Care Home: St Davids Lodge

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What the care home does well When we arrived people were sitting in the lounge watching TV, knitting and preparing for the World Cup. People told us about their day and what they were doing. They explained their calendars of activities and the occasions when their photographs were taken. We asked people how they spent their day at the home and one person said that they do cooking, decorate gnomes and watch TV. Another said that on that day they had gone to Weston-Super-Mare as a birthday outing. These individuals were then consulted about the way their needs are met. One person felt well cared for and said that the staff are good and know how to meet their needs. Their comments about complaints were then sought and they said that the service provider would be approached and felt safe at the home. Feedback was sought from a member of staff on induction and we were told that videos were used for training. We were also told that handovers when shift changes occur arecrucial to the day to day running of the home. Care planning is being reviewed and at present the manager is gathering information about the person`s changing needs. Risk assessments are also being reviewed to meet the person`s current needs. We asked about activities and understood that there is a designated driver to take people to colleges, outings and appointments. People are going out for walks which are used as a form of exercise and to diffuse potential aggressive and violent situations. We then asked the deputy about the manager`s style of management. We were told that staff know that there is a manager in post who is approachable and will act upon suggestions that benefit people. There are more activities and staffing levels have increased since the appointment. What the care home could do better: It is evident that steps are being taken to meet the requirements of the last key inspection and the manager is aware of what needs to be done to comply. There is one requirement arising from this visit which is about the service provider reporting on the conduct of the home. Random inspection report Care homes for older people Name: Address: St Davids Lodge 98 Lodge Causeway Bristol BS16 3JP one star adequate service 19/05/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Sandra Jones Date: 1 1 0 6 2 0 1 0 Information about the care home Name of care home: Address: St Davids Lodge 98 Lodge Causeway Bristol BS16 3JP 01179656965 01179656965 hazelprycejones@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Clive Pryce-Jones,Mrs Hazel Lilian Pryce-Jones Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 11 Number of places (if applicable): Under 65 Over 65 11 learning disability Conditions of registration: 11 May accommodate up to 11 persons aged 50 years and over Date of last inspection Brief description of the care home St Davids Lodge is a care home for people with learning disabilities. Since conducting the last inspection, the service provider has sought to increase the registered numbers. The application was successful and the home is now registered to accommodate 11 people with learning disabilities over 50 years. The property is situated on the Lodge Causeway, close to the Fishponds Road, shops, other amenities and bus routes. The property is detached and arranged over two floors with shared space on the ground floor and personal space on both floors. It has the appearance of a domestic dwelling and blends well with its local environment. Care Homes for Older People Page 2 of 9 1 9 0 5 2 0 0 9 Brief description of the care home Care Homes for Older People Page 3 of 9 What we found: We visited the home on Friday 11/06/2010 to undertake a random visit. The main focus of the visit was to check on the action taken to comply with the requirements of the previous key inspection. We spent time looking at the records, speaking to the manager, people at the home and staff. Care planning was discussed with the manager and we were told that at present staffs understanding is being sought about the way the person would like their care to be delivered. This will then lead to developing a more personalised approach to meeting needs. The case files of four individuals were examined and for three people social workers needs assessments were provided and up to date homes care plans and associated risk assessments were in place. Generally care plans list the need, the person ability to meet the need which includes their likes and preferred routines. This is a clear indication that there is a move towards a personalised approach to meeting needs. However, the care action plans can be more personalised, the action plans would benefit from more guidance on the way the person likes the care to be delivered. Where people have communication needs, it is part of the care plan and there is enough information for staff to support the person to make decisions. Risk assessments are in place for mobility needs and for people that use aggression and violence to communicate. Manual handling risk assessments that say the persons need, the number of staff needed to undertake the manoeuvre and the equipment needed are in place. For people that may exhibit aggressive and violent behaviour, risk assessments are completed. The possible triggers that may lead to a possible violent and aggressive incident are detailed with the actions that staff must take to diffuse and divert these behaviours. Care plans and activity rotas confirm that people are having greater opportunities to experience a wider range of activities. People at the home were keen to show the recent gardening that they were involved in and the decorated gnomes in the garden. Each person has a calendar for each month the persons photograph can be attached. Calendars indicate that people go out on trips, go shopping, garden and do knitting. Staffing