Care Home: Links Lodge

What the care home does well Links Lodge has achieved the `Investors In People Award` , which means the home has been assessed by an independent body of providing a high standard of care for people. The manager said, "Everybody has contributed". We watched during the day staff talking to people and responding in a relaxed, respectful and informal way, respecting their privacy by speaking to people in their own rooms when a problem came about. Comments from staff and people who live at the home included, "Training in respect and dignity has helped my confidence when dealing with people". Also, "They are nice to me". The assessment process for people to come and live at Links Lodge is excellent, with detailed information of health, social and welfare needs of each resident in place to ensure there needs can be met. Pre- assessments are carried out by qualified staff and trial visits are arranged to ensure they can meet the needs of potential residents. This was confirmed by talking to staff, people who live at the home and looking at assessment information. One staff member said, "We all get involved in the assessment process". It was clear by looking at the information in the AQAA, talking to staff and looking at training records,opportunities for development and the qualifications staff have achieved is excellent. People spoken to confirmed they have excellent access to both In-house courses and are supported by the manager to attend external training to ensure staff develop. The manager spoken to said, "We have 100% of staff who have completed NVQ to level 2". One member of staff wrote in a survey staff, "They keep staff training up to date". What has improved since the last inspection? The requirements made at the last random inspection in November 08 have been addressed. Although no new staff have been employed since the last inspection all staff employment records have been checked to ensure all the information and checks needed for employment have been completed. The manager has improved procedures to inform us the `Care Quality Commission` of any events or incidents that take place and ensure the welfare of the people who live at the home is maintained. This was a requirement made at the last inspection November 08. Walking around the home we saw improvements to the furnishings and general building with a new `decking` area outside, new carpets in some rooms and a new bath/shower room completed to make sure the home is comfortable. One person who lives at the home when asked what she thought of the alterations said, "Its really lovely". One staff member wrote in a survey, "Always clean and well maintained". We found care records of people who live at the home have been improved and are much easier for staff to follow and understand, They, provide all the information of the persons physical and mental health,welfare and social needs which are reviewedregularly and identify individual goals, to ensure they receive the professional support and guidance to help build confidence and as much independence as possible. One staff member said, "We have worked hard in developing thorough care plans". What the care home could do better: We spoke to staff and looking at the information provided in the AQAA, we advised the manager to look at providing training in `End of Life training` so that staff gain a knowledge and understanding of the issues around providing the right care and support people would need. One member of staff said, "It would be useful and give me a better understanding". Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Links Lodge 16 Links Road Blackpool Lancashire FY1 2RU     The quality rating for this care home is:   three star excellent 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: Kevan Royston     Date: 3 0 0 4 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 27 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 27 Information about the care home Name of care home: Address: Links Lodge 16 Links Road Blackpool Lancashire FY1 2RU 01253354744 01253590198 bdlumb1@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Karen Bradley care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 8 1 9 1 1 2 0 0 8 Links Lodge is a care home for up to eight adults with learning disabilities. The home is a large detached house situated in the North Shore area of Blackpool, close to the sea front and local amenities. There are six single bedrooms and one double bedroom. One is en-suite. There is a large lounge area that leads to a sunroom and a kitchen/diner. There are spacious gardens at the front side and rear of the home. There is a statement of Purpose/Service user Guide, which is given to all prospective residents/relatives. This written information explains the care service treatment programme that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. The fees at the home range from £490.00 to £980.00 per week. There are no additional costs. Care Homes for Adults (18-65 years) Page 4 of 27 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: We visited Links Lodge unannounced on 30/04/09 as part of the inspection process. The visit lasted approximately 5.0 hours. We spoke to people who live at the home, staff and the owner/manager to get their views of the home. Also we looked at care records, documentation which helped in the running of Links Lodge and had a walk around the building with the manager and a person who lives there. We also As part of the inspection process we talked to residents and asked staff about those residents needs. We looked in their rooms, checked care records and daily diary notes, this is called case tracking. Other residents are invited to pass their opinions to us if they wish. We sent survey/comment cards to staff and residents for there views on how the home is run. The comments were positive and some are included in this Care Homes for Adults (18-65 years) Page 5 of 27 report. Every year the person in charge or manager is asked to provide us with written information about the quality of the service they provide, also to make an assessment of the quality of their service. This document is called annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. What the care home does well: What has improved since the last inspection? The requirements made at the last random inspection in November 08 have been addressed. Although no new staff have been employed since the last inspection all staff employment records have been checked to ensure all the information and checks needed for employment have been completed. The manager has improved procedures to inform us the Care Quality Commission of any events or incidents that take place and ensure the welfare of the people who live at the home is maintained. This was a requirement made at the last inspection November 08. Walking around the home we saw improvements to the furnishings and general building with a new decking area outside, new carpets in some rooms and a new bath/shower room completed to make sure the home is comfortable. One person who lives at the home when asked what she thought of the alterations said, Its really lovely. One staff member wrote in a survey, Always clean and well maintained. We found care records of people who live at the home have been improved and are much easier for staff to follow and understand, They, provide all the information of the persons physical and mental health,welfare and social needs which are reviewed Care Homes for Adults (18-65 years) Page 7 of 27 regularly and identify individual goals, to ensure they receive the professional support and guidance to help build confidence and as much independence as possible. One staff member said, We have worked hard in developing thorough care plans. 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 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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. The admission and assessment procedures are clear to ensure the care and support needs of residents can be met. Evidence: Assessment information looked at for people who live at the home had good information before the person moved in. There was evidence of trial visits, staff and resident involvement in the assessment process to ensure people liked the home and felt comfortable. A Staff member spoken to said, We encourage flexible introductory visits to the home. This helps build relationships at an early stage and ensure people who live at the home can have their needs met. 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 the care, support and develop a care plan for each person. Staff spoken to and responses from staff surveys confirmed they have a clear understanding of how the assessment procedures work and are part of the process to Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: ensure they can meet the needs of people coming to live at the home. One staff member wrote, Its important to be involved when residents first come here. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home are supported to make decisions,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. Care records clearly identified the physical and social needs of people living at Links Lodge to ensure they receive the right care. Staff spoken to had a good knowledge of what support and care is required to help people who live at the home achieve an independent life as possible. One staff member wrote in a survey Service users are involved in the care they receive, A person who lives at the home spoken to said, I am well looked after. Following the assessment of the individual staff work closely with the person to develop a plan of daily life which promotes independence and allows risks to be taken with support and guidance. The manager tells us in the AQAA how care planning has Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: improved by developing easy detailed care plans for staff to follow and also to provide training for staff in risk taking to enable to give support to people taking risks as part of normal independent lifestyle. One staff member said Its a good way of helping service users. Records looked at show risk assessments are completed for each person and reviewed on a regular basis and where needed are updated, to ensure risk taking is part of the plan to improve confidence and independence. People who live at the home are involved in decision making within their individual care plan to build confidence. One resident said, I enjoy going out. Care Homes for Adults (18-65 years) Page 13 of 27 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. Opportunities for development are provided through each individuals individual daily plan. Meals are managed well and provide a wholesome nutritious diet. Evidence: We looked at daily care records, activities, spoke to people who live at the home and staff and confirmed opportunities to take part in the local community is available according to each persons daily programme. One person who lives at the home spoken to said. I like shopping. Records show each person has a daily life plan of activities, community based activities and events which includes going out into the local community and educational centers. One person who lives at the home said, I like the center. This is a small home and the kitchen area is of a domestic character. A member of Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: staff was preparing lunch which was home made meals with a choice. Evidence of fresh produce- fruit in a basket on the dining table and fresh vegetables in the kitchen. Comments about the food included, One member of staff is a very good cook. Also, Good food. Care Homes for Adults (18-65 years) Page 15 of 27 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: Care records looked at show they have good systems to access health care services within the community and monitor individuals needs to ensure any health problems can be addressed. The manager informs us in the AQAA how people who live at the home are supported with personal care needs according to to their wishes. One staff member wrote in a survey, We keep up to date with the service users health so we can provide the right care. We saw during the day staff helping people who need personal care support in a sensitive, respectful private way to ensure residents are treated with dignity and respect. One staff member spoken to said, It is important to be respectful and treat every one as an individual. We watched at lunchtime how medication was administered and checked medication Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: records. We found good systems in place to ensure medicines are given out correctly and at the right time. A staff member said, Staff with training give out medication Care Homes for Adults (18-65 years) Page 17 of 27 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 live at Links Lodge and there families.Staff spoken to and comments form 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. We spoke to staff and the manager and confirmed In- house training has been provided for Safeguarding Adults,one staff member spoken to said, Safeguarding adults training is provided by the home. Staff have previously attended courses with the Learning Disabilities Award Framework (LDAF) to ensure staff have a knowledge of abuse issues. Staff wrote in surveys returned, They keep us up to date with abuse training. Staff and the manager spoke of how they have an open approach to encourage comments through daily discussions, resident and staff meetings, this goes some way in sorting out any concerns before they become formal complaints. Care Homes for Adults (18-65 years) Page 18 of 27 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 well. Evidence: We had a walk around the home and found it to be clean and tidy and looked after to a high standard. The building is a large family home and the furnishings and decoration are homely and ensure people live in pleasant comfortable surroundings. We were guided around the home by a person who lives at the home who said when asked about what she thought of the home ,I love my room. Although this is a small family run home there are areas for residents to see people in private and join in activities if they choose. We looked at maintenance records and found repairs are written down to be attended to as soon as possible by a member of staff 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 preperation 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 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 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 excellent 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 around the home and found sufficient numbers of staff on duty to ensure the needs of people who live at Links 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, We are able to give support to each service user. One person who lives at the home spoken to about the staff said, I like them. There have been no new staff employed since the last inspection of the home and speaking to people confirm staff are settled and work well together with little change in personnel. One staff member said, We know each other well. Training opportunities are excellent for staff to develop there skills and ensure people living at the home receive the right care and support from a competent staff team. One staff member said, Training opportunities are very good. The owner tells us in Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: the AQAA 100 of care staff have completed the National Vocational Qualification (NVQ) to level 2 which is a recognized qualification in care. One staff member said, I am now doing NVQ level 3. We advised the manager to look into staff training for palliative care which would help people to be more aware of issues and how to support the residents. One staff member commented We are aware of the need for staff training in this area. 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 residents are met. Care Homes for Adults (18-65 years) Page 22 of 27 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 excellent 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 live at the home. Evidence: The manager has the necessary skills and is highly qualified to support staff and people who live at the home and ensure Links Lodge meets it aims and objectives. The manager also is a qualified trainer for NVQ and can provide in house training courses for staff to develop their skills. One staff member wrote, A good supportive manager. 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 sent to relatives and people who live at the home to get their opinions on how the home operates. One person when asked what she thought of the home and people who run it said, Very good, they are all very nice . Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Records looked at for people who live at the home we case tracked were found to be comprehensive,well written, easy to follow and up to date, ensuring the information contained was correct and health and social care needs are continuously monitored. 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 live and work at Links Lodge are kept safe. One staff member spoken to about health and safety said We have now involved Peninsula (a company which specialises in the formulation of policies and procedures) and updated policies and procedures. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 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. 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