Inspection on 01/07/05 for Winston Lodge

This inspection was carried out on 1st July 2005.

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

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

Other inspections for this house

Winston Lodge 24/04/07

Winston Lodge 18/04/06

Winston Lodge 11/11/05

Winston Lodge 07/01/05

Winston Lodge 15/10/04

Winston Lodge 06/04/04

Winston Lodge 29/09/03

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

CARE HOME ADULTS 18-65 Winston Lodge 362 London Road Waterlooville Hampshire PO7 7SR Lead Inspector Nick Morrison Unannounced 1 July 2005, 10:00 st The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Winston Lodge Address 362 London Road Waterlooville Hampshire PO7 7SR 023 9264 7895 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Care Management Group Limited Care Home 13 Category(ies) of Learning Disability - LD - 13 registration, with number of places Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 07.01.05 Brief Description of the Service: Winston Lodge is a care home registered to accommodate up to thirteen people in the category of learning disability. The home is owned by the Care Management Group who are based in Wimbledon. The group owns two other houses close to Winston Lodge.The home is situated within walking distance of Waterlooville town centre and is close to a range of amenities.The Responsible Individual for the home is Mr Michael Buckingham and there is currently no Registered Manager. The person in day-to-day control of the home at the time of inspection was Mr Steve Coombes. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection began at 10.00 am and lasted for five hours. During this time the Inspector toured the premises, spoke with staff and service users and spoke with the Manager. All records referred to in the report were examined on the day of inspection. What the service does well: What has improved since the last inspection? What they could do better: The service needs to devise a policy for ensuring the protection of service users’ financial interests. Continued developments in staff training will benefit service users as will improvements in the equipment in the home. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 Service users benefit from clear assessments of needs. However, Service users were not protected by the their Terms and Conditions statements. EVIDENCE: At the previous inspection there was a requirement for the home to ensure that complete assessments were in place for all service users. This had been addressed and this information was now available. The assessments were clear about individual needs and aspirations and had been completed by keyworkers with service users. Terms & Conditions of residence were in place for service users but these did not detail which room each person was to occupy. This needs to be addressed to protect service users from being moved into other rooms against their wishes. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9 and 10 Service users benefit from having clear plans in place describing their needs and being supported to take risks. Service users would benefit from staff respecting their confidentiality. EVIDENCE: At the previous inspection there was a requirement that all service users must have a service user plan in place. This had been addressed and clear plans had been recorded in response to the assessments undertaken. Risk assessments were in pace for service users for activities where an element of risk had been identified. These were kept under regular review. There had been a previous requirement in respect of staff discussing the personal care needs of individual service users in the presence of others. Examination of staff meeting minutes showed that this issue had been raised with staff and an explanation given of why it is important to be discreet in such circumstances. Despite this, the Inspector again heard a member of staff during this inspection announcing loudly that she was about to take someone to the toilet. Further work needs to be done with staff on this issue and the Manager needs to monitor staff and raise issues with them as necessary. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 10 At the previous inspection there had been a requirement that the glass in a service user’s bedroom door be covered to maintain privacy. This had been addressed. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12 and 15 Service users benefit from being supported to access a range of activities and being supported to maintain contact with their friends and families. EVIDENCE: There had been a previous requirement that the home introduced a structured system to assist service users in developing skills and becoming more independent. This had been addressed and the Inspector saw programmes in place for individuals that described what their aspirations were and how staff should support them. Service users take part in a range of activities within the home and within the community. The new assessments and individual plans in the home have highlighted particular interests of service users which are being followed up by staff to ensure that service users are involved I the things they are interested in and have the opportunity to try new activities. Good records were kept of all activities service users were involved in. Service users were encouraged and supported to maintain contact with their friends and families. Service users spoken with said that staff helped them remember birthdays and send cards and service users also felt that they could invite their friends into the home. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users have their healthcare needs met and are able to receive support in the way they want it. Service users were not fully protected by the home’s medication practices. EVIDENCE: Service users spoken with said that staff supported them in the way they wanted them to. Service users had been involved in writing their individual plans and these detailed the kind of support they required. At the previous inspection there was a recommendation that staff receive training and direction in how to write about service users so as to maintain dignity. Since then there has been training for some staff in how to do this effectively. There was a previous requirement that the healthcare needs of service users be regularly monitored and action taken where necessary. Since then the staff have booked healthcare appointments for all service users and are following up any action required. Good records were kept of each appointment and what action was necessary. There was a previous requirement to ensure that all medication records be accurate and up-to-date. Minutes showed that this had been discussed in a staff meeting and the records seen on the day of inspection were up-to-date and accurate. There was a lot of unused medication kept in the home and the Inspector has asked the Manager to dispose of this appropriately without delay. