Care Home: Marlborough Lodge

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Annual service review Name of Service: Marlborough Lodge The quality rating for this care home is: The rating was made on: two star good service 1 0 0 2 2 0 0 9 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Michele Etherton Date of this annual service review: 1 7 1 2 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: 253 Wishing Tree St Leonards-on-Sea East Sussex TN38 9LA 01424854103 01424854103 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Name of registered manager (if applicable) Trustcare Management Ltd Conditions of registration: Category(ies) : learning disability Conditions of registration: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Marlborough Lodge is owned and operated by Trustcare Management Ltd and is located in St Leonards on Sea. The home is registered to provide care and accommodation for up to six younger adults with a learning disability. The home is arranged over three floors consisting of six single occupancy bedrooms with en-suite shower rooms, a large lounge, dining room, kitchen and conservatory. Additonally Annual Service Review Page 2 of 8 Number of places (if applicable): Under 65 Over 65 6 0 1 0 0 2 2 0 0 9 there is a jacuzzi bathroom, a downstairs WC and a kitchenette for service users to use independently (where able). There are well maintained gardens, that are easily accessible to service users. There is parking to the front of the house. The town centre with its shops and access to bus and rail travel is approximately two miles away. Other local amenities are also within a short distance to the service. The range of fees charged is from £1000 to £1600 per week. Additional charges are made for chiropody and aromatherapy sessions. Potential new service users can obtain information relating to the home via the internet on the CQC website, from Care Managers, Placing Authorities, by word of mouth or by contacting the home directly. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Information we may have about how the service has managed any complaints. Surveys returned to us by residents and staff using the service and other stakeholders we may have asked to comment. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection. Relevant information from other organisations. What other people have told us about the service. What has this told us about the service? The home sent us their annual quality assurance assessment (AQAA) when we asked for it. It was clear and gave us some of the information we needed, it would benefit from more reflection on how the service can improve on current practise and future development of the service. At our last inspection we asked the home to ensure that the residents all had contracts detailing the terms and conditions of their residence, the service has advised us that this has now been implemented. We are also informed that the service has also put into place the good practise recommendations issued at the last inspection, these have included ensuring that service users cash books have two signatures for all transactions. The picture menu has been supplemented with the introduction of a widget menu also. The service has informed us that the complaints procedure has been updated and a 28 day response time included. The AQAA tells us that in the last 12 months the home has received two complaints both of which have been resolved. Two adult safeguarding alerts have been raised and dealt with appropriately. The service acknowledges within AQAA information that relatives may benefit from routine reminders of the complaints process, and it is their intention to implement annual reminders. We have been advised that all documentation including policies and procedures has had the term service user incorporated, review dates have also been added to policy and procedure information. Annual Service Review Page 4 of 8 The AQAA also informs us that changes to the care plan and user guide formats have been made to provide improved access to this information for a service user with some visual impairment. A breakdown of fees is also now included within care plan information to inform service users what is included in their fees and what things they have to pay for. The AQAA tells us that the service has been proactive in making referrals to health care professional to ensure that service users receive appropriate support for their emotional and physical health care needs. The service has indicated that there would be benefits in involving family members more in support of health plans but recognise this can only be progressed with the support and permission of service users. Although service users currently have access to a good activity schedule, the service is trying to also encourage their involvement in more meaningful and educational activities, and staff will be helping to identify additional sources of activity for service users to participate in. The service has highlighted within the AQAA and recognises the need to improve the education of service users in regard to healthy eating. This includes the support they are provided with to help them choose meals, undertake the cooking and preparation of meals, and raise awareness of maintaining good personal hygiene when cooking or at meal times. To ensure that day staff are available to support service users with activities, the AQAA informs us that the majority of cleaning is now undertaken at night. Schedules have been developed for service users to participate in the upkeep of the home through undertaking household chores and the service should ensure this expectation is made clear within Statement of Purpose and user guide information. The AQAA tells us that the service has revised its recruitment policies and implemented a new application form. Personal developments plans have also been developed for every staff member. The service has indicated that the routine checking of CRBs would be beneficial but recognise this must be company and not service led. We are further informed that there are plans to appoint a dedicated training person for the company; whose role will be able to identify staff training needs and establish training programmes to fulfil mandatory and specialist training requirements. The Current registered manager who is also a company director informs us that he will be stepping down from this post, a new manager has been appointed and commenced working in their new role on 17th December 2009. We are advised that an application to register the new manager is underway. The company is aware that following the changes to the current management arrangements, there will be a need for regular provider visit reports to be completed in keeping with regulation 26 of the Care Homes Regulations 2001. The AQAA informs us that In view of the impracticalities of maintaining the level of health and safety tests required for the Jacuzzi facility in the garden the company has made the decision to remove this. The company informs us within AQAA information that systems are in place to ensure constant monitoring and review of the service takes place, we have clarified with the home manager that this is undertaken monthly by the deputy or manager who checks Annual Service Review Page 5 of 8 all paperwork, and follows up on anything outstanding. We are advised that where shortfalls are identified these are acted upon and policy and procedure information updated accordingly if needed. We looked at the information in the AQAA and other information we have received, and our judgement is that the home is still providing a good service and that they know what further improvements they need to make. In survey responses service users living in the home have responded positively about their experience of the service they tell us that: I have continued with the activities I had in my old home and I havent had to change my routine. staff are helping me with some things, this means I can do things for myself. I like the home, staff, my room Most service users who responded said they understood how to complain and were clear who they might tell if they are unhappy, one person said they did not know and the home should ensure that all residents feel equally confident of their right to complain and how they might do that. One person informed us that they wanted to live on their own but did not feel that staff were supportive of this and had expressed views about the likely success of such a move. The home has made clear that whilst they respect the rights of the individual to express their view, the individual concerned has a full understanding as to why such a move is not possible and this decision has the full backing and support of the local authority specialist team. Staff who responded to surveys commented positively about the home they told us: The home promotes change, rights and independence Offers wide variety of options and ideas for each individual, its person centred, warm and friendly atmosphere. We asked for health and social care professionals who have links with the home to complete surveys too, again overall feedback is positive about the way the service supports service users they commented about the service that: Helps service users live independent as much as possible and help to do the things they like to do. Independent living, healthy eating promotes equal opportunities and diversity, social skills good training for staff. Always doing training working individually and as a team for ongoing development of the company to achieve the best standard of care. Annual Service Review Page 6 of 8 The service works in a person centred way much time was spent finding new day time activities after a service user disengaged from a chosen college course. I have only positive experiences of this home and organisation. One suggestion for how the service could improve was that it could be more environmentally aware. The service has informed us within AQAA information that it has an awareness of its environmental responsibilities and that the company already has some measures in place for recycling but recognises this can be improved upon and are considering implementing and environmental management system. The home continues to let us know about things that have happened since our last key inspection and they have shown that they have managed issues well. They work well with us and have shown us that their service continues to provide good outcomes for the people who use it. What are we going to do as a result of this annual service review? We are not going to change our inspection plan, and will do a key inspection by 31st January 2011. However we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 7 of 8 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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