Care Home: Dorset Lodge

Similar services:

• Chesham House
• Argyll House
• Acacia House
• Dial House Nursing Home
• Cromwell Avenue (9)

What the care home does well The service users at Dorset Lodge receive very individual care and it was evident during the inspection that staff work hard to ensure that they receive the service and support they need to enhance their lives. Care plans within the home were very detailed and provided staff with sufficient information to enable them to meet the individual`s needs. Communication at the home is very good and their is a multi disciplinary approach to both mental and physical care for the service users. The management and staff are proactive in their approach, ensuring any problems are dealt with appropriately and enhancing the service users independence and lifestyles. Feedback from the service users and healthcare professionals was very positive and included `I am happy at Dorset Lodge - the home look after me well`, `they supervise my client and report any concerns` and ` I have made good progress since being at Dorset Lodge`. The registered Manager and most of the staff have worked in the home for a long time and know the residents well. Care is provided with dignity and respect. There was a very open atmosphere in the home and staff were very positive about the Manager stating that she was very approachable and offered advice when needed. What has improved since the last inspection? There were no requirements or recommendations made at the last key inspection. There is now a high percentage of staff who have achieved their NVQ qualification and have the knowledge and skills required to provide appropriate care to the service users at Dorset Lodge. What the care home could do better: The Manager needs to ensure that all the required information on new staff is obtained and this is made available on future inspection visits, so an audit can be completed to confirm that the recruitment policy and procedure has been adhered to. Supervision records need to be clearer and developed further. Although there were set forms to record staff appraisals, it was noted that much of the information on staff files was duplicated and did not provide details of the individual session or plans and goals that had been identified. Training records need to be clearer and evidence of training needs to be developed to ensure that the correct date is recorded on when staff have actually completed updates; this is presently not happening. Systems need to be developed to ensure that the views of the service users are gained and recorded for quality assurance purposes. Key inspection report Care homes for adults (18-65 years) Name: Address: Dorset Lodge 5-7 Dorset Gardens Rochford Essex SS4 3AH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sharon Lacey     Date: 1 6 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Dorset Lodge 5-7 Dorset Gardens Rochford Essex SS4 3AH 01702545907 01702541517 dorsetlodge@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Dorset Lodge Limited Company Name of registered manager (if applicable) Mrs Julie Turner Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Dorset Lodge is a care home that provides care and accommodation to ten adults with mental health problems. The home is situated within walking distance of local shops and within a bus ride of Rochford and Southend town centre. Public transport is easily accessible. The home is decorated, maintained and furnished to a high standard, there are two comfortable lounges, a large kitchen/dining area and eight single bedrooms and one shared bedroom. Most of the bedrooms have en-suite facilities the Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 9 Brief description of the care home remaining bedrooms have their own designated bathrooms. garden to the rear and there is limited parking to the front. The property has a small Care Homes for Adults (18-65 years) Page 5 of 31 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 was a routine unannounced inspection, which took place over nine hours. The last key inspection to this service took place on the 17th April 2007. A tour of the home and inspection of the environment was completed and records and documentation were viewed. Areas looked at included information given to residents about the home and its services before being admitted, information gained by the home from residents when they first come into the home, information given to staff on the care required, the facilities and environment of the home, and any complaints that may have been received since the last inspection. An Annual Quality Assurance Assessment (AQAA) was sent to us by the Manager. The AQAA is required by law and is a self-assessment which focuses on how well the service consider they are meeting the Standards and Regulations. it also provides information about the service and how the service intends to improve over the next 12 Care Homes for Adults (18-65 years) Page 6 of 31 months. Information from this document has been used in this report were appropriate. All of the service users at Dorset Lodge are able to communicate and many were approached to gain their views about the care they receive whilst living at Dorset Lodge. Staff were also observed interacting with the service users. Questionnaires were sent out to the residents and healthcare professionals and feedback from these questionnaires have been included in the report were possible. All staff members on duty were spoken with informally during the inspection and any feedback has been included in the report. Staff questionnaires were also distributed for completion and comments included in the report. At the end of the day the inspection was discussed with the Manager and advice and guidance given regarding the findings. Care Homes for Adults (18-65 years) Page 7 of 31 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 Care Homes for Adults (18-65 years) Page 8 of 31 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get 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 31 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 31 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. Service users will be involved in the assessment process and given the opportunity to decide whether Dorset Lodge can meet their needs. Evidence: There was a clear Statement of Purpose, which set