Care Home: Shore Lodge

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What the care home does well People thinking about moving into Shore Lodge are told in writing about what it is like to live there. A member of staff will visit them before they move in to see what support they need and to make sure that the home is suitable. Shore Lodge is friendly and relaxed. The manager runs it well and makes sure that people who live there are happy. Staff listen to what people want and if they are unhappy, sort it out. They feel at home and enjoy living in a comfortable and well looked after house. People are able to make up their own minds about what they do. They can be themselves and have lots of chances to meet other people, enjoy their hobbies and learn more skills. People are able to see their family and friends when they want. The meals in the home are good. People are given the support they need and staff are polite and friendly. This is written down in a care plan to make sure that staff are clear about how to help. People can get involved in their own care plans, which are kept safely by staff. Staff look after peoples health, help them to see a doctor or specialist if they need to and look after their medication. There are enough staff to support people when they need it. The manager makes sure that staff are trained to do their jobs properly. Staff understand people, fit in with what they need and make sure they are looked after and safe. What has improved since the last inspection? This is the first inspection since the home was registered with the Care Quality Commission in March 2009. What the care home could do better: It would be safer to live at the home if changes were made to the way peoples money is looked after, how people and cars get in and out of the home and how people wash their hands in the laundry. People might enjoy living in the home more if all the gardens were finished and tidy. The support that people need and the way they are looked after could be written down better in some care plans. Key inspection report Care homes for adults (18-65 years) Name: Address: Shore Lodge Greenacres Bow Arrow Lane Kent DA2 6PB     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: Helen Martin     Date: 0 1 0 9 2 0 0 9 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 28 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) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Shore Lodge Greenacres Bow Arrow Lane Kent DA2 6PB 01322220965 01322221016 shorelodge@LCDisability.org www.LCDisabilitv.org Leonard Cheshire Disability Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Yogundrasingh Dullip Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is: Ten (10) The registered person may provide the following category/ies of service only: Care Home only (PC ) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category/ies: Learning disability (LD) Date of last inspection Brief description of the care home Shore Lodge was first established in the 1980s and was under the management of the West Kent and Medway PCT, who transferred the service, under the National Plan for the Re Provisioning of NHS supported accommodation, to Leonard Cheshire Disability. Shore Lodge has been registered with the Care Quality Commission since March 2009. Shore Lodge is a residential care facility that provides purpose built accommodation, within two adjoining bungalow units, for up to ten adults with learning disabilities. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 10 Brief description of the care home Some residents have high dependency needs, including limited mobility and early stage dementias. The premises are discretely separated from the offices and other facilities on the NHS site, having its own main gateway and secure garden areas. Full details of the services provided and the fees charged are available from the Manager. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Shore Lodge provides care and accommodation for up to ten adults with a learning disability. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Shore Lodge was registered with the Care Quality Commission in March 2009. This is the first Key Unannounced Inspection undertaken since, which included a visit to the service on 1st September 2009, where time was spent with six service users. Two Deputy Managers, three Support Workers and one visiting health care professional were spoken with. The Registered Manager was not present during the visit, although was available subsequently by telephone and email. Some judgements about the quality of the service provided were taken from observation and conversation. Some records and documents were looked at together with the premises and facilities of the Care Homes for Adults (18-65 years) Page 6 of 28 home. An Annual Quality Assurance Assessment, AQAA, has been received from the home and any other information received since the service was registered has been reviewed. All of the above have been included within this inspection process and some of the gathered evidence is mentioned in this report where appropriate. Care Homes for Adults (18-65 years) Page 7 of 28 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking about moving into Shore Lodge are given written information about the service, which helps them make an informed choice. Before they move in, people are assessed by the home to make sure that staff can meet their needs. Evidence: Written information about Shore Lodge is available for people who are thinking about moving in. There is a statement of purpose and service users guide about the service offered. Some people have been living at Shore Lodge for some time, whilst others have moved in more recently, since the home was registered with the Care Quality Commission. Before they move in, people are assessed by the home to make sure that staff can meet their needs and care plans for the support that people need are developed from this. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Prospective service users are encouraged to visit the home prior to admission and to stay for at least one night or longer, if possible to allow the opportunity to decide whether or not Shore Lodge is the right environment for them. This also enables the staff team to further assess care and support needs. Where applicable each service user has a contract with the home. