Care Home: Stonesby Lodge

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What the care home does well People living at Stonesby Lodge are supported by staff who have worked at the home for many years, and who know them well. There is good rapport between those living at the home and those working at the home and the atmosphere is friendly and relaxed. Stonesby Lodge enables those living at the home to lead an independent lifestyle, which includes access local community resources, including the Church, museums and shops, with some attending day centres and college. In some instances people living at the home have frequent contact with family and friends, and meet with them which is organised by themselves and by the use of public transport, personal transport and by the use of their mobile phone. People we spoke with who live at the home spoke very positively about the care and support they receive, with everyone saying that they wanted to continue living at the home, as the staff looked after them well, and they had no complaints. We sent surveys to people who live at the home and asked them what they thought the home did well, they wrote:`They look after you very well.` `Food is good. Help me go shopping and to the Post Office.` `The home is very clean.` `The staff are kind and caring.` `The staff are friendly towards residents.` `I like living at Stonesby Lodge.` We sent surveys to staff and asked them what they thought the home did well, they wrote:`Cares well for individuals who live in the home.` `Quality of care for individuals.` `Cares well for the residents.` What has improved since the last inspection? The Registered Manager has commenced reviewing and updating care plans, which provide more in depth information as to the needs of those living at the home, and the role of staff in providing support. Staff have received training in a range of topics, which is linked to the safety and welfare of those living at the home, and includes training in first aid and medication, and training which should enable staff to support and understand the rights of those living at the home. The Registered Manager now holds regular meetings with staff in a group and on an individual basis, which enables everyone to keep up to date with what is happening. Resident meetings now take place on a monthly basis, which provides a formal opportunity for the home to ascertain their views, and for them to talk about and plan future events and activities. Environmental improvements to the outside of the building have taken place with the front of the property being cleared and made tidy. Their is a maintenance programme which details the decorations of bedrooms and communal areas, some work has already taken place. What the care home could do better: Care plans for some individuals living at the home need to be reviewed and updated, this is a matter of urgent consideration, to ensure that the needs of those living at the home are recorded. Improvements to bathing and shower facilities need to be improved through modernisation and decoration. The Registered Person and Registered Manager need to satisfy themselves that the training staff receive has a direct and positive impact on the quality of lives of those living at the home, and influences individuals choices which are recorded within the individuals care plan. Institutional practices in the home need to be reviewed and should include discussion with those living at the home. Where restrictions are in place, these need to be recorded within the individuals care plan, and supported by a risk assessment. The Registered Manager needs to consider referring restrictions on peoples rights and choices under the Deprivation of Liberty Safeguards, being part of the Mental Capacity Act. Key inspection report Care homes for adults (18-65 years) Name: Address: Stonesby Lodge 109 Stonesby Avenue Leicester LE2 6TY     The quality rating for this care home is:   one star adequate 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: Linda Clarke     Date: 1 9 0 1 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 31 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 31 Information about the care home Name of care home: Address: Stonesby Lodge 109 Stonesby Avenue Leicester LE2 6TY 01162830128/2701744 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: gbonom@dmu.ac.uk Mr R Bonomaully care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: No additional conditions of registration. Date of last inspection Brief description of the care home Stonesby Lodge provides a service for 12 people with mental health problems, and is located on the outskirts of the Saffron Lodge Estate. Stonesby Lodge is an extended detached house which has to the ground floor a lounge/diner and a seperate lounge for those wishing to smoke. Bedrooms are located on the ground and first floor as are the toilet and bathing facilities. The home has two internal courtyards, accessible for people to use with patio furniture. Stonesby Lodge is situated on a main road, close to shops, Churches, day services, the library and other amenities. There is a regular bus service to Leicester and Wigston. The charges are assessed according to peoples needs, information regarding fees is available by contacting the Registered Manager. 12 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 31 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: one star adequate 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: We as it appears throughout the Inspection Report refers to the Care Quality Commission. The inspection process consisted of pre-planning the inspection, which included reviewing the Annual Quality Assurance Assessment (AQAA), which is a selfassessment tool completed by a representative of the service, reviewing the previous Key Inspection Report of the 3rd August 2009, and any information we have received. The unannounced site visit took place on the 19th January 2010, between 09:00 and 14:00. The focus of the inspection is based upon the outcomes for people who use the service. The method of inspection was case tracking. This involved identifying people with varying levels of care needs and looking at how these are being met by the staff at Stonesby Lodge. Three people accessing services were chosen and discussions were Care Homes for Adults (18-65 years) Page 5 of 31 held with two of them, along with others living at the home. We also