out the aims and objectives of the home and service available. The home has 10 residents between the ages of 18 to 69, who have a diagnosis of a severe and enduring mental illness. A copy of the Service User Guide was made available. The Manager stated that both documents had recently been reviewed and contained the information required. The Manager confirmed that copies of the Service User Guide would be provided to new residents at the admission stage and that both documents can be provided in other formats if required. Those service users who returned questionnaires confirmed that they had received enough information about the home before they moved in. Details of the admission process could be found in the Statement of Purpose. This stated that the assessment process would take into account the potential social, cultural, spiritual and psychological needs of the individual. There was also an Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: admission checklist on each service users files, to help ensure all the required paperwork had been completed. The Manager confirmed that she would complete any new assessments and that referrals were mainly taken from hospitals. On viewing two residents files, these contained a comprehensive assessment, which had been written in an essay format and covered areas regarding the individuals circumstances, background, hospital admissions and psychiatric history, physical health, activities, family history, personal history, education, employment history, psycho sexual history, drug and alcohol history, personalisation, attitude to treatment, rehabilitation, reviews and conclusions and recommendations. There was also evidence that family views had been gained and advocates were also involved in this process. The AQAA stated that every prospective resident has the opportunity to test drive the home. The Manager confirmed that all new residents would have an opportunity to visit the home; this is to ensure that the home will be able to meet the persons needs and also give them an opportunity to meet the other residents. She added that Dorset Lodge would not offer a place to someone whos needs they cannot meet. The staff employed at the home individually and collectively have the skills and experience to deliver the services and care, which Dorset Lodge provides and over 50 of the staff have now achieved their NVQ qualification. All residents are provided with a Contract and the Manager confirmed that these would be signed when a new resident is first admitted. Two files were viewed and both contained a fully completed copy, and had details of the room number. A copy of the homes Charter of Rights, Mission Statement, a copy of the last Key Inspection report and the Certificate of Registration were on display and service users could gain access to this information. Care Homes for Adults (18-65 years) Page 12 of 31 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 who use the service can be assured that their plan of care will clearly identify their specific individual needs and that they will be part of this process. Evidence: Dorset Lodge use the Care Programme Approach (CPA). Many of the service users placed at Dorset Lodge have psychiatric needs and the documentation in place showed that the plan of care had been developed with each individual service user and reflected their individual needs, choices and that they had been involved in the decision making process. It included details of care, treatment and rehabilitation, and there were also sections to cover any restrictions in choice. Some residents do have limited choice due to special restrictions placed on the by the Ministry of Justice. Advocates had also been involved with certain individuals and one service users was waiting for a visit from an advocate on the day of the inspection. Once the CPA has been completed with the individual it will then be reviewed as a multidisciplinary discussion at least 3 monthly, to reassess the plan of care and reset goals. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Each resident at Dorset Lodge has a key worker. Staff spoken with stated that they are updated on any changes to individual service users care via the staff handover. Residents are supported in taking risks as part of their independent lifestyle. Appropriate risk assessments had been completed to help support the service users and these had been reviewed as part of the CPA. These included assessments for health, challenging behaviour and mental health. There was a good atmosphere within the home and the routine was very easy going. The Manager stated that the service users are offered opportunities to participate in the day-to-day running of the home, but they have tried having resident meetings in the past, but these have not been very successful. She now has an open door policy, and service users can approach any of staff if they have any issues. Those who returned questionnaires reported that they knew who to speak to if they were not happy and that staff listened and acted on what they said. The Manager confirmed that staff are made aware of procedures with regard to sharing confidential information. Guidance is given as part of the staff contract, their induction and there is also a policy on confidentiality. Service users individual records had been stored appropriately and service users can be confident that information about them is appropriately stored. Care Homes for Adults (18-65 years) Page 14 of 31 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. Service users can be sure that they will participate in appropriate leisure and educational opportunities whilst living at Dorset Lodge. They will be offered meals which offer them choice, variety and meet any dietary needs. Evidence: It states in the Statement of Purpose that staff will encourage and help empower the service users to develop their potential in all aspects of daily living, social, interests, hobbies and education. It continues that each service user will have a personalised activity program, that includes self-care, budgeting skills, occupational/voluntary work and leisure interests. There was clear evidence during conversations with staff and residents that service users engage in appropriate educational and leisure activities. On the day of the Inspection many of the service users had been out to