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are supported to make choices and decisions about their lives. Their changing needs and goals are reflected in care plans, although the responsibilities of Shore Lodge staff could be better clarified in some records. Although service users are safer because staff take action to reduce the risk of any harm occurring, this could be better reflected in records. Service users confidentiality is protected by the storage of personal records. Evidence: Individual plans of care for each service user are developed with the aim to identify the support required from staff to meet their personal, social and health care needs. Two care plans seen were holistic in nature and reflected service users changing wishes, needs and goals. Information was clear and easy to follow, detailed, individual Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: and up to date. Service users benefit from being involved in their care planning and reviews. One Deputy Manager described the system in place for one service user who receives support from a Supported Living scheme in addition to Shore Lodge. The care plan for this service user reflects the care provided by the Supported Living scheme staff but does not fully reflect the responsibilities and care provided by Shore Lodge. The Provider is recommended to undertake a review of this care plan to ensure that the responsibilities of Shore Lodge staff and a plan of the care provided by Shore Lodge staff are both clearly identified. Service users are supported by staff with any risks involved in being as independent as possible. People are safer, because staff take action to reduce the risk of any harm occurring. Risks are assessed, although not all assessments for service users activities are recorded. The Provider is recommended to undertake a review to ensure that service users activities are fully reflected in written risk assessments. Service users are supported to make their own individual choices. Attention is given to support people to make decisions in all aspects of their life. Service users are able to choose how and where to spend their time and supported with domestic tasks. The confidentiality of service users personal information is maintained through the secure storage of records. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users enjoy individual lifestyles and are able to choose from a variety of leisure activities; they benefit from opportunities for personal development. Contact between service users and their families and friends is encouraged and supported where possible. Residents enjoy a choice of nutritious food. Evidence: Service users are treated with respect and supported with their responsibilities. They are treated as individuals who have different interests and aspirations. Service users are able to choose from a variety of different activities and opportunities. The routines of the home and the number of staff on duty are flexible to accommodate this. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The home employs an activities coordinator five days per week; this includes arranging outings and supporting people to college and day centres. On the day of this visit some service users spent their time at hydrotherapy, relaxing in the lounges, enjoying aromatherapy, shopping, doing a jigsaw and looking at magazines. Specially adapted vehicles are available, enabling residents to partake in the wider community, retaining their independence and accessing leisure facilities. Service users are able to participate in going to the theatre, cinema, having meals out and visiting places of historical interest. There is a sensory room and equipment available. One Deputy Manager described how the home was in the process of arranging holidays for service users. Service users are able to socialise with their family and friends both inside and outside of the home when they wish. Service users benefit from support towards independent living skills, such as in the kitchen and laundry. Each wing of the home has an album of photographs of food and meals to help people choose what they would like to eat. Staff spoken with demonstrated a good understanding of individuals preferences. One Deputy Manager said that the home liaised regularly with the Dietician. Some service users have special diets, for example soft or pureed food. The choices and food that service users eat is recorded and subsequent to the inspection menu plans were received from the Provider. There are plans to change one kitchen to low surface worktops to enable service users to be supported with cooking more easily. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from having their personal and healthcare needs met in a way that they prefer. Service users are protected by the system for the administration of medication. Evidence: Residents dignity and privacy are respected. People are asked about their wishes and needs, which are reflected in their care plans. Staff have an understanding of these and fit in with the preferred routines of each person. Shore Lodge is provides care and accommodation for up to ten adults with learning disabilities. Some service users have complex and high dependency needs, including limited mobility, early stage dementias and challenging behaviour. One Deputy Manager described the system in place for one service user who receives support from a Supported Living scheme in addition to Shore Lodge. Residents are able to see social and health care professionals when they need to and staff support residents to attend appointments. Service users have access to a range Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: of multi disciplinary support, including physiotherapy, speech and Language therapy, psychology, mental health, nutrition and the Community Nursing Service, as and when required. At the time of this inspection, a physiotherapist visited the home; a service user was supported to hydrotherapy whilst another enjoyed aromatherapy. The home provides a sensory room. Staff monitor Service Users nutrition and weight and any ongoing medical conditions. Risks to service users with mobility problems are assessed. Currently no residents manage their own medication and all benefit from support from staff to do so. Residents are protected by the systems in place within the home regarding the storage and administration of medication. All medication is stored securely and administration records are completed appropriately. There are written guidelines available for staff about the administration of drugs prescribed on a when required basis. All medication is prescribed and there are no homely remedies. All staff are trained in the administration of medication and written policies and procedures are available. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of service users are listened to and receive appropriate consideration. Service users would be better protected if improvements were made to the systems in place for managing their personal finances. Evidence: Service users are at ease and relaxed talking and spending time with the staff who listen to their views and concerns. The home provides a written complaints procedure. Service users benefit from access to this in a format they can more easily understand. Records show that since registration with the Care Quality commission in March 2009, the home has received several compliments and no complaints. Written policies regarding the protection of vulnerable adults are available for staff, which include the procedures from the local authority. Staff receive training in the protection of vulnerable adults. The home has developed Best Interest meetings to ensure that any actions or decisions taken on behalf of those Service Users without capacity to give informed consent, are taken in their best interests. Records show assessments regarding the Mental Capacity Act and Deprivation of Liberty. One Deputy Manager described the system in place for managing the financial interests of service users. Cash held on behalf of service users is kept securely, all Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: money is stored individually, transaction records are maintained and these are audited by the home weekly. Cash checked for three service users did not tally with accounts seen. The Deputy Manager explained that this was due to cash taken out today. Not all records and receipts for cash taken out and spent were present as these are not always returned promptly. Currently service users do not have individual bank accounts and the organisation has not yet audited service users monies held by the home. The system in place within the organisation and the home did not make it possible to fully audit service users cash and records at the time of this visit. The Deputy Manager stated that in future the home would arrange an advance from the organisation so that service users who had not yet had their financial affairs organised would not have to borrow from other service users. The Deputy Manager assured us that all money borrowed from service users would be reimbursed immediately. The Provider is strongly recommended to review the system in place for the auditing of service users monies within the home. This should include: Service users should have individual bank accounts; No service user should borrow money from other service users; All records and receipts for service users money taken out and spent should be returned by staff promptly; Leonard Cheshire Disability should audit the homes accounts for service users monies on a regular basis, this should be part of the regular monthly visits from a representative of the organisation to the home. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well maintained, homely and comfortable environment, although their safety and quality of life could be enhanced by completion of planned improvements to the site access and gardens and a review of infection control procedures in the laundry rooms. Evidence: Shore Lodge provides purpose built accommodation, within two adjoining bungalow units. The premises are discretely separated from the offices and other facilities on the NHS site, having their own main gateway and secure garden areas. At the time of registration with the Care Quality Commission in March 2009 discussion took place about improvements to the vehicular and pedestrian access to and egress from the site. It was agreed that improvements would be made to the pedestrian gate and car park entrance and a report was received from the organisation in August 2009. The Registered Manager stated in a telephone conversation subsequent to this visit that the improvements will be made; there has been a delay and they are waiting for the work to start. Each wing of the home has its own garden area, both of which contain areas that are planted with flowers, herbs and vegetables. One garden provides an attractive area in Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: which service users can spend time, although the other is in the process of development and contains some uneven ground. One Deputy Manager described plans for this area. In order to reduce the risk to service users and improve their quality of life, the Provider is recommended to complete their stated intention to improve the garden area for one wing of the home. The building has a style and atmosphere suitable for people who live there. Residents benefit from living in clean, tidy, comfortable and homely accommodation. The premises are suitable for their current needs, well maintained and attractively decorated. Residents have unrestricted access in the house and gardens. Each wing of the home has five bedrooms, a lounge, dining room, kitchen, laundry, conservatory and garden. There is also a sensory room and equipment. Bedrooms are personalised according to each service users preference. One Deputy Manager described how in the past, service users had purchased their own furniture, bed linen and equipment, although since the home was registered with the Care Quality Commission, this had not happened. Discussion took place and it was understood that, as the home is now registered with the Care Quality Commission, Leonard Cheshire Disability, should provide the items detailed in the National Minimum Standards. Each bedroom has ensuite facilities. In addition, there are toilets, bathrooms, a wet room and a shower room which are accessible for wheelchairs. The home provides specialist equipment designed to support service users, for example with mobility problems and wandering. There is a call system in place to alert staff in an emergency. There are plans to change one kitchen to low surface worktops to enable service users to be supported with cooking more easily. Under floor heating is provided with separate temperature controls in all rooms. There are some wall mounted low surface temperature radiators designed to protect service users from the risk of scalding. The premises are clean and hygienic. Residents use the laundry and the kitchen with support from staff, both of which are domestic in nature. The home has procedures in place for infection control, although there are no designated hand washing facilities in the laundry rooms. The Provider is recommended to review hand washing facilities in the laundry rooms in line with infection control procedures and in liaison with the Environmental Health Officer. One Deputy Manager explained that the washing machines in one wing will be able to be used again shortly. The other Deputy Manager stated that the clinical waste bin will be moved to a more appropriate location soon. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home benefit from the support of a committed, trained and supervised staff team who have a good understanding of their needs. Evidence: A good rapport was observed between residents and staff. Staff spoken with were clear about their roles and responsibilities. There were enough staff on duty at the time of this visit to meet service users needs. There are usually five staff during the day with one awake and one sleeping in at night. An activities coordinator is employed five days per week. Staff support service users with all domestic tasks. Staffing levels are flexible depending on service users needs and reflected in a written rota. One Deputy Manager stated that, from now onwards, this would detail the full names of relief staff. The home has a procedure in place which aims to recruit suitable staff who can meet the needs of residents. This includes pre employment checks, such as references, identification and a criminal records bureau check. The Registered Manager explained that all existing staff were recruited by the NHS before the home was registered with the Care Quality Commission, with the exception of one. The Registered manager assured us that appropriate recruitment checks have been undertaken for all staff. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Leonard Cheshire Disability has a national training programme for its staff and there is a Training and Development Officer allocated to the home. An induction programme is in place for all new staff. There is also ongoing training for all staff, which is designed to further develop and update their skills and meet the needs of service users. Records show courses undertaken, include food hygiene, moving and handling, fire and the protection of vulnerable adults. Specialist Training in areas such as Dementia and Acquired Brain Injury can be provided to key staff. The Manager and two Deputy Managers are qualified nurses, whilst several other staff have obtained qualifications, including over 50 per cent at National Vocational levels. Informal staff supervision takes place on an ongoing basis. The home is in the process of developing a Staff Development and Supervision Plan for the year, with the aim that all staff will receive formal supervision a minimum of six times per year with an annual appraisal and Personal Review. The Deputy Managers explained that they were in the process of updating formal supervision for all staff and were undertaking training for this shortly. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy living in a well run home with a relaxed atmosphere. Service users benefit from their views being sought about the service they receive. The health and safety and best interests of people who live in the home are safeguarded. Evidence: Shore Lodge was first established in the 1980s and was under the management of the National Health Service, who transferred the service to Leonard Cheshire Disability, who registered with the Care Quality Commission in March 2009. The Registered Manager is experienced in the management and care of people with learning disabilities and has been working in the home since its registration. They are a registered nurse with an honours degree in Health Service Management and are in the process of undertaking a qualification for Mental Health in Learning Disability and the Registered Managers Award. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: There is an open and inclusive atmosphere in the home. At the time of this visit residents were confident and relaxed chatting and spending time with staff. Residents benefit from being asked about their wishes and needs. The organisation uses a quality assurance system, which includes questionnaires to gain opinions of the service from service users, their families and health and social care professionals. The home undertakes audits on a regular basis. An Annual Quality Assurance Assessment has been returned to the Care Quality Commission. Visits to the home from a representative of the organisation as the Provider take place on a monthly basis. Issues relating to this have been previously mentioned in the Concerns, Complaints and Protection section of this report. The home has a range of recorded policies and procedures that are available for staff. These include complaints, safeguarding vulnerable adults and medication. A number of records have been looked at as part of this inspection and these have been mentioned previously within this report where appropriate. Accidents and incidents are recorded appropriately. Records and certificates seen indicated the regular testing and maintenance of systems and equipment within the home. The premises and the accommodation are monitored and audits and assessments are undertaken to ensure that potential hazards to the health and safety of residents can be identified and addressed. Service users are protected by the procedures in place for the use of cleaning chemicals and the maintenance of food hygiene. One deputy manager stated that hot food temperatures were tested regularly and from now onwards would be recorded. In order to reduce the risks of scalding, all hot water outlets have mixer valves fitted and temperatures are checked regularly. One Deputy Manager described how service users are protected in the gardens by staff supervision and temporary fencing, whilst the gas and electricity supplies are being re routed. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation 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 27 of 28 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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