Care Home: Sara Lodge

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What the care home does well Residents live in an excellent environment that is appropriate to support their lifestyle and is homely, clean, safe and comfortable. The atmosphere was welcoming and supportive. Staff are well qualified and experienced in meeting the needs of residents. The home ensures that information is made available so that prospective residents can make an informed choice about moving into the home. Comprehensive needs assessments are completed to ensure that residents` needs are known prior to moving in. Care plans are person centred and are easy to understand and look at all areas of the individuals life, which ensures residents needs are known. What has improved since the last inspection? The home has only commenced operation within the last month and this was the home`s first inspection since its registration. What the care home could do better: The service is new and at the time of the inspection, there were no permanent residents living at the home. We found that the home was meeting the National Minimum Standards at the time of the inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Sara Lodge 24 Talbot Crescent London London NW4 4PE     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: Ffion Simmons     Date: 0 2 0 6 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 25 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 25 Information about the care home Name of care home: Address: Sara Lodge 24 Talbot Crescent London London NW4 4PE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Ademola Adedoyin Type of registration: Number of places registered: care home 6 Sara Care Home Limited 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 accomodated is: six The registered person may provide the following categories of service only - Care Home only--Code PC To service users of the following gender: Either whose primary care need on admission to the home are within the following categoroes: Learning Disability-Code LD Date of last inspection Brief description of the care home Sara Lodge offers accommodation and care for up to six residents of either gender who have moderate to severe Learning Disabilities. The aim of the service is to provide a therapeutic residential and respite service, ensuring that whilst they stay at Sara Lodge, that they enjoy the best quality of life. The service aims to provide its residents with a secure, relaxed and homely environment in which their holistic care, well being Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 6 6 Brief description of the care home and comfort are of prime importance. Carers will strive to preserve and maintain the dignity, individuality and privacy of all residents within a warm and caring atmosphere. Sara Lodge is a large family sized six-bedroom two storey house situated in Hendon, London Borough of Barnet. It is situated next to a public park and within easy walking distance of local amenities and public transport links. All bedrooms have en-suite facilities and walk in shower. The home has good sized communal areas and residents have access to a safe and well-maintained garden. Weekly fees for the service range between £1047 to £1500 per week depending on the service and individual needs. Care Homes for Adults (18-65 years) Page 5 of 25 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: The key inspection took place on the evening of the 2nd of June and lasted a total of 4 hours. During the inspection, two residents were receiving respite care. We tracked the care of both clients and in doing so, we checked their personal records. Both residents communicate through nonverbal methods and so we spent time observing staff interaction. A number of other records and documentation were examined during the inspection, including care plans and risk assessments, and policies and procedures. The Acting Manager took time to complete the Annual Quality Assurance Assessment (AQAA), which has also been used as evidence to inform this report. Care Homes for Adults (18-65 years) Page 6 of 25 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 7 of 25 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 8 of 25 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. Prospective residents can be confident that their needs will be comprehensively assessed and they can visit the home prior to admission. The home ensures that information is made available so that prospective residents can make an informed choice about moving into the home. Evidence: The home has a Statement of Purpose and a guide for residents in the form of a Welcome Pack. Both documents were seen during the inspection and available for reference in the reception area of the home. Through checking residents files we could see evidence that this information had been made available to residents and their representatives to enable them to make an informed choice about living in the home. Attempts have been made to make the information within the Welcome pack accessible to the residents through the use of pictures. At the time of the inspection, the home was offering a respite service to two residents. During the visit we checked their personal files. Records showed that the home had spent significant amount of time completing detailed assessments of the residents Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: needs. Residents are invited into the home to meet the residents and staff at different times of the day including evenings, week-end and mealtimes. Staff told us that as part of the assessment process, staff visit the prospective resident in their own home to observe their preferred routines. The AQAA confirmed that Sara Lodge completes a Daily Living Needs Assessment Form, to enable care staff to have initial information, a Risk Assessment Manual Handling Form, and General Risk Assessment Forms all to ensure the prospective service users needs can be met by the home before a place is offered. The home had also obtained information from the residents social workers prior to the residents moving in. Care Homes for Adults (18-65 years) Page 10 of 25 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. Care plans are person centred and are easy to understand and look at all areas of the individuals life, which ensures residents needs are known. Staff understand the importance of residents being supported to take control of their own lives. The management of risk is positive in addressing safety issues while aiming for improved outcomes for people. Evidence: During the inspection, we checked the personal files of the two residents receiving respite care. Each had a care plan outlining their needs, which were based on their initial assessment. The plans covered all aspects of the residents life including health, personal care and activities. The plans were person centred and the AQAA told us that the care plan is reviewed regularly with the involvement of the service user, key worker and the manager. We noted from the AQAA that the home is aware of the need for annual review of the care plans. It was evident through observing the care given to residents and through checking Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: documentation, that the home works closely with residents to ascertain their wishes and preferences. The AQAA told us All our service users will be offered to attend a weekly meeting which gives them the opportunity to make decisions regarding weekly events, meal choices are done on a daily basis and any other issues relating to the running of the home or complaints they wish to bring up. The AQAA told us that all our service users are supported to take risks as part of an independent lifestyle but these are monitored through their individual risk assessments. When we checked the residents personal files we found that both residents had a personal safety and risk assessment on their files. Care Homes for Adults (18-65 years) Page 12 of 25 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. Residents can choose a wide range of creative and stimulating activities that can enhance their lifestyles and they are supported to be as independent as possible. Mealtimes are flexible and the food provided meets the cultural and dietary needs of residents. Evidence: The home confirmed within their AQAA that policies and procedures are drafted to ensure that service users fully participate in the running of the home, informed choices enable service users to take part in appropriate activities. Rights are respected for all service users During the inspection, we noted that residents were supported to keep their usual programme of daily activities whilst receiving respite care, which included attending the local day centre. Staff told us that residents would be supported to make full use Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: of local services. Residents usual programme of activities and preferences with regards to interests were recorded in their care plan. The AQAA told us that all of our service users will make full use of the services, facilities and activities in the local community, this includes the local Day Centre, College, local community events, shops, pubs, restaurants and places of worship. We visited the home in the evening, and observed residents being encouraged to spend time engaging in activities of their choice. Both residents were clearly enjoyed watching TV, drawing, playing snooker, listening and dancing to music. The Managing Director confirmed that residents would be supported to maintain family links and explained how they had encouraged family members to visit the home. The AQAA further confirmed that family members are encouraged (if service users wish) to be involved in the care needs of the individual. During the inspection, staff showed us the pictorial menu which is used to support residents to make a choice about what they would like to eat. We observed residents having their dinner together. Dinnertime was relaxed and unhurried and residents appeared to be enjoying their meals. The AQAA told us that mealtimes are flexible to suite the service users activities and schedules. Service users will be encouraged to help plan prepare and serve the meals. Care Homes for Adults (18-65 years) Page 14 of 25 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. The delivery of personal care is individual and flexible and staff respect residents privacy and dignity and are sensitive to their changing needs. The home has an efficient medication policy to safely support residents with their medication should the need arise in the future. Evidence: During the inspection, we checked residents personal records including their care plans. The AQAA confirmed that service users will have individual plans which state their preferences in the way that they are supported. This was evidenced within the care plans seen. The plans were well detailed and outlined their support needs and preferences with regards to personal care. We were told within the AQAA that the home has good links with the local boroughs learning disability teams, where appropriate referrals are made to support the home with service users who may have physical, emotional or health needs. We noted through checking the care plans, that details relating to residentsmedical history was noted. This information is gained at the initial assessment stage. Current Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: residents were staying only for respite care, however we were told that residents would be enabled to access healthcare services and would be given assistance to excercide choice in accessing health care services of their choice. At the time of the inspection, there were two residents receiving respite care. Neither of these residents were taking any medication and so at the time of the inspection, staff were not administering any medication. Procedures are in place however should the need arise. A medication policy is available for staff reference, and was seen during the inspection. The policy covered procedures to follow when ordering and storing medication as well as administering and returing medication. The policy covers the procedure for supporting residents to self-administer their medication and a risk assessment proforma is available should this be required in the future. The AQAA outlines that the home understands the need for keeping records of medication received, administered and leaving the home or disposed of to ensure that there is no mishandling. The AQAA told us that all staff will and are trained in all principles and aspects of the homes policies and procedures on medicines handling and records. Care Homes for Adults (18-65 years) Page 16 of 25 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 has an open culture that would take concerns seriously should there be any expressed. The policies and procedures for safeguarding adults are clear so that staff can act quickly to protect residents. Evidence: Sara Loge is a new establishment, which has commenced operation within the last month. The home has received no complaints to