Care Home: Pelham Lodge Care Home

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Pelham Lodge Care Home Clifton Lane Ruddington Nottingham NG11 6AB two star good service The quality rating for this care home is: 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: Lynda Dyer Date: 0 4 0 3 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. 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 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Pelham Lodge Care Home Clifton Lane Ruddington Nottingham NG11 6AB 01159213272 01159845191 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) : Voyage Ltd care home 9 Number of places (if applicable): Under 65 Over 65 9 0 learning disability Additional conditions: The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disability - Code LD. The maximum number of service users who can be accommodated is 9. Date of last inspection 2 1 0 6 2 0 0 7 A bit about the care home 9 people can live at Pelham Lodge The home is close enough to the village for people to walk there. There is also a bus stop close by. Everyone living there has their own bedroom. There is a large garden for people to use. It costs between £1,067£2,244 a week to live in this home. 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 How we did our inspection: This is what the inspector did when they were at the care home This was a key inspection that looked at the core standards relating to adults and was carried out by an inspector. The report has been written using information we had been given before the inspection and things we saw on the day of the inspection. The acting manager helped us on the day of the inspection. He gave us lots of information and was very helpful. We sent out a survey to people that live in the home, staff that work there and people that visit. 12 people filled in the surveys and sent them back to us. We also asked the acting manager to fill out a form for us. We call this an Annual Quality Assurance Assessment (AQAA). All of this helped us to plan what we needed to look at when we inspected the home. We spoke with four people who live in the home. We spoke with two staff that work in the home. We spoke with one person visiting the home. We looked at two care plans of people that lived at the home. We looked at records that were kept in the home, which included staff records and health and safety records. What the care home does well One member of staff told us about the meetings that people living there have. They said that people could tell staff what activities they would like to do. The staff knew about how the people lived at the home communicated. People living in the home told us how much they enjoyed the activities they got to do. What has got better from the last inspection There was good guidance about the medication to make sure that staff knew when it should be given. One person visiting the home said that there were always activities for people to do and that the acting manager and the staff are very good. The care plans are updated regularly to show peoples changing needs and choices. What the care home could do better When people living in the home help with the reviews of their care plan, they should sign to say they are happy with what the care plan says. There should be a complaints procedure on display in the home telling people who to speak to if they are not happy with the home. 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 Lynda Dyer Cambridge LO CPC1 Capital Business Park Fulbourn Cambridge CB21 5XE 01223 771 300 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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’s needs are properly assessed before admission to ensure that peoples needs can be met in the home. Evidence: In the Annual Quality Assurance Assessment (AQAA) the acting manager told us that the home identifies the needs of the individual from assessment of need and that they include service users in this process. It also states that new service users are offered introductory visits to the service. The care plans of two people living in the home were viewed and these contained the relevant assessments and provided evidence of what the acting manager had told us. We spoke with the most recent admission to the home and they described how they were involved in the assessment process and in the decision to move into the home. They told us about the visits to the home prior to deciding to move in and said, The best thing I ever did was move here. 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 living in the home are supported to make decisions and to take responsible risks to ensure they have control over their daily lives. Evidence: The acting manager told us in the Annual Quality Assurance Assessment (AQAA) that the service provides an individual plan based on the assessment of need, clearly indicating individualised procedures that maybe necessary. The plan is drawn up with the involvement of the service user, family, friends, advocates and relevant agencies as appropriate. Care plans that were viewed were well organised and information was easy to find. They included a range of information that is important to the individual it was written for, such as risk assessments, goals, communication skills, their abilities and how they make choices in their life. The care plans also included information about people’s health and any external professionals involved in their care. Records showed that the risk assessments and the care plans were being reviewed regularly. There was no evidence of people living in the home being included in the reviews. However we spoke to one person living in the home and they told us that they sat with staff and reviewed the information in their care plan regularly and staff confirmed this happened. One person living in the home had an alarm fitted to their door and the acting manager told us that this was to ensure their safety. This could be a potential restriction of freedom and there was not a risk assessment in place that explained why Evidence: this was fitted and giving permission, from that person living in the home, for the alarm to be used. However the acting manager addressed this on the day of the inspection and the required procedures were followed. People living in the home have regular meetings and are able to have input into decisions made about the home. A relative told us, Residents have their say in what they do and dont want People living in the home that are able to manage their own spending money are supported to do this. One person living in the home told us how they were supported to manage their own shopping budget. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living in the home are actively encouraged to develop and maintain social, emotional, educational and independent living skills. People are supported to make informed choices and maintain family and personal relationships. Evidence: We were shown by a person living in the home how their cultural needs were met by their attendance at a local cultural centre that provides activities and also by the staff at the home supporting them to access these links in an independent way. Care plans and activity plans we viewed showed evidence of people living in the home being supported to be independent and involved in all areas of daily living in the home, including where appropriate, taking responsibility for shopping, planning meals, and meal preparation. They also showed evidence of people being supported to access external learning opportunities. On the day of the inspection people living in the home that we spoke to were very enthusiastic about their hobbies and how they liked to spend their day. They showed us how staff supported them to follow their hobbies and interests in an independent way. One member of staff told us, we offer a variety of activities and ensure service users have the opportunity to express their needs and be confident that these needs will be acted on. Another told us, We have meetings, at which service users tell us what Evidence: activities they would like to do and I would say our service helps our clients to live a rich and interesting life. A health care professional was visiting one of the people living in the home on the day of the inspection and they told us that the home is always doing meaningful activities and this has facilitated a more meaningful life for their client. People living in the home were observed having their choices around food and when and where to eat it respected. The menus were varied and people had plenty of choices and opportunity to share in the preparation of the menu and the food. One person living in the home told us, The dinners are lovely. 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 . People living in the home have their healthcare needs met and they receive personal support in the way that they prefer. Medication procedures are safe. Evidence: In the Annual Quality Assurance Assessment, (AQAA) the acting manager states that the home provides service users with the personal support they require in their preferred way and meet the physical and health needs of the service user. Staff told us that people living in the home were able to choose who delivered their personal care and people living in the home spoken with confirmed this. We viewed the care plans of two people living in the home and they showed how people liked to spend their days and how much support they needed with their care. Comments we received from staff members included, Care plans are always up to date and accessible to carers and team leaders always give staff new care plans to read and Staff follow care plans to ensure consistency for service users. A health professional visiting the home on the day of the inspection told us that the staff were very good at following health care matters through and that they had robust health care packages in place. We looked at the medication procedures in the home and observed staff administering medication and this showed that people receive the medication prescribed for them safely. 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 . The home responds to complaints and people are safeguarded. Evidence: In the Annual Quality Assurance Assessment, (AQAA) the acting manager states that the home Provides a clear and effective complaints policy and ensure all service users are aware of its existence and how to use it. Complaints are dealt with in a specified time frame. They also state they Provide robust procedure for responding to any suspicion, allegation or evidence of any type of abuse and Provide a Whistle blowing policy and appropriate training to staff for any necessary physical intervention. They also say that clear recording of service user finances are done following company procedure. There is not a complaints procedure on display for people living in the home or for visitors to follow if they wish to make a complaint. However we spoke to people living in the home and received comments from relatives that showed that people mostly know how to make a complaint. The home has received one complaint in the last year, which was dealt with appropriately and within a specified timescale. The Commission have not received any complaints about the home in the last 12 months. The home has the current local safeguarding procedures in place and staff are trained in safeguarding vulnerable people. Staff spoken with were able to demonstrate how they would respond to abuse in the home. The spending money and records of two people living in the home were examined and they were being managed appropriately. 