Care Home: Conquest Lodge

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What the care home does well Conquest Lodge continues to provide residents with a good quality service. There are individualised care and support plans which are updated and regularly reviewed. Care and health checks are monitored regularly. The home is well managed and staff continue to receive a well co-ordinated training package and supervision. Residents continue to be involved in a wide range of activities and regularly access the local town for personal shopping. Residents` choice continues to be promoted in the home and they are able to personalise their bedrooms to meet their preferences and choose colour schemes and furnishings. What has improved since the last inspection? Redecoration and refurbishments have been made to the home as outlined in the requirements made at the last inspection. The weighing scales have been repaired. The room used to store medication has been re-organised to improve accessibility and administration. CARE HOME ADULTS 18-65 Conquest Lodge Dagless Way March Cambridgeshire PE15 8QY Lead Inspector Andy Green Unannounced Inspection 8th April 2008 11:30 Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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 Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Conquest Lodge Address Dagless Way March Cambridgeshire PE15 8QY 01354 659708 01354 658683 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) Conquest Care Homes (Peterborough) Limited Kerry Dring Care Home 19 Category(ies) of Learning disability (19), Physical disability (19) registration, with number of places Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Physical disabled service users only to be admitted if they also have a learning disability 7th August 2007 Date of last inspection Brief Description of the Service: Conquest Lodge is situated in a residential area of March, Cambridgeshire, and provides care and support for 19 adults with a learning / physical disability. The premises are divided into four living units with a range of garden space to the rear, including an enclosed garden for the use of residents in Windsor Unit. Car parking is available at the front of the building for visitors and staff. Conquest Lodge is owned by Conquest Care Homes (Peterborough) Limited, which is a wholly owned trading subsidiary of Craegmoor Group Limited. The weekly charges range from £868 - £1610. Copies of inspection reports are made available to residents and visitors on request. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. CSCI undertook a key unannounced inspection on 8th April 2008. We inspected a number of records including care plans, training records, health and safety records and staff files. A tour of the building and grounds was also undertaken. Two members of staff were also interviewed to gather their views of the service, training and support they received. Comment cards were also received from residents and relatives. What the service does well: What has improved since the last inspection? What they could do better: It is recommended that the kitchens and bathrooms in each unit are refurbished and modernised. Please contact the provider for advice of actions taken in response to this Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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 Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are undertaken to ensure that the home can meet prospective resident’s needs. EVIDENCE: There have been no changes to the assessment process since the last inspection. The home continues to follow a robust process to ensure that the home can meet the needs of prospective residents. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans are kept to ensure that each resident receives appropriate care and support. EVIDENCE: The care plans for three residents were seen. Clear person centred guidelines are recorded to ensure that staff provide the care and support that is preferred and required. The care plans are written in a person centred format, which the organisation uses throughout all of their homes. Personal profiles are crfeatively recorded including photographs, where appropriate, to give a more specific detail regarding the resident’s life and their history. Personal needs, preferences and dislikes are clearly stated. There was evidence that regular reviews of care and support take place to include any updates or changes in care. Additional care plans are is also in place regarding specific updates for personal care eg, bathing or showering. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 10 Each resident continues to have a key worker and link worker to ensure that care is well co-ordinated to meet individual needs. Visits from healthcare professionals are also recorded. Since the last inspection weight charts have been improved and updated. They are now recorded monthly and kept in a separate book. The risk assessment procedure continues to ensure that residents are protected from harm both within the home and when accessing the community. Examples included travelling in the home’s vehicles, mobility, challenging behaviours and eating. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff provide appropriate support to ensure that residents can access the community to engage in activities appropriate to their needs. EVIDENCE: Weekly activity programmes are recorded in care plans. Residents continue to be involved in a wide range of activities to meet their individual needs and lifestyle choices as much as possible. Examples include; local colleges, cookery, computing, music therapy, art and crafts, local day centres, meals in restaurants, bowling, gym, swimming, pub trips and cinema, discos and nightclubs. Two residents are involved in employment placements on a voluntary basis Regular trips to the town are arranged, with staff assistance for personal and house shopping. This was evidenced during the inspection with staff assisting a number of residents either in wheelchairs or using the homes transport. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 12 Holidays and day trips continue to be organised throughout the year. A varied menu is provided, with choices, to meet individual dietary needs and preferences. The home has access to a dietician for specific advice regarding individual residents. Likes and dislikes regarding food were recorded in the care plans that were inspected. Residents go shopping with staff to choose menu items. Residents are encouraged to participate in the daily running of the home as much as possible including cleaning their bedroom, preparing drinks/ meals and gardening. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is provided appropriately in the home to ensure that the residents assessed needs are appropriately met. EVIDENCE: Residents receive personal care and support to meet their needs. Input from a wide range of healthcare professionals continues to be available and visits/appointments from healthcare professionals are recorded in care plans and daily notes. Individual risk assessments continue to be recorded and reviewed to ensure that residents are protected from potential harm. Three resident files were inspected and risk assessments were in place. Examples included bathing, eating, using transport and accessing the community. Medication records were accurate and up to date. The room used to store medication has been reorganised which has improved access to medication cabinets and cupboards. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints process to ensure that concerns are dealt with appropriately. EVIDENCE: The home ensures that all concerns are fully investigated and dealt with appropriately. A copy of the complaints procedure is displayed near to the front entrance. The home ensures that residents are protected from any potential abuse and issues are dealt with in line with local authority policies. There have been two complaints raised concerning staff. Both have been satisfactorily investigated by the manager using the homes’ disciplinary procedures. One of the incidents is being dealt with via Safeguarding Adults procedures. Care staff receive appropriate training to ensure they are aware of adult protection procedures and a training sessions are organised throughout the year. Staff spoken to confirmed this to be the case. The manager and deputy are enrolling on the local authority key practitioner training scheme regarding safeguarding adults so that they can deliver ongoing training to staff in the home. Feedback from surveys received by CSCI were given to the manager. Comments received were positive and complimentary regarding the care, support and accommodation provided. However some of the relative’s Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 15 comments stated that there could be more staffing at weekends and that laundry facilities could be improved. Resident comments evidenced that they were given choice regarding daily life and access to the local community. Staff comments were positive but there were some issues raised regarding occasional staff shortages, which have impinged on resident’s activities. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,28,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment of the home provides residents with a safe, comfortable, clean place to live. However, there are areas that need attention to ensure that residents needs are suitably met. EVIDENCE: The home remains comfortable, homely and generally suitable for the needs of the residents. Since the last inspection decoration and refurbishment has been carried out in response to requirements made at the last inspection. The handyman continues to deal with day-to-day repairs and refurbishments in the home. The gardens continue to be attractively maintained with a variety of planted areas and seating. Decoration has been completed to a number of doors and protective plates have been added to the bottom of doors to prevent damage from wheel chairs. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 17 The flooring in the dining area in the Burleigh unit has been replaced and the weighing scales provided for residents with mobility difficulties have been repaired since the last inspection. It was noted that the kitchens in each unit need upgrading and refurbishing. The addition of dishwashers would also benefit each unit.The bathrooms in Windsor and Burleigh are in need of refurbishing and redecorating to meet the changing needs of residents in each unit. It was noted that maintenance issues could often give the home a poor appearance, which conflicts with the good practices seen in other areas of the home. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The agency’s recruitment and training processes ensure that residents are protected from harm. EVIDENCE: Three staff files were seen and they contained relevant recruitment information, including two references, application form and satisfactory POVA/CRB checks. The organisations personnel department continues to process all recruitment to ensure consistency. There have not been any changes to the recruitment procedure since the last inspection of the home. Staff training in the home remains well co-ordinated and a programme detailing all training provided ensuring that all mandatory and client specific training is delivered. Refreshers / updates are organised as part of an ongoing process throughout the year. Equality and Diversity training is now a mandatory session. There was clear evidence, contained in the training matrix and training files for individual staff, that updates are regularly organised throughout the year to ensure that the staffs practice remains up to date. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 19 Two members of care staff spoken to confirmed that they received regular ongoing training throughout the year in both mandatory health & safety issues and care related topics. NVQ training courses continue at both levels 2 & 3. Care staff confirmed that they received recorded supervision on a 6-weekly basis to monitor their performance and development needs. They also stated that there were regular staff meetings where staff are able to raise ideas, issues and concerns. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the manager provides supportive leadership to ensure care and support is well delivered and monitored through quality assurance processes. EVIDENCE: The home is well managed. There is a supportive management style in the home and staff are encouraged to participate in the development of the service. The manager undertakes regular training to update her own knowledge and skills. Weekly alarm and monthly emergency light testing records were inspected and they are recorded accurately. Hot water tests are carried out regularly. The manager stated that a new questionnaire entitled “Your Voice” has recently been implemented by the organisation as part of the quality assurance Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 21 process to monitor the service. Surveys continue to be sent to residents, staff and healthcare professionals. The results of the surveys are analysed at the organisation’s head office and an action plan for improvement is put in place. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 YA24 Good Practice Recommendations It is recommended that the kitchens and bathrooms in each unit are refurbished and modernised. Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Conquest Lodge DS0000015195.V362088.R01.S.doc Version 5.2 Page 25 - 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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