employment, college or doing voluntary work. The staff at Dorset Lodge are proactive in assisting the service users to take part in activities and ensuring their are opportunities for Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: furthering their education. Examples were provided were one service user had trained as a mechanic whilst living at home. One resident also works at a charity shop once a week and another helps at a daycare centre. On speaking with one service user, they stated that they had been attending college to do an English course and they had just completed their exam. They had also done their maths exam and stated they wished to study further. Most of the residents living at Dorset Lodge are physically independent and just need support from staff and monitored for any changes in their mental health. There was clear evidence on the day of the Inspection that the residents are part of the local community and many of them had been out during the morning either doing shopping, attending college or working. It was evident during conversations with service users that they use public transport to pursue their chosen lifestyles and activities. One service users reported I am independent, but know I have support and help when I need it or I become anxious and not sure. The staff enable the residents to have opportunities in maintaining and developing their social, emotional, communication and independent living skills. As previously stated many of the residents engage in appropriate leisure activities and these are encouraged by staff. One resident goes to the gym each week, which is part of his care plan. Generally the residents are able to do what they want and the staff will provide assistance if needed. There was evidence residents going out and doing leisure activities whilst inspection took place. The daily routine within the home promotes individual independence and choice. One service user spoken with confirmed that the routines are flexible and they can get up and go to bed when they want, although they added that most are encouraged to go to bed by 11 oclock, due to the need to get up in the morning. The Manager provide evidence of logging in and logging out sheets, which are completed daily. This is so staff are aware of who is at home and who is out and what they are doing. Service Users observed during the Inspection were seen to be relaxed and choosing how they wanted to spend their day. The Manager confirmed that visitors are welcome at the home any time. It states in the Statement of Purpose that family, friends and relatives will be encouraged to visit service users and maintain contact by letter or telephone. Staff support the service users to maintain family links and friendships inside and outside the home. One service user was heard arranging to go and stay with their family and this was being supported and encouraged by the staff. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: Residents confirmed they have a voting card, but on further discussion many chose not to use this. It states in the Service User Guide that breakfast is served between 7:00 am and 9:00 am (later at the weekend), lunch 12:00 till 1:30 and supper 5:00 to 6:30. Details of the weekly menu could be found on a white board in the kitchen. Meals consisted of fish and chips, chicken curry and rice, shepherds pie and vegetables, pork chops and vegetables, jacket potato and filling and roast beef. One service users added that they often have takeaway meal together. Another service user confirmed that they are encouraged to cook their own meals and service users were observed doing this on the day of the Inspection. Each service users has a weekly menu, which shows what they are having each meal time and when they are cooking their own. Nutritional records for each service users were seen. All residents were complimentary about the food and the food seen was appertising. The Manager stated that when the menu is chosen for the week she will then go out and complete shopping. Care Homes for Adults (18-65 years) Page 17 of 31 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 who use the service will receive care and support in the way they would prefer and have their care needs monitored and met appropriately. Evidence: The service users at Dorset Lodge are provided with flexible personal support. None require assistance with personal care and are all totally independent with regard to mobility and personal care. They are able to choose their own clothes, hair styles and appearance, but need assistance and support due to their mental health. Each service user has a designated key worker, which assists with planning care and providing continuity. Advocates are also arranged as required and one service users was heard arranging for their advocate to visit. Service users receive assistance with their mental health needs and this is via a multidisciplinary team of professionals. Care plans are regularly reviewed and mental health needs monitored. There were visits by social workers during the inspection and files viewed contained evidence of multidisciplinary contact and support. The Manager stated she receives good support from the hospital and social work department, to help meet the care needs of the individual service users. Feed back from the Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: professionals included good communication and support with sometimes difficult client group, maintaining them in the community, since placing a client at Dorset Lodge I have found the Manager extremely helpful and supportive. She listens to my suggestions and we agree a care programme with the needs of the client upmost and they work well with me and my client. Dorset Lodge has clear policy and procedures for the recording, storage, handling and administration of medicines. None of the present service users are able to administer their own medication, so this is overseen by the staff at the home. This is administered by staff either at breakfast, lunch or tea. Self-assessments are completed for medication, giving permission and confirming that the service users have an understanding of what the medication has been prescribed for. It was noted that the medication was well stored and records viewed had been completed and there were no anomalies. Files also contained details of allergies. Boots