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 . People live in a safe and comfortable environment. Evidence: In the Annual Quality Assurance Assessment, (AQAA) the acting manager states that the service provides an accessible, homely, clean, hygienic, safe, well maintained, and comfortable environment to meet individual service users needs and current legislation. Several comments in surveys we received said that the home could improve if they redecorated certain areas. Two people told us in surveys we received that the home was never clean. However the rest of the surveys stated that the home was usually clean and the areas that we viewed on the day of the inspection were clean. The garden is very spacious and attractive and offers the room for people to sit or to play outdoor games. There was evidence of people using the garden for games such as football and badminton. The acting manager told us that if the home wins a competition they have entered for most improved care home then there are plans for an allotment and a sensory area in the garden. The dining room, lounges, two bedrooms, the kitchen and a bathroom were looked at during the visit and all appeared clean and bright and homely. The dining room in particular is very modern and is fitted with large windows and French doors, which creates a bright and cheerful place for people to sit. The house is well lived in, and inevitably is subject to wear and tear due to the Evidence: complex needs of the people who live there. Some outstanding minor maintenance tasks were evident on the day of the inspection. Two bedrooms were viewed. Both were very well personalised and set out with the individuals preferences very obviously respected. Staff are trained in Infection control and have the correct equipment to maintain infection control procedures. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has a good staff recruitment procedure, which means that people living at the home should be, as far as reasonably possible, protected from risk from the staff looking after them. Evidence: In the Annual Quality Assurance Assessment, (AQAA) the acting manager states that staff are appropriately trained and qualified and that the service provides a robust recruitment policy. The training files of two members of staff were seen and showed that staff are attending regular mandatory training as well as other training that is relevant to the needs of the people they are supporting. The home has an agreement with the Commission that some of their recruitment records can be stored centrally in the head office of Voyage. The recruitment files of two staff working at the home were viewed and one contained the required documentation. The other contained some of the required documentation and then details of the records that were being held centrally. A health professional visiting the home on the day of the inspection told us, The staff manage behaviours well and this is due to the knowledge of the acting manager and the way he is teaching them to think in a more person centred way. Comments from relatives of people living in the home included, Staff have done wonders with my relative, Different nationalities of staff ensures that needs of the residents are met, Staff are friendly and helpful and Staff are friendly and always have time to talk with you if approached. Evidence: In the surveys we received staff told us that there was always or usually enough staff on duty to meet the needs of the people they supported and they all said that they felt they had the right training that was relevant to the role. One comment was, I am always asked if I would like to go on any training that would interest me, when I have supervision and another member of staff said, We create a homely atmosphere that ensures service users are relaxed and confident and so can discuss anything with staff. One person living in the home told us, I like Pelham, and it has good night staff, morning staff and afternoon staff. Another told us that there was always enough staff on duty. 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 people living there. Evidence: In the Annual Quality Assurance Assessment, (AQAA) the acting manager states that he is currently completing the required qualification for care home managers. The acting manager has been in position for a year but has not yet applied to the Commission for Social Care Inspection to become the registered manager. On the day of the inspection there was a health professional visiting one of the people living in the home and they told us that the acting manager had provided stability, confidence and focus to the home. I now have confidence that my client is now living a better quality life and more so is safely managed by a skilled and competent experienced manager and team. Team members improve and develop their skills in this healthy open working style and environment. Staff members we spoke to talked of how supportive the acting manager was and how much he empowered them to make their own decisions and this gave them confidence and improved their skills. They spoke of how he promoted and developed staff within the home. The 2008 quality assurance surveys and results were viewed and showed that the views of people living in the home were gained and used to include them in the way the home is run. The safety systems in the home, such as fire and water management were up to date. 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 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 17 If an alarm or any other form 06/05/2009 of monitoring device is used for a person living in the home then a risk assessment must be implemented and the persons consent sought and recorded. This will ensure people’s freedom of movement is respected. 2 37 8 The Acting Manager must make an application to the Commission for Social Care Inspection to become the registered Manager. 20/04/2009 This will ensure people live in a home that is well managed. 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 6 Ensure signatures are recorded when people living in the home and their representative, if appropriate, are involved in the reviews of their care plan. Put in place a complaints procedure telling people whom to contact if they wish to make a complaint. This should be accessible to all people living in and visiting the home. This will ensure people know how to complain. The home should improve the maintenance systems so that minor maintenance issues are addressed. This will ensure maintenance issues do not start to pose a risk to people living in the home. A development plan of re-decoration should be implemented and any areas that require decorating should be addressed. 50 of care staff working in the home should hold a National Vocational Qualification (NVQ) in care. 2 22 3 24 4 24 5 32 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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