Inspection on 21/06/05 for York Lodge

This inspection was carried out on 21st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

York Lodge 01/06/07

York Lodge 26/01/06

York Lodge 04/10/04

York Lodge 16/06/04

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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 York Lodge 129 Balcombe Road Horley Surrey RH6 9BG Lead Inspector Kathy Martin Announced 21/06/05 09:30 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. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service York Lodge Address 129 Balcombe Road, Horley, Surrey, RH6 9BG 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) 01293 785235 Welmede Housing Association Ltd to be advised CRH 8 Category(ies) of LD - Learning Disability - 7 registration, with number LD(E) - Learning Disability - over 65 - 1 of places York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The age/age range of the persons to be accommodated will be: 21 - 65 YEARS, TO INCLUDE TWO (2) PERSONS OVER 65 YEARS Date of last inspection 04/10/04 Brief Description of the Service: York Lodge is a large detached property situated in a residential road, which is within walking distance of the town of Horley. Accommodation is arranged over three floors. This service provides care to 8 tenantss (this is how the service users wish to be called) with learning disabilities, who all have single rooms. The home is managed by the Welmede organisation.There are goodsized communal areas, and a designated smoking area. The home has gardens in the front and the rear of the property, and parking spaces are available in the front of the house. Emphasis is paced on enabling and supporting individual tenants in their daily living choices, and a relaxed and companionable environment was evident. The home is managed by the Welmede organisation. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is the first CSCI inspection this year. The home will receive a second inspection by the end of March 2006. The inspection was announced therefore staff and tenants were made aware of the visit. The inspector was advised that service users wished to be called “tenants” and therefore are referred to as such throughout this report. The inspector arrived in the morning and the tenants were busy in their own routines and planned activities. The acting manager was not present. The Deputy manager was in charge and was present throughout the inspection. She was later joined by the Area Manager who was present for the feedback and general information about the home. There was evidence to suggest that staff worked well as a team and were observed communicating with each other with ease and sensitivity towards the tenants. The CSCI sent out comments cards prior to the inspection to tenants, their relatives and staff. 4 comment cards were received from the tenants alone and all gave positive feedback, which was later confirmed with them in person during the visit to York House. The CSCI also asked the home to complete a pre-inspection document ahead of the inspection date, which provides a range of important information about the home, their policies, their record keeping and the services they provided. The inspector had plenty of opportunity to speak to 3 tenants and they talked about their experience of living in York House. They expressed how happy they were and how free they felt to pursue their interests outside of the home. This service has very physically independent tenants who are able to go out on their own and attend activities unaided. Assistance from staff is in the form of encouragement and organisation within a planned care to enable tenants to retain control of their lives and their activities. What the service does well: The staff were very good at communicating with the tenants and showed understanding of their needs and also were able to convey this in well structured care plans. There is good support from the Area Manager to the team. The home has met all the previous requirements set at the last inspection in October 2004 and the team was seen as pro-active. The staff spoken with were courteous and helpful to the tenants and also to the inspector. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 6 The tenants stated that they felt they were being well looked after and they enjoyed living there and had all they needed. They spoke highly of the staff. What has improved since the last inspection? What they could do better: 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 York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 7 contacting your local CSCI office. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 8 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 York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 9 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) 1 an 2 There are sound assessments procedures in place to ensure that prospective tenants are given plenty of time to decide on their new placement and which involved a number of persons. The assessments were well managed. EVIDENCE: The inspector asked to inspect the notes of the new referral made to the home. So far, there was a clear assessment form completed with all the relevant areas of needs, risk assessments, medication and an assessment of activities undertaken by the applicant in detail. There were references made about the care manager, staff, the acting manager, the area manager, relatives/ parents and the tenant. Meetings are organised initially where the prospective tenant lives. Then the applicant is asked to visit the home and meet with the other tenants and the staff. This normally allows the applicant to ask further questions, see their bedrooms, get a feel of the home and chat to the staff and the residents. If this has a positive outcome and the applicant is happy s/he is invited for lunch, then an overnight stay followed by a weekend stay and eventually a placement is offered officially for a trial period. A contract is then drawn with the relevant parties signing to this document. (This was evidenced in the notes belonging to other tenants). The deputy manager also explained this process of admission to the inspector. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 10 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, 7 and 9 Each tenant had an Essential Lifestyle Plan (ELP), which clearly reflected that each tenant contributed to the documentation. There was regular update of the plans and good documentation available to staff and to health care professionals to enable them to give holistic care to their tenants. EVIDENCE: The inspector inspected 2 ELPs, which covered a range of information pertaining to the care needs, goals and aspirations, activities and holidays. Also included were a full history of any medical problems, likes and dislikes and also a family/ social history. There were several risk assessments about each tenant on crossing roads, absconding, falling, walking unassisted and bathing/ showering. These were well managed and updated regularly. The staff explained that the tenants were very active and were encouraged to maintain as much independence as possible and therefore the risk management was vital to allow them to take reasonable risks so as to live as full a life as possible. There were regular social workers’ reviews of care and placements, which were attended by the tenants. Staff maintained records of all their communications with tenants and the other health care professionals, family and others. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 11 York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 12 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) 12,13 and 16 Tenants were encouraged to develop in their social skills and take part in their community events. There was support to enable them to do so well whilst being encouraged to maintain autonomy and make their own choices as much as possible. EVIDENCE: The tenants in York Lodge were very active and most are able to go out and attend various community activities, go to the different amenities in Horley and also mingle with each other in the house. Holidays are organised. Trips have included Blackpool, going to New York and Eastbourne. Two tenants talked about their activities, which included trips to watch a football match, going to snooker, horse-riding, golf and visiting relatives. The home encouraged tenants to pursue education and the development of new skills. There were tenants currently attending adult education courses in pottery (one tenant showed the inspector the work done in the class which was of high quality), art and cooking (which a tenant talked about enjoying very much). The inspector observed two tenants talking to staff about their plans for the day and it was evident that the tenants knew what they wanted to do and York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 13 were able to decide for themselves how they wanted to spend their day. One support worker had returned from a trip to the post office with a tenant and talked about it to the inspector and the deputy manager stating that they had not wanted to stop for coffee as usual and preferred to come back as per their (the tenant’s) wish. It was required that tenants are given more encouragement and indeed assistance to clean their bedrooms as there was evidence that these areas were left to the tenants. This responsibility may appear a burden to some and therefore need to be shared with the staff to ensure that regular room cleaning take place so that a clean and pleasant environment is maintained. Many tenants take part in daily household tasks as part of their planned care. This was well managed for the exception of the bedrooms. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 14 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 Tenants are given appropriate support to attend to their personal care. EVIDENCE: All tenants were able to manage their personal care with minimal assistance from staff. There were sufficient bathing facilities and all rooms are single. Tenants were issued with a personal key to their own bedrooms. There are many areas within the home for tenants to receive visitors in private. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 15 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 The home encouraged tenants to talk about their care and the way the home run. There were procedures in place to protect tenants from abuse and neglect. EVIDENCE: There are regular meeting in the home and notes are taken. The inspector was able to see these. Issues for discussion included holidays, new events, bedtime routines and communal living arrangements. There are review meetings held regularly organised by care managers, which tenants attend. The 3 tenants that the inspector was able to meet were very complimentary of the services offered by the home. They said that they were able to talk to staff when they wanted and they felt valued. There were very good working relationships formed between staff and the tenants. This was evident when observing their interactions between each other. The home had procedures to deal with the protection of vulnerable adults and offered training to all staff on the same. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 16 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 and 30 The home is very homely and comfortable. The home was generally well maintained and there was one issue regarding health and safety in regard to the kitchen floor that was slippery. The general areas of the home were clean and tidy. However tenants’ bedrooms were not regularly cleaned. EVIDENCE: The home offered a reasonable standard of accommodation to the tenants. Each had a single room of differing sizes with their own personal items with audio-visual equipment, music instrument and collectables. One requirement was made under Regulation 42 regarding the slippery floor in the kitchen to be replaced for Health and Safety reasons. With regard to Standard 30: Tenants’ bedrooms require regular cleaning, as they are not being done as often. It is acknowledged that the staff worked with the care plan of each tenant and encouraged as much independence as possible. It is also acknowledged that tenants are very busy and go out a lot. However, as the cleanliness in the home is also the responsibility of staff, it is expected that these tasks are shared and that bedrooms are regularly cleaned to maintain a pleasant atmosphere all round. It was recommended that the bathroom on the first floor be re-decorated. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 17 York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 18 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) This section was not inspected and will be looked at the next inspection Although this section was not inspected in full during this visit, training is offered to staff in all mandatory subjects such as abuse, moving and handling, communication and health and safety. EVIDENCE: This section will be looked at in more detail during the next visit. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 19 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) 38 and 42 There was evidence that the home functioned well in spite of the fact that there has not been a registered manager for some time. The acting manager and the staff team worked well together and were supported by the area manager. There were 3 Health and Safety issues that will need to be addressed. EVIDENCE: The acting manager and the staff team are working well together until a new manager is in post. This, the area manager stated would be soon. The home was being run efficiently. The staff were aware of the paperwork and knew what was expected of them. They knew the care of each tenant and were working well with them. They had a very good rapport with their tenants and each other. Staff demonstrated through their interactions with the tenants their understanding of the principles of care and values of care. Three requirements were made regarding Health and Safety under Standard 42: York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 20 1. Safety catches need to be fixed to the two cupboard doors on the top floor stairs as the doors do not close properly and therefore obstruct the staircase posing a hazard. 2. The flooring in the kitchen needs replacing with a non-slip and suitable surface for a busy kitchen. 3. A risk assessment need to be in place in regard to smoking in the house. York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 21 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 York Lodge Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 22 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 30 42 42 Regulation 16 (2) (j) 13 (4) (a) 13 (4) (a) Requirement Timescale for action 12/08/05 4. 42 13 (4) (b) (c ) All service users bedrooms must be cleaned regularly safety catches need to be fixed 12/08/05 to the two cupboard doors on the top floor stairs the flooring in the kitchen needs 12/08/05 replacing with a non-slip and suitable surface for a busy kitchen. A risk assessment need to be in 12/08/05 place regarding smoking in the house 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 24 Good Practice Recommendations It was recommended that the bathroom on the first floor be redecorated York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 York Lodge h09-h58 s13847 York Lodge v225555 210605 stage 4.doc Version 1.30 Page 24 - 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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