Care Home: Chase Lodge Care Home Ltd

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What the care home does well We saw that Chase Lodge continued to provide a homely atmosphere for people living there. Peoples rooms were personalised and the communal areas had comfortable furniture. Staff were dedicated to promoting a home where individual choice was very important enabling people to live a life that reflected their diverse needs, opinions and beliefs. People we spoke to said they were very happy living at Chase Lodge, we were told by more than one person that moving to Chase Lodge was the best decision they had made. People said that staff supported them and helped them lead fulfilling lives with the freedom to come and go as they wished. Whilst in the home we noticed people spent the day in and out of the building following their own interests or activities. One person said they had been helped to fill their diary with a variety of interesting pursuits including a course at the local College. We also saw that care plans for people were individual and agreed with the person, they showed that people were supported in maintaining their physical and emotional health and wellbeing. The fee charged covers all costs in the home as the registered providers feel the fee should cover everything therefore there are no extras charged. What has improved since the last inspection? Since the last inspection the manager had continued to develope the person centred care plans and we saw that they were used as a working document. This meant that staff were aware of the diverse needs of people living in the home. Following our recommendation at the last inspection the manager had developed a concerns and complaints book, which contained the details of any concern or complaint, the response from the manager and the final outcome, indicating what changes had been made to improve the service provided by the home. People living in the home showed us that the lounge bay window had been repaired and was a popular place to sit. The cooker mentioned during the last inspection had been replaced. What the care home could do better: No requirements were made following this inspection. We have included one good practice recommendation in this report. The manager needs to look at ways of including peoples plans and future goals. This refers to enabling people to look at goals they would like to attain and how the home would support them. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Chase Lodge Care Home Ltd 4 Grove Park Road Weston Super Mare North Somerset BS23 2LN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Juanita Glass     Date: 1 4 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Chase Lodge Care Home Ltd 4 Grove Park Road Weston Super Mare North Somerset BS23 2LN 01934418463 Telephone number: Fax number: Email address: Provider web address: sallywalker1@googlemail.com Name of registered provider(s): Type of registration: Number of places registered: Chase Lodge Care Home Ltd care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: May accommodate up to 19 persons aged 30 years and over requiring personal care only. Date of last inspection Brief description of the care home Chase Lodge is a care home catering for 19 people with mental health problems. The aim of the home is to provide a caring and supportive environment, which is relaxed and comfortable. The intention is for service users to function in a stress free atmosphere where demands put on them are minimal. The home does not set out to rehabilitate service users, however there are skills which they are encouraged to acquire leading to an enhancement in their life. 19 19 Over 65 19 19 Care Homes for Adults (18-65 years) Page 4 of 27 Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over one day and a total of five hours were spent in the home. To gather enough evidence to support our judgements for this inspection, We The Commission asked the service provider to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gives us some numerical information about the service, and how they intend to maintain or improve outcomes for people using their service. Once we had received this information we carried out a visit to the home and spoke to people living there, the staff and relatives. Whilst in the home we also looked at documents maintained for the day-to-day running of the service. These included care Care Homes for Adults (18-65 years) Page 6 of 27 plans, staff recruitment, training and supervision. Also records relevant to the administration of medication, the service records and health and safety. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Adults (18-65 years) Page 8 of 27 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from sufficient information in an appropriate format to help them make an informed choice of home. They can visit and have a trial period before they decide to stay. They also benefit from an in depth assessment that looks at their personal needs. Evidence: We asked the manager for a copy of the Statement of Purpose and Service User Guide. These were readily available and contained all the information we would expect to see to help people make an informed choice about where they wanted to live. The manager said that they did not have alternative formats but would be able to arrange for them to be provided if needed. We looked at the care plans for people living in the home. We saw that they contained in depth pre-admission assessments, which identified peoples personal needs. They also showed that the manager had met with people who wanted to move into the home and discussed their needs and expectations. We also saw care plans from Social Services which may identify needs the service user was not aware of. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: One person commented on the process and said they had been kept well informed and felt they had been given as much information as they needed at the time. Care Homes for Adults (18-65 years) Page 12 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from clear person centred care plans that have been discussed and agreed with them, showing that they are consulted and make decisions about their life. They also benefit from clear risk assessments that enable them to take reasonable risks as part of their independent lifestyle. Evidence: We looked at the care plans for people living in the home. They showed that peoples personal preferences were respected and taken into consideration when planning the care that the service provided. All the care plans were person centred and included an assessment of peoples needs. We saw that the care plans had been agreed with people living in the home and some had been signed by them. The care plans showed what needs had been identified and how those needs were going to be met. They did not include a desired outcome for the person which would have shown us that they had agreed a long term strategy with agreed goals and aspirations. We looked at the care plan for one person who liked to stay away at times, it was Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: clear what strategies were in place and how staff managed the situations when they arose. People spoken to said they knew about their care plans one person said they had agreed their care plans. Others said they knew they were there but were not interested in discussing them. They said that when they had a review with their Social Worker they knew they would be involved and would talk about what they wanted then. Staff spoken to were aware of the need for people living in the home to make decisions about their daily lifestyle, they supported people in making individual choices, which were risk assessed they then explored ways to meet those choices. Care Homes for Adults (18-65 years) Page 14 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from appropriate leisure and social skills activities relevant to their assessed needs. They maintain contact with friends, family and the local community. They are supported to be as independent as possible and are involved in most areas of daily living in the home. People benefit from a healthy and nutritious diet. Evidence: People spoken to said that they had ample opportunity to take part in either an activity in the home or the local community. They were observed to come and go at will throughout the day and at one stage it was difficult to find someone to talk to as they had all gone for a walk or to the shops following their chosen interest. One person said they had signed up for two courses at the Carlton Centre and already had quite a full diary of events. Another person said they had just returned from shopping and enjoyed the freedom. Care plans reviewed showed that people took part in a variety of activities both educational and leisure, one person worked in a voluntary Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: basis within the community, whilst another had attended an interview to help at a charity drop in centre in the town. Staff stated that they were in the process of arranging a weekend away after the school holidays were over. One person commented on being able to continue with their church contacts and the manager stated that they could support anybody to continue to follow their religious beliefs, with visits to their place of worship or visits to the home arranged. People commented on being able to continue to see friends and families and some had developed meaningful relationships both in the home and the local community. The home continued to provide a four weekly menu, which people said was very good, they all said they enjoyed the meals, and one person said, the best thing about this place is the food good home cooking. Lunchtime was a busy affair with people chatting and generally treating it as a social occasion. We saw fresh vegetables and people confirmed that they ate healthy options and could always make a choice if they did not want what was on offer. Care Homes for Adults (18-65 years) Page 16 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Chase Lodge benefit from personal and specialist health care support that is provided in a person centred way respecting choices and rights. They benefit from and are protected by the homes policies and procedures for the administration of medication Evidence: We looked at peoples care plans, as previously stated we found that they were individual to the person and agreed with them. They told us what physical and emotional problems people may have as well as their activities of daily of living. We saw that people were offered support in an individualised person centred way. People spoken to said they felt they were treated as a person rather than another resident, one person we had met in a previous care home said that it had been the best choice they had taken moving to Chase Lodge they felt people understood them as an individual. One person said they felt well cared for and that staff understood their needs. Everybody spoken to confirmed that they felt the care provided was about them and not about rigid routines. We watch the way staff spoke to people in the home, they were very relaxed with a light hearted banter between staff and residents. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: We saw that people were assisted to attend GP appointments as well as hospital and clinic visits. Some people had plans in place for psychiatric intervention if a crisis should arise and staff had appropriate contact details and detailed action plans for specific people if the local mental health team was needed. We also saw that well person clinic appointments were encouraged and support provided by staff to attend routine check ups. Chase Lodge has very clear policies and procedures for the receipt and administration of medication and staff receive training before they can give medication to people. We looked at the records kept by the home for medication and the way that medication is stored. We saw that all procedures were being carried out correctly. We also saw that staff were following the correct procedures when they gave medication to people living in the home. Care Homes for Adults (18-65 years) Page 18 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from and are protected by the complaints and safeguarding procedures in the home. Staff are fully aware through training with local authority of the procedures to follow to protect people from abuse. Evidence: Copies of the homes complaints policy were easily accessible they are included in the service user guide and displayed in the home. People spoken to said that they felt confident that any concerns they raised would be dealt with appropriately. One person said that they were able to approach any member of staff and that the manager was always available with an open office policy. The manager keeps a record of any concern or complaint and this includes how they responded and any outcome. The home also has very clear policies and procedures for safeguarding vulnerable adults, a copy was also available in an easy read version for people who may have difficulty reading the written policy. Staff had attended both in-house and local authority training in managing safeguarding issues protecting people from harm. The manager confirmed that they had arranged training for staff in the Mental Capacity Act, Deprivation Of Liberties and the local authorities safeguarding investigators course. People spoken to said they felt safe living at Chase Lodge and one person said they felt staff had their best interests at heart. Staff spoken to said they were aware of the homes policy for whistle-blowing and said they felt confident they could raise issues with both the manager and provider. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a homely well-maintained environment within which they are free to express their personal preferences and hobbies, meaning each private room is different. All areas are clean and tidy with a planned programme of maintenance and redecoration. Evidence: We carried out a tour of the premises but we did not go into any private room that we were not invited into. People living in the home said they could do what they liked to their room within reason and staff helped them choose their colour scheme and furniture. The communal rooms were comfortably furnished and people said they liked the home as it was. Some areas that needed renovation and repair at the last inspection had received an extensive make over. All areas of the home were clean and free from odours one person said they liked to sit in the quiet room as it was more relaxing another person said they liked to mix with other residents but preferred their own room as it was their space. We saw rooms that reflected the persons personality with pictures and bookcases and personal music systems. We observed staff working in the home they followed the correct infection control guidelines ensuring that people were protected from cross infection where necessary. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a staff team who have a clear understanding of their roles and responsibilities, they are competent and trained to meet the diverse needs of the people in the home. They are also protected by the policies and procedures in place for the recruitment of new staff and supervision of existing staff. Evidence: We saw that staffing levels were appropriate for the number and assessed needs of people living in the home. Staffing was flexible so if someone needed extra support for a trip out or hospital visit it did not impact on other people by reducing the number of staff in the home. We looked at the personnel files, the manager confirmed that they had not needed to recruit new staff since the last inspection, which meant people benefited from a stable staff team enabling continuity to their support and care. One person had been interviewed and the manager was waiting for their references and the CRB (Criminal Record Bureau) report to be returned before inviting them to start supervised work and their induction. We could not look at completed induction programmes but the manager confirmed that they followed the Common Induction programme encouraging staff to continue with their NVQ training in health care. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: We also looked at the training records for all staff in the home, all mandatory training was up to date and we also noted that staff had attended training that would help them understand the specific needs of people in the home. As previously stated this included planned training for people regarding the Mental Capacity Act and Deprivation of Liberties, we saw guidance in the home for staff to consult regarding both these areas. Staff had been encouraged to obtain an NVQ in Health Care this had resulted in 76 of staff in the home having an NVQ level 2 or above. There were very clear records of staff supervision, they showed that staff regularly discussed with the manager their strengths and weaknesses identifying areas that they would like to receive training in or develope further in the professional roles. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a home that is well managed in an open and approachable manner, which considers people input into decisions taken about running Chase Lodge. Policies and procedures and record keeping for health and safety safeguard people living in the home. Evidence: We spoke to people about the way Chase Lodge was run, they all said they thought the manager and staff did a very good job. One person said, I told you last time they were brilliant and nothing has changed that opinion. Another person said that having not been in the home very long they were very pleased with the way they were listened to by the manager and staff. The manager and staff work toward improving life for people in the home by recognising their diverse needs and listening to their opinions. All the people spoken to supported this. People in the home also said they could raise issues with the owners Mr and Mrs Bladon. We looked at the comments received when the home carried out their Quality Assurance process, which means they asked people about the service they were Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: receiving. Comments were all positive and when people had made suggestions they had been included in plans for future improvements. It was evident from talking to people and looking at records kept in the home that peoples opinions did underpin changes made in the home to improve the service provided. We found that all health and safety checks were in place and up-to-date. The fire risk assessment for the building was available for inspection and the fire-log showed that all recommended checks were being carried out. Service records showed that regular checks were being carried out following current guidelines. This ensures people using the service, visitors and staff are protected by robust health and safety policies and procedures. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 The registered person needs to include future goals and aspirations for people to work toward in their care plans. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!