medication training is provided to staff via an in-house training pack. Care Homes for Adults (18-65 years) Page 19 of 31 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. Users of the service and their families can be confident that their complaints will be listened to and appropriately handled. Evidence: Dorset Lodge has a clear complaints procedure, which is available to all residents and their families and is also part of the Service Users Guide. The process includes timescales and also who to complain to. The complaints procedure was last reviewed on 1st January 2010. The home was noted to also have copies of the complaints procedure on the wall, so that residents can gain access to it. The complaints folder was viewed and this contained details of the complaints procedure and a set form, which had space to record details of the complaint, action taken and whether the issue had been resolved. No complaints had been received since the last inspection. All those who returned questionnaires confirmed that they were aware how to make a complaint. Polices and procedures were available for Safeguarding Adults and this included guidance to staff on signs of neglect etc. Documentation showed that staff had also attended safeguarding training with Essex County Council. No safeguarding issues have been raised since the last inspection. All service users are able to manage their own financial affairs. Care Homes for Adults (18-65 years) Page 20 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, comfortable and safe environment, which meets their individual needs. Evidence: Dorset Lodge offers service users a safe and well maintained environment. The homes premises is suitable for its stated purpose and the furnishings and fittings are of good quality and domestic in nature. Residents were observed using the communal areas around the home and also their bedrooms. There was a relaxed atmosphere. Nine of the bedrooms are single and one is shared. Some bedrooms have ensuite facilities and there were also separate bathrooms and toilets around the home. The home does not need any adaptations or equipment, as all residents are fully able and independent. All service users are self caring and none need any assistance with personal care. The premises are kept clean, hygienic and free from offensive odour throughout. There are systems in place to control the spread of infection and places around the home for staff to wash and dry hands appropriately. Laundry facilities are sited away from the food preparation area. Service users are able to use the laundry facilities alone or have assistance from staff. Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: The AQAA stated that the plan for the next 12 months is to maintain the decoration of the home to a high standard, but did not provide details of what improvements had been made over the last twelve months or what improvements had occurred since the Key Inspection 3 years ago. Care Homes for Adults (18-65 years) Page 22 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by competent and qualified staff. Training and supervision is provided to staff, but accurate records are not always kept. Evidence: Staffing rotas were requested and viewed. These contained details of the staff members name, their position and the shift to be worked. There are presently two staff on duty in the morning, two staff on in the evening and one staff member at night. The Manager is supernumerary to staffing levels. The staffing levels at Dorset Lodge are sufficient to meet the present service users needs. It was established that agency staff are not used and any annual leave or sickness is covered by the present staff. This helps to provide continuity of care, as the staff are aware of the service users needs. Many of the staff have worked at Dorset Lodge for many years and are well aware of the residents needs. The Manager stated that she does recruitment of new staff. The file of the last person recruited at Dorset Lodge was viewed, to ensure that the correct recruitment policy and procedure had been followed. This file did not contain a copy of the application form or any references. A protection of vulnerable adults check had been completed on the 24/06/09, but his was sometime after the person had actually started work within the home. A criminal record check had also been completed on the 20/07/09, Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: but the person had at this point worked at the home for over 18 months. The contract of employment had been signed and dated 19/01/09. An induction had been completed on 11/05/08, but this was queried due to the review date on the form being recorded as 01/01/09. A Medical had been completed, but this did not contain a date, so it was not possible to establish when it had been done. When speaking to the Manager regarding the lack of information about the staff member, she advised that some of the information had been lost and that is why they had requested a second CRB and POVA first check. As no further staff had been employed since the last Key inspection it was not possible to gain sufficient information to clarify whether the Manager had followed the correct recruitment procedures, this is an area that needs to be further developed. There are presently 12 staff employed at Dorset Lodge and staff spoken with confirmed that they have training that this is regularly updated. Mandatory training consists of health and safety, fire drill training, food hygiene and first aid. It was established that most training provided to the staff is done via in house training from B.V.S literature. Medication training is provided via a training pack, which has been produced by Boot the Chemist. Two staff files were viewed to check for evidence that training had taken place and to ensure that regular updates had been provided since the last Key inspection. From the training certificates seen it was noted that all the training had been completed on the same day each year. For example one staff member had attended first aid training and the dates on the certificates were recorded as the 3/4/10, 3/4/09, 3/4/08 and 3/4/07. Food hygiene was recorded as 03/03/08, 03/03/09 and the 03/03/10. Moving and handling training, health and safety, Managing challenging behaviour and Fire prevention had all been recorded on the same day over the