Care Home: Drake Lodge Care Home

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What the care home does well The owners of Drake Lodge, Mr and Mrs Ileladewa supports the staff member with their training and development ensuring that people living at the home receive the best possible service. The staff survey returned under the heading, what does the service do well wrote, " Cares very well for both staff and residents". The homes recording and care planning process ensure that people living in the home care needs are clearly understood, and are easily accessible to those providing the care. What has improved since the last inspection? The home has undertaken many improvements since the last inspection including the painting the outside of the house, landscaping the rear garden and decorating most of the bedrooms. CARE HOME ADULTS 18-65 Drake Lodge Care Home Drake Lodge 42 Meredith Road Peverell Plymouth Devon PL2 3QJ Lead Inspector Kim Fowler Unannounced Inspection 12th September 2008 07:45 Drake Lodge Care Home DS0000064535.V368451.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 Drake Lodge Care Home DS0000064535.V368451.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. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Drake Lodge Care Home Address 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) Drake Lodge 42 Meredith Road Peverell Plymouth Devon PL2 3QJ 01752 773848 01752 773848 drakelodgepl23qj@btinternet.com Mr Adewale Michael Ileladewa Mrs Christianah Bosede Ileladewa Mrs Christianah Bosede Ileladewa Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service must only accommodate service users between the ages of 25 and 65 Two named service users over the age of 65 Date of last inspection Brief Description of the Service: Mr and Mrs Ileladewa purchased Drake Lodge Care Home in August 2005. The home is a semi detached large Victorian Villa in the middle of a residential street, on the edge of the Peverell area of central Plymouth. A full range of amenities and facilities are within walking distance and Central Park is just across the road from the home. The service can accommodate up to five service users over two floors. The home is entered on the ground at the front. There is one bedroom with en suite bath and toilet on this level as well as the communal lounge, dining room and kitchen. On the first floor level is one double room with en suite shower and toilet, two double bedrooms and one single bedroom. The main bathroom with toilet is also on the first floor. There are no shared rooms and due to the age of the building all the ceilings are reasonably high giving an additional feeling of space in the home. There is a large area of patio garden to the rear of the building. The service offered by the home is registered for men and women with mental health issues between the ages of 25 and 65 years of age. Because of the layout of the home this service would have difficulty supporting residents with significant mobility difficulties. The present group of residents has a mixed range of ages and abilities. The current fee ranges are £521 to £610. Drake Lodge Care Home DS0000064535.V368451.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 3 star. This means the people who use this service experience excellent quality outcomes. The unannounced inspection took place over 1 day and started at 7:45am and finished at 12:10pm. The Registered Provider, Mr Ileladewa and the Registered Manager, Mrs. Ileladewa were available throughout the inspection. The inspector made a tour of the building and spoke to most of the people living in the home. Documentation relating to the care planning process and the management of the home were examined. Prior to the inspection people who live in the home were sent surveys to allow them to comment upon their experiences. Five cards were returned as well as one staff members survey received. Any comments are in the relevant section of the report. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 6 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. Drake Lodge Care Home DS0000064535.V368451.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 Drake Lodge Care Home DS0000064535.V368451.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): 2/4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents referred to the home can be confident that they will be provided with sufficient information for them to make an informed choice about living at this care home. EVIDENCE: The home has admitted one new resident since the last inspection was carried out. This person’s file was examined and showed that a pre-admission assessment had been completed. The owners, who were in attendance throughout the inspection, stated that they had visited this person in their previous placement and held discussions about trial visits and had undertaken several trial visits to the home before this person moved into the home. During discussion with 4 of the people who live at the home and the person who was admitted since the last inspection confirmed that they had visited the home 4 or 5 times before they moved in. They went onto say that they had, “stayed for a meal” and had joined in weekly activities sessions with other people living in the home to enable them to make a informed choice about the home. The file held also contained the placing authorities assessment and provided additional information to ensure that the home was able to meet this persons needs. This information provided this person with information that the home Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 9 can not only meet their health care needs but also their emotional, social, cultural and religious needs. The homes AQAA, returned to the Commission state, “Full professionally conducted assessment is undertaken by the owners before the commencement of trial visits by any potential service user”. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. 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. People are encouraged and well supported to make daily decisions about their own lives were possible, to maintain independence. EVIDENCE: Two care plans for people living at the home were examined and each showed detailed descriptions of each person’s needs and included personal care needs and medication taken. These files contained information to assist the staff in meeting the assessed needs of individuals. Information was recorded that showed regular reviews had been undertaken and included evidence that people living at the home and the CPN (Community Psychiatric Nurse) were involved in these review meetings were possible. The homes AQAA states, “Service users have full and comprehensive care plans in place. The care plans included a detailed history of mental health needs; information about professional input as well as current medication”. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 11 One of the owners, Mr Ileladewa, stated that one person living at the home had requested that he would like to attend a college course. Letters and correspondence was held on this persons file to state that a place had been secured and they were due to start next week. Mr Ileladewa stated that specialist input was sort when required and this information was recorded into individual files and included written guideline provided by the specialist support services. One file examined showed information received from the CPN and Mental Health unit to provide assistance to staff. The owner stated that people living in the home are given choices as much as possible including if they wish to go out or not. However due to the needs of some of the people living in the home this is not always possible. The home does have a structured free time and choice is given on what individuals wish to spend this time doing. One person spoken with said they went for a walk everyday and another person was attending a specialist day unit during the inspection. One file held a daily activities programme and this included visits to the pub, museum and bowling alley. Risk Assessments are in place and held on each file and these risk assessments include people accessing the community and being supported by staff. Risk assessments were found to be comprehensive and gave clear guidelines for staff to follow. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. 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 people living in Drake Lodge can be confident that the home will promote and provide support for them to access the local community and leisure activities, while promoting independence. The home welcomes and encourages families and friends to visit. EVIDENCE: One person is due to commence a college course next week and two others living at the home have shown an interest to start a course next year. Recorded into the care records are the daily activities each person attends and how these activities create interest and stimulation. This includes playing in a football team, bowling, table tennis and visiting local shops. People are encouraged to go out into the local community when possible and this has included visits to the local pubs, café, shops and swimming pool. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 13 The daily records were examined and recorded the dates and times of family visits either to the home or people visiting family homes. The owner stated some people attend the local specialist day centre, MIND and Crossways group set up for people with mental health issues, to meet friends. One person attends a community group to meet up with friends who live else where in the community. Each person has a key to their bedroom and one person has guidance and rules in place on the use of alcohol within the home, this was drawn up to ensure it is controlled to meet their needs. This agreement was drawn up with outside agencies involved and agreed by the person it relates to. One person who lives in the home is away on a family holiday abroad and will be away for 5 weeks. The careful planning for this trip was well documented and involved the family and other agencies including the pharmacist to provide 5 weeks medication. The 4 weekly set menu was displayed but the owner confirmed that choice was possible whenever needed. Either the owner or his wife, the Registered Manager, cooks the meals. All the people living in the home are involved in shopping, preparation and cooking where and when possible. Meal times are not set as people regularly access the community and the kitchen is available for snacks and drinks at any time. The meal served during the day of the inspection was fish and chips with fresh vegetables. Everyone in the home selected this choice after the owner had spoken to each person individually to ask for their choice. During discussion with the people living in the home about the food they said it was “good”, “very nice”, “I like it and I do have a choice”. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18/19/20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Access to health care is maintained to promote the wellbeing of all who live in the home. People receive personal support in the way they prefer and require. EVIDENCE: All personal support is recorded into individual care plans and these are easily accessible for the staff employed and all rooms are single. These care plans are based on assessed needs and evidence was recorded that these are regularly reviewed and then signed. All the people currently living in the home are able to manage their own personal care needs. However several require prompts and this information is clearly recorded into individual files. Either one of the two owners or the one employed staff member sleeps in each night. The sleep in person will only go to bed when all the people living in the home have retired to bed. Everyone is signed to the local GP and the owners state that they have an excellent relationship with the GP surgery and people are able to visit the GP Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 15 as and when they wish. One person stated that they visit the surgery independently and others have some support. The CPN is currently involved with the home and visits regularly to assist several people. The homes AQAA states, “The wellbeing of the service users is promoted because there is a good access to health care services and the service providers are well trained professionals with a lot of experiences in dealing with the service users personal and healthcare issues”. The medication system was checked during this inspection and found to be well recorded and documented and the home uses the blister pack system to dispense medication. Either one of the two owners administers the medication as both are qualified nurses and fully understand the principles of medication. One person has started to self medicate and is currently doing this every two days with a view to increase when they have gained confidence. Another person also self medicates and this system is checked and signed off monthly. There are risk assessments in place to support the self-medication system. The controlled drug book was checked and showed a clear audit trail of medication received, administered and returned. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 16 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 people living at Drake Lodge can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. EVIDENCE: The home has a complaints procedure available and this is displayed for all to access. However one of the owners are in everyday and will resolve any issues between people living in the home straight away. The complaints procedure included how to contact the Commission. It described the process that would be used if a complaint is made and included timescales and the AQAA says, “The service users are aware they could make a complaint and felt comfortable to do so if needed”. One person living in the home was able to say that they were aware they could make a complaint and felt comfortable approaching either of the owners and that the owners are in most days. The Commission has no recorded complaints on file. Both Mr. And Mrs. Ileladewa have completed the local authority Safeguarding course. The one employed staff member spoken with confirmed that they had Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 17 also completed the Safeguarding course. And from discussion with this staff member it was clear they were aware and how to manage any issue raised. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 18 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): 24/30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Drake Lodge continues to maintain a clean and suitable environment for it’s stated purpose and people living at the home can be assured that they will live in a comfortable home that is regularly maintained. EVIDENCE: This home provides appropriate accommodation and facilities to meet the needs of people currently living in the home. The home is well maintained and has benefited from having the downstairs painted and new carpets throughout the home. All but one of the people living in the home has had their bedrooms painted. One person does not wish to have their bedroom painted and this information is recorded into their individual file. The outside of the home has also been upgraded and this includes the painting of the house and the rear garden landscaped. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 19 A tour of the building showed the home to be clean, tidy, warm and well maintained. And each bedroom reflects individual tastes. A smokers shelter is available in the rear garden for the comfort of any smokers. The homes laundry facilities are domestic in character and a sluice facility is available if required. Mrs Ileladewa has also completed the local authorities Infection Control course. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 20 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): 31/32/33/34/35/36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are supported by well-motivated and caring owners and staff member in sufficient numbers to meet the needs of those currently living at the home. EVIDENCE: The home only employs one worker and this file was looked at and the worker was spoken with as part of the inspection process. It was clear from this discussion that this worker was aware of their role and responsibly. The staff member confirmed that they had completed an NVQ (national Vocational Qualification) at level 2 in care. Other training completed includes Fire Safety, Health and Safety and Safeguarding. The owner and the staff member confirmed that they meet regularly to discuss and areas of concern and training and development needs. This staff members files contained all the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) and references ensuring as far as possible unsuitable staff are not employed. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 21 Mr Ileladewa holds the qualification of a Trained Trainer and is a course leader and lecturer on Health and Social Care at the local college. Thus providing the staff member with regular updated training to assist them in carrying out their job. The files also showed regular recorded supervision. The staff member spoken to say that the owners are friendly and approachable. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 22 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 excellent. This judgement has been made using available evidence including a visit to this service. The management of this home is very good and ensures that records are effectively maintained. The staff member is well trained to meet the needs of people living at the home. EVIDENCE: Mr. And Mrs. Ileladewa, who are both qualified nurses, are in the home most days and both keep up to date with their training – there were certificates displayed on the homes notice board. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 23 Each has a staff file that also holds certificates on training and includes Infection Control, First Aid and Safeguarding. Mrs Ileladewa also holds a Registered Manager award. The completed Quality Assurance forms seen showed that these are given to people living in the home, relatives and visiting professionals. All contained positive comments. The Environmental Health department have recently visited the home and no issues of concern were raised. The homes AQAA returned to the Commission goes onto say, “The service users surveys clearly state how well the service users think of the owners, the food in the home and the care they receive”. One person living in the home has their money managed by an appointee and another manages their own money. One person collects thier money twice a week from the appointee. This agreement was drawn up with involvement with other professionals including the CPN and Care Manager and the person whose money it is. One person also has a solicitor to assist them with managing their money and 2 people hold cash cards to draw out money as and when they wish. Sampling of servicing records indicated that equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment. Gas and electrical appliances were being routinely serviced and checked. Electrical systems were being serviced during the inspection by a outside contractor. The fire protection system was well maintained. Maintenance checks are being carried out. The staff member is receiving appropriate fire protection training to ensure that they have the skills to deal with emergencies. Good health and safety practices reduce any unreasonable risk, affecting people living at the home, to an acceptable level. Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 24 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 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 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 4 3 4 X 4 X 3 X X 3 X Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 25 N/A 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. Refer to Standard Good Practice Recommendations Drake Lodge Care Home DS0000064535.V368451.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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. 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