Care Home: Maple Tree Lodge

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What the care home does well The manager and staff knew about the needs, likes and dislikes of the person living at the home. There was a friendly homely atmosphere and the person living at the home appeared relaxed and at ease.People are given copies of their care plans and other information about the home in an easy words and picture format.People decorate their bedrooms how they like and have their own things around them.There are lots of opportunities to go out and take part in leisure and recreational activities.The home is kept clean and comfortable and there is a nice garden that people can use.Staff keep peoples money safe and receipts are kept for all money spent. What has improved since the last inspection? Since the last inspection, the electrical wiring system at the home has been tested and passed as safe. A new carpet has been ordered for the hallway. Staff induction is specific for caring for people with learning disabilities. What the care home could do better: The registered manager needs more time each week for administration and managerial duties. Some staff health and safety training needs renewing. Some staff health and safety training needs renewing. Key inspection report Care homes for adults (18-65 years) Name: Address: Maple Tree Lodge 87 Byron Street Loughborough Leicestershire LE11 5JN The quality rating for this care home is: two star good 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: Debbie Williams Date: 0 8 0 4 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 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: Maple Tree Lodge 87 Byron Street Loughborough Leicestershire LE11 5JN 01509269637 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): manager.mapletree@aermid.com Aermid Health Care (UK) Ltd Name of registered manager (if applicable) Mrs Julie Cresswell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered provider may provide the following categories of service: 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 Date of last inspection 1 3 0 4 2 0 0 9 Care Homes for Adults (18-65 years) Page 4 of 28 A bit about the care home Maple Tree Cottage is a care home providing personal care and support for up to 3 residents with a learning disability. One resident was living at the home at the time of this inspection. One of the bedrooms was being used as an office. The home is a bungalow, located on a quiet residential road in Loughborough. Residents have their own bedrooms and there is a lounge/dining room, bathroom and kitchen. The home has a small garden to the rear with access via a portable ramp. People are supported to access a range of day care and leisure activities. The charges for living at the home vary depending on individuals assessed needs and level of support required. Care Homes for Adults (18-65 years) Page 5 of 28 Details of what is included in the charges can be found in the service user guide (a document which provides relevant information about the home), which is given to all residents on arrival at the home. A copy of the last Care Quality Commission (CQC) inspection report is displayed in the kitchen of the home, and copies of this report are available from the manager. Care Homes for Adults (18-65 years) Page 6 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: 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 Care Homes for Adults (18-65 years) Page 7 of 28 How we did our inspection: This is what the inspector did when they were at the care home This inspection took place on the 8th of April 2010. We talked with the person living at the home. We looked around the home and looked at some of the papers and files in the office. We looked at care plans and other papers. We talked with the registered manager. What the care home does well The manager and staff knew about the needs, likes and dislikes of the person living at the home. There was a friendly homely atmosphere and the person living at the home appeared relaxed and at ease. People are given copies of their care plans and other information about the home in an easy words and picture format. Care Homes for Adults (18-65 years) Page 9 of 28 People decorate their bedrooms how they like and have their own things around them. There are lots of opportunities to go out and take part in leisure and recreational activities. The home is kept clean and comfortable and there is a nice garden that people can use. Staff keep peoples money safe and receipts are kept for all money spent. Care Homes for Adults (18-65 years) Page 10 of 28 What has got better from the last inspection What the care home could do better The registered manager needs more time each week for administration and managerial duties. Some staff health and safety training needs renewing. Some staff health and safety training needs renewing. Care Homes for Adults (18-65 years) Page 11 of 28 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA Tel: 03000616161 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 12 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 13 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with the information they require to make an informed choice before moving in to Maple Tree lodge. People have their needs assessed before moving in and staff are equipped to meet the specialist needs of people living at Maple Tree Lodge. Evidence: A service users guide is available for people living at Maple Tree Lodge and for prospective residents. This document provides information about the facilities and services provided and enables people to make an informed choice before moving. The service users guide is available in easy word and picture format. The registered manager assesses the needs of all prospective service users to ensure that their needs can be met. There has not been any new people moving in to Maple Tree Lodge for some time so assessment of this outcome area was limited. Staff have been provided with training and have the skills required to meet the specialist needs of people living at maple Tree Lodge, this includes communication skills. Care Homes for Adults (18-65 years) Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessed needs are reflected in individual care plans and the person living at the home was supported to make decisions and take risks as part of an independent lifestyle. Evidence: We looked at care plans and care records. Care plans set out in detail individual needs and preferences and the actions staff needed to take to meet these needs. Social services care plans and care plan reviews were also in place. Care records were provided in formats that were accessible to the person living at the home. Staff had the skills and experience to communicate effectively. Care plans and risk assessments set out the actions staff needed to take to minimize risks and to meet needs, however they had not been reviewed for some time so we made a requirement about this. Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person living at Maple Tree lodge was given opportunities to participate in appropriate leisure activities and take part in age, peer and culturally appropriate activities. Evidence: We looked at records of recreational and leisure activities. People living at the home participate in a full and varied programme of activities which include time outside of the home on a daily basis. People have access to activities and amenities in the local area. Activities provided meet the individual needs and preferences of people living at the home. A ratio of one to one staffing is provided and this ensures that activities and support are provided on an individual basis. Routines of daily living are made flexible to meet peoples needs. We observed interactions between the registered manager and the person living at the home, interactions were positive and it was evident that the relationship was respectful and appropriate. Staff promote independance and involve people in the day to day running of the home. Care Homes for Adults (18-65 years) Page 16 of 28 Care Homes for Adults (18-65 years) Page 17 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. Personal support and Health-care needs were met. Evidence: We looked at care plans and care records, individual needs and preferences were included with care plans. We spoke with the registered manager who demonstrated a good awareness and understanding of needs and preferences. We looked at care records and found that people living at Maple Tree Lodge had good access to health care services and attended regular appointments with dentists, chiropodists and GPs as required. We looked at medication procedures and records and found that medication was being managed effectively and safely. Staff responsible for managing medication had received training in this area. 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. People are protected from harm and the risk of harm or abuse was minimized. Evidence: The providers complaints procedure was included within the service users guide and this was in an easy read format so was accessible to people living at the home. All staff working at Maple Tree Lodge had received training in safeguarding procedures. The registered manager demonstrated a good knowledge of safeguarding procedures and was able to describe the correct actions to take in the event of suspected abuse. Polices and procedures in place for managing peoples personal money minimized the risk of financial abuse. 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. Maple Tree Lodge provides a comfortable, homely and well maintained environment. Evidence: Maple Tree Lodge is a semi detached bungalow in a residential area. The home is registered to accommodate three people but at the time of this inspection one of the bedrooms was being used as an office and one bedroom was being refurbished. The registered manager told us that the provider planned to extend the home in order to provide a separate office and the existing office would then return to use as a bedroom. The home has a lounge dining area which is furnished and decorated in a homely way and provides comfortable accommodation suitable for peoples needs. We looked at residents private accommodation which was personalized to suit the preferences of the person living there. The garden provided attractive and accessible outside space, the person living at maple Tree Lodge was involved in the maintenance and upkeep of the garden area. We made a requirement at the last key inspection that carpets be replaces in the hall, the registered manager told us that carpets were being replaced in the hall and in the empty bedroom the day after this inspection. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: There is a communal bathroom at the home with a walk in shower. All areas of the home were clean and tidy. 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. Individual needs are met by a competent staff team. Evidence: Staff had the skills and experience to meet the needs of the person living at the home and had received training about peoples specific specialist needs. All but one of the care staff employed had achieved a National Vocational Qualification in care. All staff had undergone induction training when they first began working at the home. Staff turnover was low. Induction training provided was specific to work with people with learning disabilities. Staff were deployed on a one to one ratio. Recruitment procedures were robust and ensured that the relevant checks and references were obtained before people commenced working at the home. An ongoing program of staff training and development was in place. The person living at Maple Tree lodge at the time of this inspection appeared comfortable Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: and appeared to have a good rapport with the registered manager. 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 in the best interests of the person living there. Staff are well trained and competent. Evidence: The registered manager was qualified and experienced to run the home. A requirement was made that more supernumerary time be given to the registered manager for management and administration duties. The person living at the home appeared to have a good relationship and seemed at ease with the registered manager. Regular quality assurance audits are carried out by the companies responsible individual and the results of these are sent to the CQC. Staff had completed all necessary health and safety training and information about safe working practices was available for staff at the home. Where possible people living at the home were involved in health and safety training such as fire safety training. Moving and handling training and training regarding the control of hazardous substances required updating but the registered manager told us that this training had been planned in. Information provided confirmed that routine maintenance checks and servicing had been Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: carried out. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes  No  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 Description 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 Description Timescale for action 1 6 14 Care plans must be reviewed 21/05/2010 at least six monthly. This is to ensure that changing needs are reflected within care plans. 2 33 18 04/06/2010 The registered manager must be given sufficient supernumerary time in which to carry out managerial and administration tasks. This is to ensure the home is run effectively and efficiently. 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 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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