looked at requirements made at the previous Key Inspection carried out on the 3rd August 2009, to ascertain whether these had been complied with. We sent surveys to people living at the home and staff the home employs. Care Homes for Adults (18-65 years) Page 6 of 31 What the care home does well: What has improved since the last inspection? The Registered Manager has commenced reviewing and updating care plans, which provide more in depth information as to the needs of those living at the home, and the role of staff in providing support. Staff have received training in a range of topics, which is linked to the safety and welfare of those living at the home, and includes training in first aid and medication, and training which should enable staff to support and understand the rights of those Care Homes for Adults (18-65 years) Page 7 of 31 living at the home. The Registered Manager now holds regular meetings with staff in a group and on an individual basis, which enables everyone to keep up to date with what is happening. Resident meetings now take place on a monthly basis, which provides a formal opportunity for the home to ascertain their views, and for them to talk about and plan future events and activities. Environmental improvements to the outside of the building have taken place with the front of the property being cleared and made tidy. Their is a maintenance programme which details the decorations of bedrooms and communal areas, some work has already taken place. 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 31 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 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Stonesby Lodge enables people to make an informed decision as to whether the home is appropriate to their needs by providing information about the services it provides and through its assessment process. Evidence: We sent surveys to people who live at the home, a majority of people stated that they had received information about the home prior to moving in, and that this information had enabled them to make a decision about whether the home was suitable for them. We wanted to find out how the needs of people were determined so that the home knew whether they could meet someones needs before they moved into the home. We looked at the records of three people who live at Stonesby Lodge, and found that individuals had had their needs assessed by a Social Worker, in the case of one person whose move to the home had had to taken place quickly due to personal circumstances the Registered Manager of Stonesby Lodge had undertaken their own assessment, by speaking with the person concerned, and their Social Worker. This Care Homes for Adults (18-65 years) Page 10 of 31 Evidence: process ensures that the home can be confident that a persons needs can be met prior to their moving into the home. Records we looked at informed us that once a person moves into the home, regular reviews and meeting takes place which involve the individual and representatives of the home, along with relevant health and social care professionals. Care Homes for Adults (18-65 years) Page 11 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stonesby Lodge are supported to make choices and decisions about their daily lives and say that they are supported and cared for by staff however their are institutional practices which restrict autonomy. Evidence: We looked at the care plans and records of three people living at the home, and found that since our last key inspection of the home, up to date care plans were now in place for some. Care plans we viewed provided information as to individual abilities and strengths, including coping mechanisms and indicators for dealing with their mental health. Care plans provide staff with information as to their role in providing support. All care plans that we viewed had been developed with the involvement of the person, and had been signed by them. Care plans for other people living at the home still need to be developed so that they are up to date and accurate, the Registered Manager is working towards this goal. Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: We spoke with several people who live at Stonesby Lodge, and they told us that they make decisions about their daily lives, this was confirmed by reading care plans, daily records and through our observations. We did note that their are areas for improvement which we discussed with the Registered Person and Registered Manager, and provided examples of where staff had restricted people from having what they wished, due to institutional style habits and behaviours, an example of this whas when we observed a gentleman living at the home asking for a cup of tea, but was told no, when the person asked why, the member of staff told them that they had to clear away after the lunchtime meal and mop the kitchen floor. When we asked the staff member why the gentleman couldnt have a cup of tea, they said Ive got to clear away, its always been done this way. We also noted that people who live at the home ask a member of staff for their cigarettes and lighter/matches, when they wish to have a cigarette and that lighters/matches are handed over to staff in the evening, and returned to them in the morning. This is another example of an institutional approach to care, we found no risk assessments in place to indicate that by people keeping their lighters/matches they were a risk to themselves or others living at the home. This practice should be reviewed on an individual basis, and discussed with the individual, and recorded within their care plan. Where risks are identified a risk assessment needs to be in place, and consideration needs to be given as to whether a Deprivation of Liberty Safeguard referral needs to be made, where restrictions are placed on individuals. We spoke with one gentleman who said that he found the home to be easy going, whilst a lady told us that the staff help me, I go out when I want and do what I want. People who live at the home were relaxed throughout our visit and were happy to converse with us about their daily lives. We observed that the rapport between staff and people living at the home was positive, and that people living at the home enjoyed the company of staff and spoke affectionately about them. We sent surveys to people who live at the home, information we gathered from surveys told us that they feel able to make decisions about what they do each day and that the staff and managers treat them well. Some surveys contained additional comments which included:The staff are kind and caring. I like living at Stonesby Lodge. Help me to go shopping and to the Post Office. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: The staff are very friendy towards the residents. Comments from surveys show that people living at the home feel positive about where they live, and find staff to be supportive and caring. Surveys did not contain any negative comments about the home or the staff it employs. Care Homes for Adults (18-65 years) Page 14 of 31 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. Individuals live a lifestyle of their choosing by taking part in a range of activities within the community and the home. Evidence: We wanted to find out how people spend their day, and how the staff working at the home support people to make decisions and stay in contact with relatives and friends. We sent surveys to people who live at the home, responses to question in surveys told us that people take part in activities and that they enjoy the meals provided by staff working at the home. Some surveys included additional comments which included:Food is good. Help me go shopping and to the Post Office. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: I like the social occasions. We spoke with people living at the home and they told us of the range of activities they take part in, and their involvement within the local community. One gentleman told us that he was taking a computer course at College, whilst several others told us that they go regularly to the local Church on a Sunday, with some people going on a Monday to a club attached to another local Church. By reading care plans we found that people living at the home take part in a range of activities and events, one person organises their own holidays visiting friends and family, whilst others attend day care facilities. One lady told us that they like to keep occupied, and have taken up crocheting, and they continue to draw and copy text from books at the local library. Two ladies said that they enjoy each others company and go out to local museums and attractions around Leicester. We were told by people living at the home that they have a bus pass which means that they can travel independently. Care plans and discussions with individuals living at the home told us that some keep in contact with family and friends, visiting them regularly by taking a bus or in one instance by using their own transport. Contact with family and friends is also maintained by telephone, with some at the home having a mobile phone and some stay in contact by writing letters. A member of staff told us that three people who live at the home, were later in the year going on a three day tour of Yorkshire, which involved visiting locations which are part of television dramas. Day trips were also being planned to local Cities by train which included Derby and Nottingham. We looked at the minutes of resident meetings which are held monthly and found that a majority of people who attend have provided ideas as to the location of day trips and events, which included zoos and locations such as Skegness. We observed people in the home leaving and returning independently throughout the day, whilst others occupied themselves with jigsaws, puzzles and crocheting. One gentlemen told us that hed finished turning over the garden, and was waiting for the whether to improve so that he could plant and grow vegetables, he went onto tell us that he also enjoys painting. We asked people if they had enjoyed Christmas, they told us that theyd had two Christmas Trees, and that theyd all had presents, they went onto tell us that three local Churches had got together and visited the home and provided for Carol Service, and that theyd had a Christmas Party. Information Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: provided by people who live at the home and our own observations and reading of documentation evidences that people have access to a range of activities and events within the community which the home encourages and facilitates. We saw people helping to set and clear away tables for the lunchtime meal, and we saw minutes of resident meetings, where those living at the home had discussed different meals for the menu. Care Homes for Adults (18-65 years) Page 17 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health care needs of people are met which inlcudes the administration and management of medication. Evidence: We wanted to find out how the health and personal care needs of people living at the home were met. Daily records and information held by the home evidenced that people have access to health care professionals which included General Practitioners, Community Psychiatric Nurses, Dentists and Opticians. We sent surveys to people who live at the home, which asked them whether their health care needs were met, all said that they were. Care plans which we viewed provided information about peoples health care needs, including the contact details for them. People living at the home require no support with personal care, but some require encouragement. No specialist equipment is required by people living at the home. We sent surveys to staff which asked them if theyre give up to date information about the needs of people, all indicated this always happened. Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: We looked at the medication records and medication of three people whose records we had looked at and found all to be in good order, which included Controlled Drugs. Since the previous key inspection the home has purchased a Controlled Drug cabinet, which ensures the safe storage of this medication. Since the last key inspection, staff have received training on the administration of medication, and further training is planned which will be delivered by a Pharmacist that will focus on the use of medication which is prescribed to people living at the home, this will help staff to understand how medication effects the people in their care. Care Homes for Adults (18-65 years) Page 19 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stonesby Lodge are able to express concerns, and have access to a complaints procedure, however institutional practices need to be reviewed. Evidence: We wanted to find out how the staff at Stonesby Lodge promote the