Care Home: Haven Lodge

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What the care home does well The manager tells us in the AQAA, Haven Lodge in February 2009 has achieved the `International Standards Organisation (ISO) award for setting high standards of staff training and development including the recruitment of staff and systems they have in place to ensure people are protected and provided with care and support they need. One staff member said, "Its a big achievement". The admission procedure is thorough due to potential residents living out of the district. The manager tells us in the AQAA they have to ensure they have all the information on a person including health,social welfare, physical and mental health to ensure when they come and stay the staff can meet their needs and provide a good service. One staff member wrote in a survey, "Its very important before people come and stay we have all the information required to make sure we can provide a good service". Our time at the home found routines relaxed with people allowed unrestricted access to communal areas and outside gardens, people were getting ready for the trip out for the day. One resident spoken to said, "I enjoy the trips ". A member of staff said, "We try and create a relaxed atmosphere and give the residents as much independence as possible". Training opportunities and development of staff skills continue to be a priority, so that staff have the confidence and competencies to provide the care and support people who stay at the home need. Some members of staff have exceeded the required qualifications to work in a care home to ensure they continue to develop skills. One staff member said in a survey, "You are always supported to go on courses". A staff member spoken to said, "The manager encourages staff training". What has improved since the last inspection? There is programme of refurbishment to the home, and walking around the building we found some new furniture in bedrooms, new televisions and the manager tells us in the AQAA all carpets have been professionally cleaned to make the home pleasant for people on holiday. One person who stayed on holiday at the home wrote in a survey, "Its a lovely home, always clean". What the care home could do better: We advised the manager some repainting of doors in hallways and walls would improve the look of the building and keep it well maintained. The manager spoken to said, "There is a rolling programme of redecoration". Key inspection report Care homes for adults (18-65 years) Name: Address: Haven Lodge 80 West End Road Morecambe Lancashire LA4 4DY     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: Kevan Royston     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 28 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 28 Information about the care home Name of care home: Address: Haven Lodge 80 West End Road Morecambe Lancashire LA4 4DY 01524418309 01524418309 havengroup@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Miss Sylvia Peters Name of registered manager (if applicable) Miss Julie Pauline Brown Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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: Learning Disability - Code LD Tha maximum number of Service Users who can be accommodated is: 7 Date of last inspection Brief description of the care home Haven Lodge is situated in Morecambe and is registered as a home providing holidays and respite care for up to seven people with learning disabilities. Accommodation is provided in single bedrooms which are adequately fitted and furnished. Care and activities are provided after a thorough assessment. A team of well motivated staff is employed by the home to meet the social and care needs of the people who come to stay. Care Homes for Adults (18-65 years) Page 4 of 28 7 Over 65 0 Brief description of the care home Admission to Haven Lodge is strictly short term as no permanent residents are accepted. There is a Service user Guide and Statement of Purpose outlining the details of the home and service provided, so people can make an informed choice. The cost of stay at Haven Lodge is based upon the assessments of the people, the level of personal needs and activities they require. The lower rate is £415 per week with no upper limit. Care Homes for Adults (18-65 years) Page 5 of 28 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 unannounced visit was part of the key inspection process and took place on the 16/03/10. We spoke to people who are staying on holiday at the home, staff, the manager, and briefly to a group of residents in the lounge. Care, maintenance, previous inspection reports and other records were looked at, as well as a walk around the building. As part of the inspection process we talked to people using the service and asked staff about those people needs. We also looked at their rooms, care plans and daily notes, this is called case tracking. Other people who staying at the home were invited to pass their opinions to us if they wish. We received responses from surveys/ questionnaires sent to people who are staying at Haven Lodge and staff for their views on how the home is run. Comments we did receive were positive and some are included in this report. Care Homes for Adults (18-65 years) Page 6 of 28 Every year the person in charge or manager is asked to provide us with written information about the quality of their service they provide and to make an assessment of the quality of their service. This document is called an Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. Care Homes for Adults (18-65 years) Page 7 of 28 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission and assessment procedures are clear and presice to ensure the care and support needs of people who come to stay on holiday can be met. Information gathered at the assessment stage for people is thorough and comprehensive. Evidence: We looked at the assessment information for people who are staying at the home, and found all relevant information regarding health and social care to ensure their needs can be met. One staff member said, its important to get as much information as possible. Social Services assessments and mental health information had been obtained by the manager before people moved in to ensure they have all the information needed to provide care and support whilst on holiday. One person staying at the home spoken to said, Its a nice place to stay. Pre- admission visits by prospective residents who are considering coming to stay are not practical, however the manager confirmed families and social workers are very welcome to come for tea or a trial visit. