Inspection on 11/11/05 for Winston Lodge

This inspection was carried out on 11th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Winston Lodge 24/04/07

Winston Lodge 18/04/06

Winston Lodge 01/07/05

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 Inspection 11th November 2005 10:30 Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 1 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 Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 2 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 Stationery 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 DS0000011672.V265075.R01.S.doc Version 5.0 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 Provider Web 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 (13) registration, with number of places Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st July 2005 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 Stephen Spear. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over two days (11th and 14th November 2005) as the Manager was not available on the first day. The Inspector toured the premises, spoke to staff and service users and looked at relevant records. What the service does well: What has improved since the last inspection? What they could do better: Over the previous three inspections there has been a significant improvement in the standard of the service on offer at the home. Things that had not previously been in place had been addressed and the service had begun to move forward. This has coincided with the appointment of a new manager and deputy manager at the home. However, since the previous inspection in July, the manager had moved on to another service and the previous deputy manager had become the manager. He continues to identify ways for the service to develop and move forward, but the deputy manager post has not been filled. The result of this has been a decrease in the management time going into the home and, as a direct result, the standard of the service has begun to slip. Training and supervision of staff had not been addressed and the manager was not having time to attend to monitoring and maintaining the quality assurance systems in the home. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 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 DS0000011672.V265075.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 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 the following standard(s): 5 Service users are protected by the written Terms & Conditions of their stay. EVIDENCE: At the previous inspection a recommendation was made that the Terms & Conditions for each service user should state the room they were to occupy. This had been addressed and was stated on all copies of the Terms & Conditions. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 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 the following standard(s): 7, 9 and 10 Policies and practices within the home ensured that service users’ right to make decisions about their own lives was upheld. The risk assessment processes in the home did not fully protect service users. EVIDENCE: The policies and procedures within the home emphasised the rights of service users to make decisions about their own lives. Staff observed on the day of inspection supported service users in making decisions and were respectful of the decisions they made. The Manager had introduced the idea of Keyworker Sessions where each service user was able to spend time with their Keyworker on a monthly basis to discuss any aspects of their life or issues within the home. Records from these meetings showed that staff listened to what service users wanted to do and acted upon it. One service user who was at a day service on the day of inspection decided to come home, as she was bored there. There was no problem in her deciding to come home and staff responded to her wishes. Risk assessments were in place where potential risks had been highlighted. There was little evidence that these were kept under regular review. Some Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 10 assessments were due to have been reviewed three months ago and others had not been reviewed since 2003. Also, there were a lot of risk assessments for some service users and it appeared that these were not all current. A requirement has been made that all risk assessments in the home are audited and reviewed and that those that are no longer necessary be withdrawn. There was a recommendation from the previous inspection that 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. This related to staff talking about service users’ personal care in front of other people. The provider’s response to the previous report stated, “Ongoing staff training, guidance and mentoring is provided to ensure that all staff uphold the dignity of service users at all times”. However, supervision session notes and training records showed no evidence that this issue had been addressed and a requirement has been made in respect of this. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 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 the following standard(s): 13, 16 and 17 Service users benefit from being part of the local community and having their rights respected. EVIDENCE: Service users were supported to make use of the local community. Activity plans on each person’s file showed what each person was doing throughout the week and matched what was happening on the day of inspection. Some service users used local day services as well as local clubs. Service users were also supported to access non-segregated activities within the community. Activities were also organised within the home, but some feedback from service users stated that there were not enough of these. The rights of service users were emphasised through the policies and procedures of the organisation. Service users spoken with confirmed that staff knock on their bedroom doors before entering and that they each have a key to their room. The rules within the home were made clear in the Service User Guide. Menus in the home showed that service users had a varied and nutritious diet and service users spoken with were positive about the food in the home. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 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 the following standard(s): 20 Service users are not fully protected by the home’s medication training practices. EVIDENCE: The organisations medication policy states that medication “training will be carried out by a suitably qualified person”. The actual practices in the home mean that new staff are just shown how to administer medication by existing staff and that this happens on three occasions and then the new member of staff is deemed competent to administer medication. This level of training seems inadequate and does not even match up to the organisation’s own policy. Accredited training from a suitably qualified person should be provided and a requirement has been made in respect of this. The disposal of out-of-date medication had been a requirement at the previous inspection and this had now been addressed. The medication records in the home were clear and medication was stored appropriately. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 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 the following standard(s): 23 Service users were not fully protected from abuse, as staff had not received relevant training. EVIDENCE: The previous inspection report had listed five requirements in relation to protecting service users from abuse. These related mainly to the way service users were supported with their finances and the organisation has assured the Commission for Social Care Inspection that all these requirements have now been addressed. It was difficult for the inspector to fully assess the way service users are currently supported with their finances as there had recently been a robbery in the home and all service users’ income and bank books and details had been stolen from the safe. The police have been informed and are dealing with the issue, while staff in the home are in the process of sorting out these issues on service users’ behalf. This is the second time this has happened in the last year. There was a recommendation at the previous inspection that all staff have training in responding to instances of suspected abuse. This has not been addressed since the previous inspection. The Inspector was able to see evidence that the Manager had been addressing the issue with the organisation and some training had been planned and then later cancelled. No staff had received this training since the previous inspection and a requirement has been made in respect of this. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Service users benefited from living in a clean home but would benefit further from the downstairs bath being cleaned regularly. EVIDENCE: The home was generally kept clean and hygienic throughout. The laundry was well managed and appropriate infection control procedures were in place. The bath in the downstairs bathroom was quite dirty all around the top and a requirement has been made that this be cleaned. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Service users were protected by the home’s recruitment policies and practices but would benefit from staff being better trained and supported to do their job. EVIDENCE: Staff spoken with and observed during the inspection demonstrated positive attitudes and characteristics important to their role and knowledge of supporting service users on a day-to-day basis. Recruitment procedures and practices within the home were clear and were evidenced by adequate documentation being kept on each member of staff’s file. All necessary pre-employment checks were carried out and there was no evidence that staff began working in the home prior to all the necessary information being available. The organisation has a training plan in place but staff in the home had suffered from the fact that courses were cancelled. As mentioned in standard 23 there had been no training in responding to instances of suspected abuse. The manager had identified a number of training needs for staff in the home, including mandatory training, which the organisation had not yet responded to appropriately. For some staff there was no evidence of any training and for a newer member of staff there was no evidence of an induction taking place. A requirement has been made in respect of training. Staff support and supervision session had not taken place on a regular basis since the previous inspection and the manager reported that this was due to a Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 16 significant drop in the amount of management hours in the home. A requirement has been made in respect of this. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 EVIDENCE: The home currently has no Registered Manager. The Commission for Social Care Inspection has not yet received an application from the current manager to become registered and a requirement has been made in respect of this. As mentioned elsewhere in this report, the fact that the organisation has not appointed to the vacant Deputy Manager post is having an effect on the standard of service provided. There are some Quality Assurance processes within the home and the organisation has a clear and comprehensive Quality Assurance policy in place. However, not enough management time has been allocated to coordinating quality assurance and publishing the results of service user surveys. A recommendation has been made in respect of this. As mentioned in standard 35, not all staff had received the training necessary to promote and maintain a safe environment and safe working practices. Six staff have no Health & Safety training, three have no Fire training, five have no Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 18 First Aid training, six have no Manual Handling training and six have no Food Hygiene training. During the inspection of the building the Inspector observed that the banisters on the main staircase were loose and that the carpet at the top of the stairs was loose. Requirements have been made in respect of these. Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 19 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 X X X 3 Standard No 22 23 Score X 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 1 2 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 1 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 1 1 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Winston Lodge Score X X 1 X Standard No 37 38 39 40 41 42 43 Score 1 X 2 X X 1 X DS0000011672.V265075.R01.S.doc Version 5.0 Page 20 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. Standard YA9 Regulation 13 (4) (c) Requirement A full audit of all risk assessments must take place and all risk assessments must be kept under regular review Further staff training and guidance in maintaining the dignity of service users should be implemented and staff performance in this area must be monitored by the manager All staff involved in administering medication must receive accredited training from a suitably qualified person All staff must receive training in responding to instances of suspected abuse. The downstairs bath must be kept clean All outstanding staff training needs must be addressed All staff must receive regular support and supervision The Manager must apply to become registered The banisters must be repaired The stair carpet must be repaired Timescale for action 30/11/05 2. YA10 18 (c) (i) 31/01/06 3. YA20 18 (c) (i) 30/11/05 4. 5. 6. 7. 8. 9. 10. YA23 YA30 YA35 YA36 YA37 YA42 YA42 18 (c) (i) 16 (2) (j) 18 (c) (i) 18 (2) 9 (1) 13 (4) (a) 13 (4) (a) 31/01/06 11/11/05 31/03/06 11/11/05 30/11/05 11/11/05 11/11/05 Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations The Manager should ensure the quality assurance processes are fully implemented and that results of service user surveys are published Winston Lodge DS0000011672.V265075.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 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 DS0000011672.V265075.R01.S.doc Version 5.0 Page 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. 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