Care Home: Elizabeth Lodge

What the care home does well The building is well maintained and the standard of decoration is very good. The building is very spacious and there are a number of communal areas for residents to choose where to spend their time. A resident spoken with stated that they were very happy living at Elizabeth Lodge and that they love their bedroom. They also showed immense pride and pleasure when talking about showing their home to a group of friends who had visited their home when they hosted a club night at Elizabeth Lodge. Staff spoken with felt well supported and advised that care plans provide clear information about the needs of the residents and how they are to be met. Staff are given regular opportunities to attend training and to update their knowledge and skills and those spoken with valued this. What has improved since the last inspection? The statement of purpose and service user guide has been reviewed and updated. The quality of care plans has improved and there is now detailed advice and guidance for staff to follow to ensure that residents` needs are met. One staff member has just completed NVQ (national vocational qualification) at level two, another is just about to complete this course and another is working towards the qualification. There are increased opportunities for staff to attend short training courses. Training is due to be provided on health action plans and where appropriate a plan will be drawn up with residents to ensure that their health needs continue to be met appropriately. Records held in relation to staff recruitment show that the home is now more thorough in obtaining all the necessary checks. The home has introduced a new quality assurance system based on obtaining of views of relatives and visiting professionals about the quality of the care provided in the home and this will be expanded to seek the views of residents. What the care home could do better: Four requirements have been made as a result of this inspection. Two have been carried over from the previous inspection in that they were partly met. These requirements have been reworded to ensure that the home is clear about what is required to meet them. They relate to the need to ensure that goals in care plans are clear and in relation to the rotas kept, the need to ensure that all hours worked on a one to one basis with residents is clearly documented on the staff rotas. Other requirements made relate to the need to have sufficient staff on duty at all times and to the need to ensure that there is a system in place to allow residents access to their money at all reasonable times. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Elizabeth Lodge 3 Bowley Road Hailsham East Sussex BN27 2DB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Caroline Johnson     Date: 0 3 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Elizabeth Lodge 3 Bowley Road Hailsham East Sussex BN27 2DB 01323846287 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Elizabeth Care Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 9 The maximum number of service users to be accommodated is 9. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Elizabeth Lodge is registered to provide accommodation and care for nine (9) people with a Learning disability. The home is a detached house situated in a residential area of Hailsham and is located close to the town centre, although no public transport runs past the home. The Hailsham ponds and weekly market are within walking distance. There are five single bedrooms on the ground floor and four on the first floor, all have en-suite facilities. The en-suites are made up of a step in shower, toilet and sink. In addition there is a bathroom in use on the ground floor with a bath seat. Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home The range of fees as of May 2008 were 814 to 1,084 pounds per week. Fees are negotiated with Social Services and are based on assessed individual needs. Day care fees are not included in this fee. Additional fees are charged for hairdressing, toiletries and magazines. A copy of the most recent inspection reports will be available at the home and from the owners upon request. 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: two star good 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: For the purpose of this report the people living at Elizabeth Lodge will be referred to as residents. As part of the inspection process a site visit was carried out on 03/06/2009 and it lasted from 10:15am until 3.45pm. One of the owners facilitated the inspection. Over the course of the inspection there was an opportunity to meet with one of the three residents. In addition time was spent with two members of care staff in private. A full examination was carried out of two care plans. In addition records seen included; staff recruitment and training, medication, menus, quality assurance and leisure activities. Elizabeth Lodge was opened in December 2007. There was a registered manager in Care Homes for Adults (18-65 years) Page 6 of 31 post at that time. However, the manager resigned from her position in January 2008 and a new manager was appointed in March. This manager has since left and a new manager was appointed to manage the home. She was registered in May 2009. However, in the days prior to the inspection she advised the Commission of her intention to resign from her position. The owners are currently considering the management arrangements for the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get Care Homes for Adults (18-65 years) Page 8 of 31 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. Prospective residents are provided with detailed information about the services available within the home. Evidence: There is a detailed statement of purpose in place. However, the only document that could be located at the time of inspection was a version that had been prepared in advance of the home being registered. Information provided in advance of the inspection indicated that the document had been updated since the last inspection. Following the inspection a copy of the up to date statement of purpose was forwarded to the Commission. The service user guide has been updated since the last inspection and the owner advised that each of the residents has their own copy of this document. Whilst no pre-admission documentation was examined on this occasion, information provided in advance of the inspection described a very detailed and thorough procedure in place. There was evidence in the care plans seen that the needs of the current residents had been fully assessed and were being reviewed at regular Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: intervals. In one of the two care plans seen there was a terms and conditions of residency. Although the home is registered to accommodate nine people, at the time of inspection there were only three residents accommodated. 