date. The home has a complaints policy which was available for residents and their representatives within the statement of purpose and welcome pack. A complaint form is available for use to record any future complaints that may be received. The AQAA told us that the complaints procedure has been adapted in different formats to enable service useres to make a complaint if necessary. The home confirmed within the AQAA that the service users will be able to complain and have their views listened to and acted on. The policy The residents staying at Sara Lodge at the time of the inspection were observed to be very comfortable in the company of staff and were clearly enjoying their time at the home. The home has policies and procedures for safeguarding residents from abuse, negtlect and self-harm. They have also obtained copies of the London Borough of Barnets Safeguarding Adults from Abuse policy in pictorial format. This was available on display at the reception area so that residents can see it. The staff team have received training in safeguarding adults, and further training is currently being arranged through links with a local authority. Care Homes for Adults (18-65 years) Page 17 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in an excellent environment that is appropriate to support their lifestyle and is homely, clean, safe and comfortable. Evidence: Sara Lodge is a large family sized six bedroomed , two storey house situated in Hendon, London Borough of Barnet. The home is situated next to a public park and within easy walking distance of local amenities, including shops, post office, GP and Dental surgeries. The home is close to public transport links including the London Underground station. The home has a large, well maintained and secure rear garden offering residents the privacy to enjoy outdoor space. The home has a large living space with comfortable leather seating and a TV for residents to watch. A large dining table with chairs is provided so that residents and staff can sit together to eat. The home has been decorated and furnished to a high standard making the home a very comfortable and attractive place to live. There are six en-suite bedrooms in the home. At the time of the inspection, only two of the bedrooms were occupied. One of the vacant bedrooms on the ground floor had been made into a temporary sensory room and the other vacant room was being used Care Homes for Adults (18-65 years) Page 18 of 25 Evidence: as a games room, and had a snooker table and synthesiser in it. Each room is fitted with an internal fire alarm system, nurse call system, internet, TV cabling and emergency lighting system and automatic door closures. We found the premised to be safe, homely, comfortable and bright. We were told that residents can choose the room they wish to occupy and can choose their own decor. Staff commented that residents can bring in personal items of their choice. Care Homes for Adults (18-65 years) Page 19 of 25 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 homes recruitment procedures are satisfactory for protecting residents. Staff are well qualified and experienced in meeting the needs of residents. Evidence: At the time of the inspection there were two members of staff and the Acting Manager on duty supporting the two residents. We checked the files of two members of staff. This demonstrated that the necessary recruitment checks had been undertaken to make sure that they were suitable to work with the residents. The AQAA confirmed that a comprehensive induction programme and training procedures are in place. The staff currently employed at the home are very experienced and are well qualified with two of the staff holding a National Vocational Qualification (NVQ) at level 4 and another holding an NVQ at level 3. Staffs personal records demonstrated that they were up-to-date in their training in safe working practices. Our observation of staff and residents interaction demonstrated that the staff are very committed to delivering a high standard of care. Staff provided a supportive atmosphere where residents were observed to be enjoying their time at the home. Care Homes for Adults (18-65 years) Page 20 of 25 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 management team has a clear understanding of the key principles and focus of the service, based on organisational values and priorities. They work to continuously improve services. Residents health, safety and well-being are protected by robust policies and procedures and through staff training. Evidence: There has been a change in Management at the home. The Managing Director is currently acting as the Manager of the home. A suitable person has been identified to be the Manager and is currently in the process of applying to the Commission to become the Registered Manager. She holds an NVQ level 4 Registered Managers Award and has gained hands-on care experience and management experience in the care settings for individuals with a Learning Disability and complex behaviour problems. Sara Lodge is a new establishment which has commenced operating within the last month. The home is committed to delivering a high quality service and has a Quality Assurance Manager in post. The Quality Assurance Manager has care and Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: management experience at establishments providing holistic care to vulnerable people. The homes Quality Assurance Manual was shared with us during the inspection. The manual sets out the programme that the home will follow to assess and assure quality. The manual identifies who is responsible for maintaining quality in all areas of care. The programme outlines that Quality Assurance audits will take place regularly, service users and staff meetings will take place quarterly and feedback questionnaires will be sent annually to seek the views of residents, relatives friends, Gaps and other Health Care professionals. The home has an identified person responsible for Health and Safety and maintenance. Policies and procedures are in place for maintaining the health and safety of residents and staff. We viewed the homes Fire Risk Assessment and health and safety checks, which demonstrated that all checks were up-to-date. Staff receive health and safety training and their records showed that they were up-to-date. All hazardous substances were safely locked away at the time of the inspection. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © 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. 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