Care Home: Park Lodge (45)

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What the care home does well The home consults individuals about their satisfaction with the service they are receiving. The service has a settled staff group and has the numbers and skill mix of staff sufficient to meet people`s needs. The management and administration of the home is based on openness and respect, and has an effective quality assurance system in place. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. The staff respect and promote individuals` cultural, religious and spiritual needs. What has improved since the last inspection? There has been improvement made with regards to care planning, staff supervision and quality assurance. Training has also taken place as far as adult safeguarding is concerned and this is ongoing. The home has recently redesigned and restructured the format of the individual`s care plans to make them more accessible to people who use the service. People are encouraged and assisted in developing their inter-personal communication, educational, social, employment and independent living skills. What the care home could do better: The registered provider must ensure that all relevant documentation are in place as stated in Schedule 2 of the National Minimum Standards before staff start working with vulnerable people. The health, safety and welfare of people using the service and staff must be promoted and protected. Key inspection report Care homes for adults (18-65 years) Name: Address: Park Lodge (45) 45 Carshalton Park Road Carshalton Surrey SM5 3SP     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: Mohammad Peerbux     Date: 1 7 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 23 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 23 Information about the care home Name of care home: Address: Park Lodge (45) 45 Carshalton Park Road Carshalton Surrey SM5 3SP 02086694252 F/P02086694252 hoozeer@beeb.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Tracescent Limited care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (CRH - 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 Brief description of the care home Park Lodge is a care home for younger adults with learning disabilities. It is situated on the Carshalton Road between Wallington and Carshalton and is on a bus route. The home is a traditional brick built detached house. It comprises eight single bedrooms. There is a lounge, an open plan kitchen/dining room, a conservatory and other facilities including toilets, 1 bathroom, 2 showers rooms, a laundry room and a small office. 1 5 0 4 2 0 0 9 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 23 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 peterchart Poor Adequate Good Excellent How we did our inspection: This is the first key inspection for the year 2009/2010 and was facilitated by the registered provider. Various records were looked at as well as staff files . All registered adult services are now required to fill in an annual quality assurance assessment (AQAA) .It is a self-assessment that the provider (owner) must complete every year. The completed assessment is used to show how well the service is delivering good outcomes for the people using it. Some information from this AQAA are included in the report. Care Homes for Adults (18-65 years) Page 5 of 23 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. 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 6 of 23 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 7 of 23 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 home undertakes an assessment of the healthcare needs of individuals prior to their admission to ensure that their needs would be met. Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. There has not been any new admission to the service so standard 2 was not assessed fully however this was met at previous inspections. Care Homes for Adults (18-65 years) Page 8 of 23 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. Generally, individuals care plans include detailed information about their needs and personal goals. This helps staff to know their needs and how to meet them. Evidence: There has been improvement made with regards to the standard of care planning. Staff are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. All people who use the service have an individual plan which they are working towards. The care plans are a working document and are reviewed regularly. The home recognises the right of individuals to take control of their lives and to make their own decisions and choices. There is some evidence that individuals are involved in decision making about the home, such as day to day living and social activities. All people are also supported and encouraged to have an active role in the community. Each care plan includes a risk assessment, which is reviewed regularly. The Care Homes for Adults (18-65 years) Page 9 of 23 Evidence: management of risk is positive in addressing safety issues while aiming for improved outcomes for people. Where there are limitations, the decisions have been made with the agreement of the person or their representative where possible. Care Homes for Adults (18-65 years) Page 10 of 23 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. People are being provided with a range of opportunities for recreational and social activity that is in accord with their social, cultural and religious needs. They are assisted in maintaining contact with family and friends, and links with the local community are encouraged. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. Evidence: The service has a strong commitment to enabling people to develop or maintain their skills, including social, emotional, communication, and independent living skills. Individuals are supported to identify their goals, and work to achieve them. People are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. People who use the service have the opportunity to develop and maintain important Care Homes for Adults (18-65 years) Page 11 of 23 Evidence: personal and family relationships. The staff practices promote individual rights and choice, but also consider the protection of individuals in supporting them to make informed choices. The home tries to be flexible and attempts to provide a service that is as individual as possible, using its resources effectively. The service actively supports people to be independent and involved in all areas of daily living in the home. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. Care Homes for Adults (18-65 years) Page 12 of 23 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. Overall the arrangement for health care needs of people is good and they receive personal support in the way they prefer. Evidence: Personal support is responsive to the varied and individual needs and preferences. The delivery of personal care is individual and flexible, consistent, reliable, and person centred. Staff respect privacy and dignity and are sensitive to changing needs. People have access to healthcare and remedial services. Staff make sure that those who are fit and well enough are encouraged to be independent, have regular appointments and visit local health care services. The health care needs of individuals unable to leave the home are managed by visits from local health care services. The home has a medication policy which is accessible to staff, medication records are generally up to date for each person and medicines received, administered and disposed of are recorded. Care Homes for Adults (18-65 years) Page 13 of 23 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 who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse, and have their rights protected. Evidence: The home has a complaints procedure that is clearly written and easy to understand. The procedure explains how to make a complaint and that the complainant can expect a response about the outcome of any investigation to a complaint within 28 days. The policies and procedures for Safeguarding Adults are available and give clear specific guidance to those using them. We were informed that all staff working in the home have had refresher training in Safeguarding Adults. Care Homes for Adults (18-65 years) Page 14 of 23 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 home is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the individuals health and emotional well being. Evidence: The home provides a physical environment that meets the specific needs of the people who live there. The home is kept very clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Care Homes for Adults (18-65 years) Page 15 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has the numbers and skill mix of staff sufficient to meet individuals needs and ensure their safety. Evidence: There are consistently enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. However the provider needs to ensure that staff members are not working too many hours. The service has a recruitment procedure that meets statutory requirements and the NMS. During the inspection we noted that not all staff had all the relevant documentation in place as far as staff recruitment is concerned. Two staff files sampled at random did not have evidence that the person is physically and mentally fit for the purposes of the work they are to perform at the care home. The home recognises the importance of training, and tries to deliver a programme that meets any statutory requirements and the National Minimum Standards. It is recommended that the manager keeps a staff training matrix to ensure staff are up to date with their training. There has been improvement made with regards to staff supervision however further Care Homes for Adults (18-65 years) Page 16 of 23 Evidence: improvement is needed. This was discussed with the provider during the inspection. Care Homes for Adults (18-65 years) Page 17 of 23 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 management generally provides guidance and direction to staff to ensure people receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the individuals. Evidence: The service has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. The manager ensures staff follow the policies and procedures of the home. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are in place to measure success in meeting the aims, objectives and statement of purpose of the home. The AQAA was received on time and contains clear and relevant information. The AQAA lets us know about changes the home has made and where they still need to make improvements. Records with regards to health and safety are of a good standard and are routinely completed. Certificates relating to health and safety were up to date servicing Care Homes for Adults (18-65 years) Page 18 of 23 Evidence: certificates. However the provider must ensure that the hot water temperature in the bathroom upstairs is within the recommended level. Care Homes for Adults (18-65 years) Page 19 of 23 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 20 of 23 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 1 34 19 The registered provider 16/04/2010 must ensure that all relevant documentation are in place as stated in Schedule 2 of the National Minimum Standards before staff start working with vulnerable people. For the safety of people who are using the service. 2 42 13 The hot water temperature must be within recommended level. For the safety of people who are using the service as well as visitors and staff members. 07/04/2010 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 1 35 It is recommended that the manager keeps a staff training Page 21 of 23 Care Homes for Adults (18-65 years) 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 matrix to ensure staff are up to date with their training. Care Homes for Adults (18-65 years) Page 22 of 23 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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