any issues could be raised. And, completed in the section titled; How We Have Improved over the Last 12 Months; regular service user meeting to highlight any concerns. Records of complaints were available and contained details of one complaint that was unrelated to the care received by the service users. The manager admitted that she generally resolved any concerns from relatives before it developed into a complaint. It was recommended that the manager list any concerns in the complaints book and record the outcomes for future reference and to show how problems were being addressed at the home. Care staff consulted about safeguarding issues were knowledgeable and able to describe what action is they would take, for example, if the service user was found to have unexplained bruising. Staff confirmed that diagrams of the body were available in care plan folders to pinpoint bruising and staff were confident about bringing this to the attention of the manager. Staff were also aware of the whistle blowing options available to them. The home had a copy of the Hampshire safeguarding policy and procedure 2008. There was evidence in place showed that the homes AQAA accurately stated that; all staff received safeguarding adults training. Please see the recommendations section of this report. 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 . The new home provided service users with a clean, tidy and homely environment that enabled them safe access to all areas. Evidence: The recently refurbished home had been in operation since May 2008. It was accessible to wheelchair users and provided spacious corridors and accessible communal areas. The home was considering how best to develop the patio area at the rear of the premises. A small, private paved area with overhanging trees and bushes would offer a shady place on a sunny day. The patio was accessible to service users who will be able to enjoy developing the area further in the summer months ahead. The service users benefited from living in a clean, tidy, homely environment. Service users were observed listening to a choice of music provided by a jukebox in what was a relaxed and comfortable area. Personal possessions such as photographs, ornaments, electrical goods and photographs situated in the service users bedrooms reflected personality and preferred colour scheme, confirming the statement made in the homes AQAA; the home is decorated to the choice of the service users. Bathroom areas contained equipped sufficient to accommodate the service users personal care needs. Each area was clean and tidy without any offensive odour. The utility room contained a washing machine with a sluice cycle and an area for staff to wash their hands with ample liquid soap and paper towels. This area was also, clean and tidy and provided a safe space for care staff and service users working in the area. In order to ensure that the home was kept in good condition the home listed maintenance work to be completed. The homes AQAA confirmed that; we have a maiden system to ensure that any repairs etc are carried out; this is backed up by maintenance forms which are only signed off once the work is completed. 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 . Staff were aware of service users care needs and had received training that was relevant to the service users social and healthcare needs. Robust recruitment procedures had been implemented to ensure that new staff worked with service users had been properly vetted. Evidence: Care staff were well informed and confident working with the service users. The complement of staff on duty during inspection included staff from a care agency commissioned by the home. Care staff consulted about what it was like working at the home said; Its so friendly here, The home supported service users to do the things they wanted to do. The home ensured that they received, Quality time with the service users. We dont get limited time. Its very relaxed here. The home had implemented robust recruitment procedures. The personnel files of three care staff were sampled including details of the agency staff and new staff employed. Documentation acquired following the homes vetting procedures were in place including; criminal records bureau (CRB) notifications , personal references and employment histories detailing experience. The agency commissioned by the home had provided details of their care staff that included CRB, experience and training status. Care staff were able to meet the care needs of the service users due receiving the relevant training that met the needs of the service users in areas of care, including; food hygiene, health and safety, fire safety and the safeguarding of vulnerable adults. Training that was service user focused and directly linked to service user care need, for example; epilepsy medication updates and the safe use of medication ensured that care staff were confident providing the support required. It was evident that the Evidence: homes AQAA was an accurate reflection of the training and experience of care staff when it stated that; all relevant training to maintain the home within the guidelines and framework set by The National Care Standards, Skills for Care Is, Implemented and remained ongoing. 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 manager and care staff worked together to support and encouraged service users their relatives and advocates to participate in the running of the home. Health and safety practices ensured the well-being of care staff and service users. Evidence: The registered manager had been with the service users at the organisations sister home during the refurbishment of White Lodge and had experienced all the trials and tribulations that are usually associated with moving house. This had broadened her knowledge and experience of the service users care needs, and strengthened relationships with relatives, advocates and care staff. Relatives met during the inspection confirmed that they could discuss any matter with the manager, that their relatives had become more independent and that they were very pleased with the overall quality of care and the home environment. Care staff confirmed that their training needs were being met and quality time with the service users was not limited. Care staff had received supervision and appraisal, training was relevant to meet in the care needs of service users and care staff confirmed that they were confident of obtaining any training required. The manager was committed to continued professional development and had achieved her Registered Managers Award (RMA) and in the last six months had obtained training updates in relation to a number of areas relative to meeting the needs of service users. Service users relatives and significant others had the opportunity to express their views at service user meetings and relative consulted confirmed that, as stated in the homes AQAA, and open door policy was practiced. There was evidence of regular Evidence: involvement of service users and their relatives involved in the care planning and reviewing processes. This confirmed the homes AQAA statements that; service user’s rights and dignity are respected by all staff. It went on to confirm that the homes; quality assurance system, fire risk assessment, health and safety audit etc (was) all in place. There were no health and safety concerns apparent following a tour of the premises. Cleaning materials and other cleaning agents were kept in an appropriately locked compartment. Toilets and bathrooms were clean and free from odours and contained ample liquid soap and paper towels. The homes care staff included agency care staff who knew where assembly points were situated and evacuation procedure in the event of fire and evidence of fire drill practice was in place. Are there any outstanding requirements from the last inspection? Yes No 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 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 Description 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 Description 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 1 6 It is recommended that the information contained in the, ‘About Me’ handbook, should be given more prominence, made more accessible and easier to read It was recommended that the manager list any concerns in the complaints book and record the outcomes for future reference. 2 22 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 © (2008) 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. 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