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: To help ensure staff can provide the care and support and help people have a good holiday whilst at Haven Lodge the manager has put together extensive brochures which include a picture format of the home, with all the information people need to make an informed choice. One staff member spoken to about the admission process said, Comprehensive information is sent out to people and families who are considering coming to stay. Care Homes for Adults (18-65 years) Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported to make decisions daily,which help them in daily life whilst taking risk into account. Evidence: We looked at care planning records and action staff are taking to provide the support people need to have an independent lifestyle as possible whilst on holiday. Care records clearly identified the physical and social needs of people staying at Haven lodge to ensure they receive the right care. Staff spoken to had knowledge of what support and care is required to help people have a good holiday and be as independent as possible. The manager tells us in the AQAA how they have improved risk assessments by using previous information from people who have stayed, and information from social workers and families. This ensures people are kept safe and allowed to be as independent as possible within a risk framework. One staff member said, We have improved our care planning. One resident spoken to said, I tell them what I would Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: like to do. As a course of good practice reviews of care for each person are carried out on a daily basis due to residents only staying for a short while and their changing needs for activities and outings. One resident wrote in a survey, The place is excellent. Care Homes for Adults (18-65 years) Page 14 of 28 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. Meals are suited to the individual person staying at the home, they are well balanced and nutritious. Activities are centred around the choices of people staying at the home. Evidence: The people who come and stay at Haven lodge are on holiday and from different regions therefore not involved in the local community. However the staff encourage trips out to local amenities and social events to ensure people mix with the local public. One staff member wrote in a survey, Its most important to get people to know the local area. This is a small home and the kitchen area is of a domestic character. A member of staff was preparing a meal for when the residents returned from their trip out. Evidence of fresh produce, fruit in a basket on the dining table and fresh vegetables in Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: the kitchen. Comments about the food included, Meals are flexible and individual choices can be met due to the small number of residents on holiday. Also one person staying here on holiday said, great food. As this is a holiday respite home activities are centred around individual choices on a daily basis to ensure people have a good time and enjoy what they like to do. We looked at daily care records, activities, spoke to people who live at the home, staff and confirmed opportunities to take part in daily trips out and activities are the choices of the residents. One relative of a person who uses the home said, My son loves the home and the daily trips out are excellent. One person staying at the home said, I like going out on the trips. The amount of staff on duty is high so that people can be supported individually and enjoy things they like to do daily One staff member spoken to said, We do have more staff on duty which benefits the residents Care Homes for Adults (18-65 years) Page 16 of 28 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. Promotion of health is taken seriously and they have good systems to monitor residents health needs. Evidence: The people who are staying at Haven lodge are from out of the district, however the manager tells us in the AQAA arrangements are made with local GPs should any health problems arise. One staff member spoken to said, It works well . The manager informs us in the AQAA how people who are staying here are supported with personal care needs if required and according to to their wishes. One staff member wrote in a survey, We promote as much independence as possible when It comes to people looking after themselves. We found good systems in place to ensure medicines are given out correctly and at the right time for people staying at the home. A staff member said, Staff trained give out medication. We saw during the morning staff helping, encouraging and supporting residents in a sensitive, respectful private way to ensure people are treated with dignity and respect. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: One staff member spoken to said, The residents are always treated with respect and dignity It is important to be respectful and treat every one as an individual. Care Homes for Adults (18-65 years) Page 18 of 28 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. Procedures for complaints are in place and handled well to ensure people feel listened to. Evidence: There is a complaints policy and procedure which is given to all people who come to stay at Haven lodge and their families. Staff spoken to and comments from surveys returned confirmed people are aware of the procedure and what to do should they wish to complain. There has been no complaints since the last inspection. Surveys returned from people who stay at the home all ticked the box yes when asked if they knew who to speak to if they had a complaint. We spoke to staff and the manager and confirmed training has been provided for Safeguarding Adults. One staff member spoken to said, We have recently done our Safe guarding training. The manager tells us in the AQAA they have introduced a brochure outlining all the issues around safeguarding and abuse to ensure people who come and stay and their families are aware of any safeguarding concerns and the procedure to follow. Care Homes for Adults (18-65 years) Page 19 of 28 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. The building is kept clean and tidy and maintained. Evidence: We had a walk around the home and found it to be clean, tidy and maintained. The building is a large home, the furnishings and decoration are homely and ensure people live in pleasant comfortable surroundings. Comments from people who come and stay included, Its kept clean and tidy. Also, A nice place to come and stay. The manager tells us in the AQAA how they have improved the surroundings by replacing televisions with new up to date screens, continued decoration of communal areas and kitchen equipment replaced to ensure people who stay live in comfort. Walking around the building we found some hallways and doors with paintwork chipped which we pointed out to the manager. The manager informed us a programme of redecoration was ongoing and the areas would be repainted to ensure the building continues to be well maintained. We looked at maintenance records and found repairs are written down to be attended to as soon as possible by staff if minor or contractors to ensure people are kept safe and the home is maintained. There is a laundry facility which is situated away from the kitchen and food Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: preparation area. Policies and procedures are in place for the control of infection to protect and safeguard people. Care Homes for Adults (18-65 years) Page 21 of 28 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. The availability of training and good access to courses means the staff are well trained and have the skills to support people who live at the home. Thorough recruitment procedures are in place to make sure suitable staff are employed. Evidence: We looked at staffing rotas, spoke to staff and watched people being helped to get ready for the arranged trip out, and found sufficient numbers of staff on duty to ensure the needs of people who are staying at Haven Lodge are being met. On the day of the visit there was plenty of staff so that one to one support could be given if any person needed it. One staff member wrote in a survey, There is enough of us to provide a good service to all the residents staying here on holiday. One person staying on holiday said, Plenty of people to look after me. Thorough recruitment procedures are in place to ensure suitable people are employed. We looked at staff records for recruitment and found all the checks required were in place and each staff member had been checked properly and received induction training. Speaking to staff and information in the AQAA confirm there has been no change in personnel for a long time which helps staff understand each other better and provide Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: quality support for people coming to Haven Lodge on holiday. One staff member spoken to said,We all get on well together. Training opportunities are good for staff to develop their skills and ensure people staying at the home receive the right care and support from a competent staff team. One staff member said, Training is very good. The manager tells us in the AQAA 75 of care staff have completed the National Vocational Qualification (NVQ) to level 2 which is a recognised qualification in care. One staff member said, I have completed level 3. Staff spoken to said they are clear about their role and work well in a small staff team to ensure the individual and collective needs of people staying on holiday are met. Care Homes for Adults (18-65 years) Page 23 of 28 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. The home is run well with good systems in place for the protection of people who work and stay on holiday at the home. Evidence: The manager has the necessary skills and is qualified to support staff and people who come and stay at Haven Lodge on holiday and ensure the home meets it aims and objectives. Comments from staff and surveys returned praised the manager on how the home is run,they included, A very good manager, and, A nice place to work. One resident on holiday spoken to said, I love coming here. There are good systems in place to get together staff, relatives and residents views on how the home is developing and how they feel the home is run. There are regular staff meetings and questionnaires given out to residents and families at the end of the holiday to get opinions on how the home operates. Records looked at for people who are staying at the home we case tracked were found to be comprehensive,well written, easy to follow and up to date, ensuring the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: information contained was correct and health and social care needs are continuously monitored during their stay. We looked at health and safety records and found a procedure in place for recording any accidents, regular checks on fire safety procedures and all equipment checked, ensuring the people who stay and work at Haven Lodge are kept safe. Haven Lodge has achieved the International Standards Organisation (ISO) award for setting high standards of how the home operates, staff training and development including the recruitment of staff and systems they have in place to ensure people are protected and provided with care and support they need. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 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 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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