levels were discussed the manager and we were told that they have increased since the last inspection. Since the increase of the staffing levels, there is a minimum of three staff on duty at all times. On some days there are four staff to give people more opportunities for activities. Currently staff have a combined role of cooking, cleaning and caring, the manager recognises that the staffing levels need to increase so that the standards can be further increased, for example, catering and personal development. Three staff were recruited in the last 12 months and their personnel files were examined to determine the recruitment process followed. Completed application forms that seek full Care Homes for Older People Page 4 of 9 employment history, the names of two referees (one of which must be the most recent employer) and disclosures of criminal background which must be signed by the candidate are in place. This means that the manager is taking steps to assess the person suitability to work with vulnerable adults. Written references and cleared Criminal Records Bureau (CRB) disclosures obtained confirm that the recruitment process is robust. Since this visit the manager has undertaken a risk assessment for staff that have declared criminal convictions and are awaiting their CRB. We spoke to the manager about registration and the leadership style that will be used to implement systems that provide consistency and raises standards for people to have better outcomes. The manager told us that the application to register as manager is going ahead and will be applying to CQC to become the registered manager of St Davids Lodge. The manager said that the homes Quality Assurance system where standards of care are assessed is being used to identify gaps. Since appointment nine weeks prior, the manager has gathered information from staff through supervision. We were told that feedback about the what is good about working at the home and the benefits in order to develop an action plan. The action plan is based on what is needed, getting to know relatives and liaising with external agencies. A calm approach finding solutions to issues as they arise is the leadership approach with a management style that includes being open to suggestions and knowing how to put measures in place. We understood from the manager that the current structures and routines of shifts work well and reporting are the tasks that need to happen each day. These reports act monitoring systems and relate to communication books and handovers when shift changes occur. Consistency is then maintained by keeping staff informed about daily occurrences, staff meetings with pre-set agendas and visits from the service provider. A record of the visits from the service provider must be recorded and must report on the conduct of the home. What the care home does well: When we arrived people were sitting in the lounge watching TV, knitting and preparing for the World Cup. People told us about their day and what they were doing. They explained their calendars of activities and the occasions when their photographs were taken. We asked people how they spent their day at the home and one person said that they do cooking, decorate gnomes and watch TV. Another said that on that day they had gone to Weston-Super-Mare as a birthday outing. These individuals were then consulted about the way their needs are met. One person felt well cared for and said that the staff are good and know how to meet their needs. Their comments about complaints were then sought and they said that the service provider would be approached and felt safe at the home. Feedback was sought from a member of staff on induction and we were told that videos were used for training. We were also told that handovers when shift changes occur are Care Homes for Older People Page 5 of 9 crucial to the day to day running of the home. Care planning is being reviewed and at present the manager is gathering information about the persons changing needs. Risk assessments are also being reviewed to meet the persons current needs. We asked about activities and understood that there is a designated driver to take people to colleges, outings and appointments. People are going out for walks which are used as a form of exercise and to diffuse potential aggressive and violent situations. We then asked the deputy about the managers style of management. We were told that staff know that there is a manager in post who is approachable and will act upon suggestions that benefit people. There are more activities and staffing levels have increased since the appointment. 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 set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes R 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 12 The manager must ascertain 03/08/2009 and take into account the wishes and feelings about the care to be provided. Care plans must show that people at the home have a say about the way their care is to be delivered by the staff. Including the monitoring of the activities that they undertake. Not Fully Met 2 27 18 The manager must ensure that the staffing levels are appropriate to meet the needs of the people at the home The manager must ensure that the staffing levels meet the needs of the people accommodated at the home. Not Fully Met 06/07/2009 Care Homes for Older People Page 7 of 9 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 31 26 Where the registered provider is an individual and not in day to day control, he must visit monthly and report on the findings of the visit. The registered provider must visit the home monthly to assess the outcomes for people at the home. 18/07/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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 noncommercial 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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