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Service users felt their complaints and concerns would be listened to and had some knowledge about how to complain. The financial interests of service users are not protected by the practices within the home. EVIDENCE: Since the previous inspection the home had updated its Complaints Procedure and developed a format for responding to complaints. No complaints were recorded at the time of inspection. Service users spoken with had different interpretations of the Complaints Procedure but all said they would talk to a member of staff initially and felt their concerns would be listened to. There was a previous recommendation that staff receive training in responding to instances of suspected abuse. This has occurred for some staff but needs to be implemented for all staff. The home’s approach to dealing with the finances of service users is a cause for concern. Issues identified during the inspection included service users paying for drinks, lunch and bus fares for staff when they are supporting them in the community, paying for bedroom furniture and bedding, and paying for carpets and the cost of having them fitted. There had also been a service users’ meeting where all service users had apparently agreed to pay one hundred and fifty pounds each for the redecoration of the conservatory area in the home and changing it into a games room. This was despite the fact that the assessments for four service users state that they have no understanding of money and that no independent advocate was involved in this process. The Inspector was of the view that the home could not demonstrate that all service users had made an informed decision about this cost and also that they should not be asked to pay for it in the first place. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 14 The home is responsible under the Regulations for providing adequate furniture, bedding and other furnishings including floor coverings and equipment suitable to the needs of service users. The home is also responsible for ensuring that any equipment provided is maintained in good working order and that all parts of the building are kept clean and reasonably decorated and that rooms used by service users are suitable for their needs. Equipment must be provided by the home. If it needs replacing because it is not in good working order or it does not meet the needs of service users, then the home is responsible for the cost of replacing it, not the service user. Service users should not be paying for items such as paint, wallpaper, carpets etc. that they could not take with them if they left the home. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26 and 30 Service users benefit from a homely and safe environment. They would benefit further by equipment being replaced when necessary. EVIDENCE: The home is suitable for its stated purpose, well maintained and meets the needs of service users. There is adequate communal space in the lounge, dining room, conservatory and garden. It is near to local facilities and in keeping with the local environment. At the previous inspection there was a requirement that all service users have lockable space within their own rooms and this has now been addressed. There was also a recommendation that the home be cleaned and a regular cleaning schedule be introduced in order to maintain cleanliness. The Manager has now introduced cleaning schedules and these are largely undertaken by night staff. There was a wooden chair in the downstairs bathroom, which was old and worn and may contribute to spreading infection in the home. The enamelled bath is chipped and may also contribute to the spreading of infection. The home needs to repair or replace these items. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 36 Service users benefited from being supported by adequate numbers of staff who were well supervised. EVIDENCE: One service user spoken with said that two staff had left and three were off sick. She said they needed more staff in the home. The Inspector looked at rotas, which demonstrated that sufficient numbers were on duty throughout the week. There were staff that had recently left and the service user was obviously missing them. Agency staff had covered some of the gaps in the rota, but overall the home had managed to decrease the use of agency staff since the previous inspection. A recommendation had been made at the previous inspection that support and supervision sessions should be implemented for all staff at regular intervals. This had been addressed and examination of records showed that sessions took place regularly and covered the relevant aspects of each member of staff’s job. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Service users were protected by the health and safety practices within the home. EVIDENCE: There were a number of requirements at the previous inspection relating health and safety including hot water temperature, reviewing the fire escapes, risk assessments for service users regarding the banister upstairs, an overflowing drain and an insecure garden wall. All of these had been addressed and were no longer cause for concern. The home has fire notices posted throughout the building and these have symbols on them to make them easier to understand for service users. Service users and staff were regularly involved in practice evacuations of the building. Staff had received necessary health and safety training and the manager was committed to ensuring a safe environment. All aspects of the building were monitored on a regular basis and records kept. Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 3 3 x x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Winston Lodge Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 19 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 20 23 23 Regulation 13 (2) 13 (6) 13 (6) Requirement All out-of-date medicines must be removed from the home and disposed of safely The Manager must ensure that all the items it requires service users to pay for are legitimate The Manager must involve independent advocates in any transactions where service users are being asked to pay for items for the home The home must provide adequate furniture, bedding and other furnishings including floor coverings and equipment suitable for the needs of service users The home must ensure that equipment provided is maintained in good working order The home must ensure that all parts of the home are kept reasonably decorated Timescale for action 2/7/05 1/9/05 1/9/05 4. 23 16 (2) 1/9/05 5. 23 23 (2) 1/9/05 6. 7. 23 23 (2) 1/9/05 Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 5 10 Good Practice Recommendations Terms & Conditions of residence should specify the room that each person is to occupy. Further staff training and guidance in maintaining the dignity of service users should be implemented and staff performance in this area needs to be monitored by the Manager Training in responding to instances of suspected abuse should be extended to all staff The wooden chair in the downstairs bathroom should be replaced The bath in the downstairs bathroom should be replaced or repaired 3. 4. 5. 10 30 30 Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Winston Lodge H54 S11672 Winston Lodge V234900 010705 Stage 4.doc Version 1.30 Page 22 - 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!