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. Care planning would be enhanced further by ensuring that goals and aspirations are clearly stated with advice for staff on how to support residents in achieving them. Evidence: Two care plans were examined in detail. Both contained a wealth of information and advice and guidance for staff to follow to ensure that residents needs are met. In each case the residents have signed their agreement with the care plans in place. Two of the residents have had an annual review this year. In relation to the third resident there is dispute regarding who has responsibility for monitoring the placement. There were a range of risk assessments in place ensuring that where there is a perceived risk there is advice for staff to follow. As required at the last inspection there are now risk assessments in place in relation to challenging behaviour and in relation to the management of epilepsy. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: A requirement was made at the last inspection in relation to ensuring that goals in care plans being specific, measurable and appropriate to the needs of the residents. A review of the goals had been undertaken and the numbers of goals had been reduced from six to two. However, there was no advice for staff about how these goals were to be achieved and no specific recording to measure progress. For example one goal was to encourage the resident to try and control my behaviour and not to be so hard on myself as I always think I am not doing things right. There was no reference to how this should be monitored. The owner advised that having attended a course recently she had picked up on the need for further work in this area and would ensure that it is addressed as soon as possible. A daily records folder is kept in relation to each resident. Within each folder there is a record of behaviour charts, daily logs, guidelines for the use of medication prescribed on an as required basis and a record of all one to one time provided. The daily log generally relates to personal care and is a tick list. A couple of lines are used to describe the morning and afternoon shift. The one to one time log will state three hour activity or one hour activity and may state reading or writing but there is no further reference to the activity and it is not clear how this has been planned or implemented. In addition there is a list of time slots, for example it may state ten minutes of emotional support, ten minutes personal care or twenty minutes for household tasks. There is space to write choices and decisions made but these make no reference to the choices actually presented to residents. It was reported that residents meetings are held regularly. However the only minutes seen were dated October 2008. These minutes showed discussions relating to Halloween and Christmas. The owner referred to a number of choices and decisions that residents would have made in relation to activities and day trips but these are not currently documented. The home needs to find a way of demonstrating more clearly the choices and decisions made by residents. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities to participate in a variety of in-house activities but staffing levels at times can mean that not all residents are able to make good use of their community for activities. Evidence: One resident attends a day centre three days a week. It was reported that arrangements have been made for all three residents to attend various college courses one day a week from September. Two residents also attend a club and this has recently been increased to two evenings a week. On the evening prior to the inspection staff reported that the home hosted the club at Elizabeth Lodge. Twenty people were invited to share a range of activities both in-house and in the garden. They also had drinks, snacks and general entertainment. A resident spoken with said that they really enjoyed the evening and stated I enjoyed showing my friends around my house. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: It was reported that a PECs system (picture exchange communication symbols) is used to inform one of the residents of their activities and the time they are due to take place. Residents are supported to maintain contact with their families and friends. One of the residents spends each weekend day with their parents and their parents take them to a church service on Sundays. Staff spoken with stated that there are lots of in-house activities arranged and that they try to keep residents busy and stimulated at all times. They make the most of opportunities to use community facilities but that this is dependent on staff levels and is not as frequent as they would like. When there are two staff on shift they walk to the local pond, use local shops and occasionally restaurants. There is no house transport but the owner and manager both use their own cars to take residents to activities. The owner also advised that residents are being supported to apply for bus passes. The owner advised that rather than going away for annual holidays residents have instead opted to have days out. The rotas provided for inspection showed that four days have been set aside for days out and that there were three staff on duty on these days to facilitate this. The owner advised that have taken residents to the theatre. One of the residents stated that they had just been to a family wedding and really enjoyed the day. Residents are encouraged to participate in daily living tasks in-house. There was a four week menu plan in place and the owner advised that every four weeks this is changed. There is a long list of choices available for residents to choose from but record keeping does not show the choices presented or the actual decisions made by residents. There is a set meal for the main evening meal. Alternatives available include fish fingers, burgers, sausages and a choice from the lunch menu. There were no records indicating that residents had made choices other than what was on the menu. The owner advised that they have a likes/dislikes list and the menus have been formulated with this in mind. At the time of the last inspection the then manager advised that they would photograph each of the meals as they were prepared and then laminate the photograph. Staff advised that this work has yet to be completed. It was reported that one of the residents loves being involved in food preparation. Care Homes for Adults (18-65 years) Page 16 