last 3 years. The second file was noted to be the same. This was discussed with the Manager who stated that the course certificates would be printed off on the anniversary of the day the training is required, but the course would then be arranged as soon as possible. It was pointed out that this is not good practice due to training documentation stating training had been provided, when in fact staff had not yet attended. It was recommended that a new system is introduced to clearly record training and that certificates are not printed off until the actual training has been completed, so that they reflected the correct date. Other training staff had attended included health and safety, challenging behaviour, risk assessment and the principles of care. Over 50 of the care staff at Dorset Lodge have now achieved NVQ training. Presently there are three staff who have achieved their NVQ 4, five have their NVQ 3, two have their Leadership and Management qualification and one their Registered Manager Award. One staff member is also an NVQ assessor. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: New staff complete an induction when they are first employed at Dorset Lodge and this covers aims and objectives, quality, role and responsibilities, job description, rotas, uniform, smoking, grievance, moving and handling, health and safety, RIDDOR and personal safety. It states in the Statement of Purpose that regular supervision sessions are offered to support staff and discuss their job description. Files viewed contained a staff agreement for supervision. Staff meetings that had occurred since the last key inspection included 09/04/07, 01/08/07, 10/12/07, 21/12/07, 22/07/09 and 17/02/10. These dates showed that regular meetings had not occurred. Two staff files were viewed for evidence of staff appraisals and one to one sessions. These contained documentation to show that both staff had been seen at least 7 times, but once again it was pointed out to the Manager that the dates recorded on the appraisals were quite ambiguous as it showed that supervision had occurred on the same date each time and much of the information recorded was the same. Those staff who returned questionnaires confirmed that they received support, with one adding good support from Manager. Care Homes for Adults (18-65 years) Page 25 of 31 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. Service users live in a a well managed home that is run in their best interest. Evidence: The service users at Dorset Lodge benefit from a well-run home. The Registered Manager has significant management experience and has also achieved her Registered Managers award. She is a Registered Mental Nurse, so has the knowledge and experience to care for the client group registered for. There is an open and pleasant atmosphere within the home, and staff and service users spoken with stated that the Manager is approachable. During the inspection service users were noted to approach both management and staff freely, to discuss issues relating to their plan of care. There are systems in place to assist in the auditing of the Home and one process includes a self-assessment, which the Manager stated is completed annually. The last self-assessment was completed in January 2010 and this was briefly viewed. Family friends, staff, professionals and visitors had also been provided with questionnaires in February 2010. At present the Manager has not collated the information received back or produced an action plan for any issues raised. Only two service users meetings had Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: occurred since the last key inspection three years ago, one was in 2006 and the other in 2009. The home was runner-up for the South East Essex-based care home award 2009. The home has written policies and procedures in place and the Manager is aware of current legislation. Both staff and service users have separate files and there are systems in place for the safekeeping of records. There were some area of improvement highlighted at this inspection with regards to records. This was in connection to recording the full date, as sometimes this only consisted of the month and year, improving training records and also supervision records. Incidents/accident forms were seen and these had been completed correctly. There was an accident book which consisted of a separate form with details of the accident/incident and any action taken. No accidents had occurred within the last 12 months. COSHH assessment forms had been completed and the home had safety data sheets and guidance for chemicals. All chemicals were locked in a cupboard under the stairs. The Fire Safety Officer had visited Dorset Lodge on the 4th March 2010 and no requirements had been made. The gas certificate was seen and dated 21/01/10 and the electrical certificate was 26/06/08. Insurance was in place for the home. Checks on water temperatures and radiators were seen and okay. Risk assessment forms had been routinely completed. Care Homes for Adults (18-65 years) Page 27 of 31 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 28 of 31 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 1 34 19 A person shall not be 29/05/2010 employed at the home unless all the documents specified in paragraph 1 to 6 of Schedule 2 are in place. This is in connection to the information missing on the staff file inspected. 2 35 18 Ensure that staff are provided with training and updates that are relevant to their role as a carer. This is in connection to any training provided to staff being clearly recorded with the correct date. 29/05/2010 3 36 18 Staff will be appropriately supervised. This is in connection to staff receiving regular support and supervision and this being clearly recorded. 29/05/2010 Care Homes for Adults (18-65 years) Page 29 of 31 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 2 3 36 39 41 It is recommended that staff receive supervision at least 6 times a year. Systems need to be developed to ensure feedback and views are actively sought from the service users. Ensure any records made a clear and include the full date. It is recommended systems are introduced to record supervision and training more clearly as presently the date this occured is ambigous. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - 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!