Latest Inspection
This is the latest available inspection report for this service, carried out on 19th March 2010. it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Hales Lodge.
Annual service review
Name of Service: Hales Lodge The quality rating for this care home is: The rating was made on: two star good service 0 3 0 3 2 0 0 9 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.
Has this annual service review changed our opinion of the service?
Yes You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Judith Last Date of this annual service review: 1 0 0 2 2 0 1 0 Annual Service Review Page 1 of 7 Information about the service
Address of service: Somerton Road Winterton On Sea Great Yarmouth Norfolk NR29 4AW 01493393271 P/F01493393271 H2022@mencap.org.uk www.mencap.org.uk Royal Mencap Society Telephone number: Fax number: Email address: Provider web address:
Name of registered provider(s): Name of registered manager (if applicable) Conditions of registration: Category(ies) : learning disability physical disability Conditions of registration: All service users have a learning disability; all or some may also have a physical disability Total number of service users not to exceed 8 Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: The former registered manager resigned her post and was removed from the registration certificate in October last year. Since then, two acting managers have been responsible for the day to day running of the service. 0 3 0 3 2 0 0 9 Number of places (if applicable): Under 65 Over 65 8 8 0 0 Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service
Annual Service Review Page 2 of 7 Hales Lodge is a purpose built care home providing care and accommodation for up to eight adults with learning and physical disabilities. The home is divided into two single storey bungalows interconnected by a corridor. Residents share all facilities. Specialist equipment is in place to ensure that residents are able to receive the most appropriate care. All residents have single accommodation and there is a good range of communal space. When we last visited, fees for the service ranged from £731 to £1,400 per month, individually assessed according to peoples needs and dependency. There are additional charges for hairdressing, chiropody and personal spending. People share the cost of the vehicle according to the amount they use it, and mileage is charged at 20p per mile for social outings. There is no charge for transport to medical appointments. People also pay rent. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review:
What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Surveys returned to us by three people living at the home, by one of their relatives and by six staff working there. Information we have about how the service has managed any complaints. What we have been told by the acting managers about things that have happened in the service. These are called notifications and are a legal requirement. The last key inspection and the results of any other visits we have made to the home, as well as the history of the service. Relevant information from other organisations and what other people have told us about the service. What has this told us about the service? The Annual Quality Assurance Assessment that the home was asked to fill in was supposed to be back with us by 25th December 2009 at the latest. It did not arrive when we asked for it and we had to send a reminder. Homes are required to submit this information by law and within 28 days of our request. This did not happen. The area manager and acting managers say there was an error in staff passing the information on which they have now addressed. When the information did arrive it told us a lot about what the acting managers feel is done well, and also what plans there are to continue improving the service. This includes plans to make improvements to the environment, so that it is more suited to peoples needs. The proposed improvements have taken a long time to organise and some have been outstanding for a long while. The acting manager says there is now a two year timescale for completing the work necessary. We will want to see what progress has been made when we next look at the service, so that we can see changes have been made to better meet peoples needs in their own home. We know that people in the home have complex health and communication needs. Four out of six staff say they always have up to date information about peoples needs and two say this is usually the case. This means that staff continue to be aware of the kind of support that people need to meet their needs and keep them well. Annual Service Review Page 4 of 7 When we last visited the service we saw that the former manager had raised concerns about the staffing levels in the service with Mencaps managers. She highlighted that she felt there were the risks to the safety of people living in the home because of staff shortages and the reliance upon agency staff. Staffing levels had improved when we visited. The information sent to us this time indicates that there has been a significant turnover in staff (with 9 having left in the last year). The home is once again making regular use of agency staff. The information shows 32 separate shifts covered by agency staff during the three months before the form was completed and that permanent staff have needed to cover additional shifts. The acting manager says they have tried to ensure that they use the same temporary staff so that people have consistent care. Of the six staff who completed surveys for us, only one was able to confirm that there were always enough staff on duty to meet peoples needs. One wrote that they felt that sickness, the managers vacancy and staff leaving would mean the home would be approximately 126 hours a week short staffed in January. Another commented that sometimes people did not get the one to one support with their day time activities that they needed. We will want to look at this closely the next time we look at the service. Information supplied to us shows that only two of 16 care staff employed have had training in malnutrition care and assistance with eating. This is of concern given the numbers of people at the home with complex needs, who require food to be thickened or processed in a particular way and who need assistance to eat it to maintain their nutrition and safety. We know from our previous visits that staff work hard to try and find alternative ways to communicate with people living in the home so that they are able to make decisions about their care and what they do in their daily lives. They were also making a lot of efforts to try and use technology that would help people with some independence. A survey sent to us by a relative says that they feel the service always supports the person to live the life they choose and says that staff treat each person as an individual regardless of disability. This supports information from the acting manager which shows staff continue to work hard to support people as individuals and that efforts have been made to develop support circles for those people who have limited input from their families. This means staff continue to try and involve people in the running of their home and in day to day decisions as well as providing opportunities for those who are important to the person to raise any concerns about peoples care. Surveys returned to us by people living in the home (helped to complete them by staff) show that only one person was able to communicate clearly that they knew how to make a complaint if they needed to. This means that circles of support and advocacy on peoples behalf by families and staff, is particularly important in raising any concerns. A relative wrote to us that they know how to complain if they need to. We know from our last visit that staff had actively supported someone to express concerns about the way they had been treated and that this had been robustly investigated by the former manager. This shows that efforts are made to establish where there might be any concerns and to resolve them. Annual Service Review Page 5 of 7 We also know from previous visits and from information supplied to us this time, that recruitment continues to provide for proper checks on staff so that people are protected from prospective staff who may be unsuitable to work with vulnerable adults. We acknowledge that the acting managers have worked hard to ensure the day to day running of the service and that they have been aware of the need to inform us when things happen. However, some concern has been expressed to us that morale, leadership and organisation of the staff team has been affected since the home last had an experienced (and registered) manager and that the support available to staff through supervision has also declined. We were told shortly before this review that a manager has now been appointed and is going through the vetting process before starting work. When she is in post, we will want to look at whether this has improved the effectiveness of the staff team, increased support and leadership and promoted retention of staff. We will also want to make sure that the improvements proposed are delivered so that the quality of service people living in the home get, is enhanced. What are we going to do as a result of this annual service review? We think that staff continue to work hard to meet peoples health and personal care needs well and that people are protected. However, reviewing all of the information we have, and changes in the management and staffing of the home, we think we need to change our inspection programme. Under our current inspection regime we would normally carry out a key inspection by 2nd March 2012, with service reviews in between. However, we will carry out a visit to the service by the end of June 2010 to ensure that people continue to receive safe support from a consistent and effective staff team. Annual Service Review Page 6 of 7 Reader Information
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