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems in place ensure that residents healthcare needs are met. Evidence: The home seeks specialist advice and support when needed in relation to meeting the needs of the residents accommodated. The Community Learning Disability Nurse is involved in providing advice and support for one resident. The nurse was also due to provide training the day following the inspection on health action plans and it was envisaged that plans would then be drawn up with residents for future use. Records showed that residents are supported to attend a wide range of healthcare appointments such as the dentist, opticians and chiropodist. In relation to one resident it was noted that their weight was being monitored on a monthly basis. In relation to the second resident it was noted that their weight had not been monitored since March. However, there was a goal in place stating that staff should assist the resident in taking regular exercise and join in activities in-house/outside walks. In one file seen there were guidelines for the use of as required medication that the Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: owner advised had been written by the community learning disability nurse and agreed with the gp. However, although there was a typed name on the document the only signature on the document was that of the manager. The arrangements in place for the storage and handling of medication were in order and all records seen were up to date. The medication returns book could not be located at the time of inspection. Residents wishes in relation to dying and death have yet to be assessed and there is no actual policy and procedure in place in relation to dying and death. 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. Systems are in place to enable anyone wishing to make a complaint to do so. The systems in place for the management of residents finances should be reviewed to ensure that residents have access to their money as required. Evidence: There is a detailed complaint procedure in place and a simplified version of the procedure is included in the service user guide. The owner advised that there have been no complaints received since the last inspection of the home. It was reported that there is a detailed procedure in place on adult protection and prevention of abuse. A copy of East Sussex multi-agency guidelines is also available for staff to read. The owner and manager have completed training on the protection of vulnerable adults. It was reported that training has been booked for staff to attend a course but that it is not due to be held until October 2009. The owner advised that she is appointee for all three residents. All the residents now have their own bank accounts and their DLA (disability living allowance) and PA (personal allowance) is paid directly into these accounts. This is a new procedure that has recently been introduced. Residents are the only ones that can sign for their Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: monies and the owner is appointee for all three. There is no house car but residents are charged mileage as part of transport costs. It was reported that the cost of this has been agreed with care managers. If there is a shared journey the cost is split. At the time of inspection the home was in the process of applying for bus passes. Records were seen in relation to one resident and some records were seen in relation to another. It was noted that residents will be supported to withdraw a certain amount of money. This money is then stored in a safe and ten to fifteen pounds is then available in a wallet for general use by them. Staff have access to these wallets and support residents with all purchases providing receipts for all expenditure made on their behalf. In relation to one wallet seen it was noted that another resident had borrowed 15 pounds leaving the resident very short of money. Both residents had plenty of money in the safe but staff have no access to the safe. The owner advised that the manager has access to the safe. There is also a petty cash system in place but this only provides ten pounds a week in case of shortfalls in shopping. Care Homes for Adults (18-65 years) Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is well maintained and decorated to a very good standard. Evidence: The building was completely refurbished in 2007. The only areas seen during this inspection were the lounge, dining room, kitchen, meeting room and ground floor bathroom. In addition there is an activities room. All bedrooms have ensuite facilities and those occupied have been personalised by the residents with support from staff/relatives. There is a large garden to the rear of the property. All areas seen during the inspection were clean and had been decorated to a very good standard. All of the staff team are currently doing a correspondence course on infection control. As recommended at the last inspection the home reviewed the hand drying facilities and there are now paper towels available to assist in the prevention of cross infection. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the support of a dedicated team of staff, however greater protection would be afforded if there were sufficient staff employed in such numbers as to properly fulfill residents goals, aspirations. Evidence: One of the residents is funded to receive eighteen hours one to one support a week, another is funded for seventeen hours and a third is funded for approximately twentytwo hours a week. At the time of inspection there were two staff members on duty. However one staff member was new to the home and was shadowing the other staff member and therefore technically not counted in the staff numbers. The owner had been in earlier to take one of the residents to their day centre. Generally the rota shows two staff on duty but there were occasions when there was only one. At the weekend there is often only one staff member but this reflects the fact that one resident is out with their relatives throughout the day every weekend. One to one hours are not shown on the rota and it would not have been possible to provide each resident with their full one to one funded hours with the current staff numbers. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: It was reported that with the exception of the manager all staff employed are contracted to work two shifts a week. All remaining shifts that need to be covered are then displayed and staff can request to work the additional hours. If the hours cannot be covered then the owner will step in. The owner advised that one staff member that has been on sick leave is due to return to work and that another staff member is awaiting their CRB (criminal records bureau) check so staffing levels will increase making it easier to ensure that one to one hours are met. All new staff have a thirteen week probationary period during which they have four weekly reviews. The owner advised that she deals with the recruitment of staff in terms of gathering information but that the manager is also involved in the interview process. It was reported and confirmed by a staff member on duty that new staff commence work in advance of them having a full CRB (criminal records bureau) check but that they are supervised until this is obtained. A pova first check is obtained for all new staff. Records were seen in relation to two staff recruited since the last inspection of the home. In both cases there was a completed application form and at least two references. The home had been thorough in carrying out all necessary checks. Within each file there was a job description in place. Regular reviews of progress had been carried out and in relation to one staff member that had commenced working in the home, records showed that a range of training courses had been attended. All staff have a copy of their job description. There is also a detailed job description in place for the manager of the home. However, the manager does not have a copy of the owners job description. This would aid further clarity between roles and responsibilities. All of the staff team commenced common induction standards but they have not yet completed instead focussing more on their NVQ (national vocational qualification). One has completed level 2, one has almost completed and one is now on sick leave but due to commence a phased return to work soon. It was reported that that pova (protection of vulnerable adults) training has been booked for October 2009 and that fire safety training has been booked for June 2009. Staff do manual handling training by viewing a DVD. Staff are currently doing a correspondence course on infection control. One staff member has yet to do a formal course on the administration of medication. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: The owner and manager completed several short courses on challenging behaviour including, understanding challenging behaviour, understanding positive behaviour, challenging environments communication systems and challenging behaviour and early interventions. Other staff are now being booked to attend these courses. The manger also completed a course on recruitment. All of the staff team completed a course on epilepsy. The owner and manager attended courses on mental health and on autistic spectrum disorders. Three staff have completed training on food hygiene, four have completed first aid and three makaton. 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. There are some good systems in place to ensure that the home is managed well and these are continuing to be developed and improved upon. Evidence: Elizabeth Lodge was opened in December 2007. There was a registered manager in post at that time. However, the manager resigned from her position in January 2008 and a new manager was appointed in March. This manager has since left and a new manager was appointed to manage the home. She was registered in May 2009 and has completed NVQ (national vocational qualification) at level four and the RMA (registered managers award) and has many years experience with learning disabilities. However, in the days prior to the inspection she advised the Commission of her intention to resign from her position. The owners are currently considering the management arrangements for the home. Information provided in advance of the inspection showed that the homes policy and procedure manual is being kept up to date. Staff meetings are held regularly and Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: minutes were seen for meetings held in January and March 2009. Both sets of minutes were detailed providing staff with clear advice of the procedures to be followed. Staff spoken with at the time of inspection described the manager as very supportive. They both said that there is a very good staff team in place who get on well and work together to get the job done. Since the last inspection a new quality assurance system has been introduced this involves seeking feedback from the relatives of residents on the quality of the care provided in the home. A comments/suggestions box has also been put up to encourage visitors to share their views. Two comments were in place from outside agencies, one survey stated that the home provides a calm and safe environment, staff work hard to find ways in which residents can be more independent. Staff work well as a team. It also said that one way the home could improve would be to provide More days out for residents and spending more time with residents to do activities one to one. Surveys from relatives were very positive. It was noted that the outcome of the surveys had not been collated and no feedback had been provided to those that completed the forms. The owner advised that they have questionnaires for seeking the views of residents but they could not be located at the time of inspection. In addition the homes annual development plan was not available at the time of inspection. It was reported that all staff have regular opportunities to take part in fire drills. 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 6 15 15 [1] [2] The Registered Person must ensure care plans clearly set out each individual residents aspirations and life goals. That personal goals are clearly reflected in individual care plans. 18/08/2009 2 22 17 17 [2] The Registered Person must ensure that residents have access to their monies at all reasonable times. Residents need to be protected from abuse. 17(2) Schedule 4 para 7. The Registered Person must ensure that the staff rota shows the hours worked by staff including all one to one support to be provided and ensure that a record is kept that the hours have been worked. 31/07/2009 3 33 17 31/07/2009 Care Homes for Adults (18-65 years) Page 29 of 31 Residents must be supported by an effective staff team. 4 33 18 18 [1] [a] 31/07/2009 The Registered Person must have regard to the assessed needs of residents and to the homes Statement of Purpose to ensure that at all times suitably qualified, competent and experienced persons are working at the care home in sufficient numbers for the health and welfare of residents at all times. Residents must be supported by an effective staff team. 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 35 All staff should received induction that is in line with the Common Induction Standards. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 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!