safety and welfare of people who live at the home. Surveys which we sent to people living at the home told us that they are aware of how to make a complaint, and that they know who to speak with if they are unhappy. We read the minutes of resident meetings, which evidenced that the Registered Manager periodically reminds people how to make a complaint. Stonesby Lodge and the Care Quality Commission have not received any complaints or concerns since the previous key inspection. We observed that those that live at the home and staff employed have a good rapport, and that no one was excluded from conversations, everyone got on well, and conversed and shared jokes, this also provides an open environment into which individuals feel confident to raise concerns. We looked at staff training records and found that staff have received training on Safeguarding Adults from Abuse, the Mental Capacity Act which included Deprivation of Liberty Safeguards. The training provides staff with information and guidance as to how the rights and choices of those in their care are to be promoted, we observed some practices in the home which are institutional (as detailed in the section Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: Individual Needs and Choices) which need to be reviewed by the Registered Person and Registered Manager. The Registered Manager needs to ensure that training staff receive is linked directly to the care and support people receive which is supported by their care plan. Care Homes for Adults (18-65 years) Page 21 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Stonesby Lodge provides adequate accommodation; improvements to some facilities within the home are required to enhance the comfort and lifestyle of those living at the home. Evidence: We had a tour of communal areas of Stonesby Lodge; we found that bathrooms, toilets and showers whilst clean, were in need of modernisation and decoration, this is viewed as a priority. The flooring in a toilet area which we noted to be of poor quality when we lasted visited the home has now been replaced with new flooring. The lounge/dining room, which gives access to the kitchen, has had new laminate flooring within the dining area, and the Registered Manger told us that the lounge area of the room was to be decorated and a new carpet fitted, the homes maintenance programme does not provide a timescale for this work. The homes maintenance programme shows that other work already completed includes, tidying up the front garden, which has been cleared and has had gravel laid. Windows to the front of the property have in part been replaced, and the maintenance programme shows that other windows to the front of the property have been scheduled to be replaced in the near future, the Registered Manager told us that they Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: have been ordered. We also looked at the smoking room, this had been painted, and when we looked at the room a resident living at the home told us it was a lot more cheerful since it was decorated. Bedrooms are detailed in the planned maintenance programme for decoration, we noted that one bedroom had been decorated with new flooring, and another bedroom was in the process of being decorated. We read the minutes of resident meetings which showed that the Registered Manager has consulted with those living at the home, and told them of environmental improvements, and asked them for their views and colour choices. We sent surveys to people living at the home which asked them if the home was clean and tidy, all indicated that it was. Surveys in some instances contained additional comments:The home is very clean. The home is well provided for, in good condition, everything that everyone needs. The environment is very nice. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Stonesby Lodge are supported by staff that know them well and who have received training that enables them to better understand the support and care required people need. Evidence: People who live at Stonesby Lodge are supported by a consistent staff team who have worked at the home for many years, and this has enabled good supportive relationships to be developed. There are always two members of staff on duty during the day; this sometimes includes the Registered Manager. One member of staff is at work during the night. We found that some staff have attained a National Vocation Qualification (NVQ), at level 2 and/or 3. Since the last key inspection staff have received a range of training which is linked to the safety and care of people living at the home, and has included First Aid, the Mental Capacity Act, Medication and Fire Awareness. Further training is planned about medication used in the home, which will be facilitated by a Pharmacist. Training is also being organised by the Registered Manager for a Community Psychiatric Nurse to provide information about mental health. The Registered Manager needs to ascertain if the training staff receive, has a positive impact on the quality of care and support of those living at the home, and meets their needs, this would also Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: enable the Registered Manager to identify further training needs. Stonesby Lodge has a small staff team, who work closely with the Registered Manager, a system for formal appraisal and supervision has now been developed, we saw evidence of this within the staff files that we viewed. Staff meetings now take place on a regular basis, with minutes being taken, the minutes that we looked at showed us that the improvements the home needs to make have been discussed. We looked at the recruitment records of care staff working at the home and found that they included an application form and a Criminal Record Bureau (CRB) disclosure and written references, this means that people who live at Stonesby Lodge are supported and cared for by staff who have been vetted as appropriate to work with vulnerable adults. We sent surveys to staff, which asked them if their recruitment was thorough and whether the training they received enable them to meet the needs of people living at the home, all indicated that their recruitment was thorough and that training met their needs. Care Homes for Adults (18-65 years) Page 25 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of Stonesby Lodge has focused to improve record keeping, and improved the service through staff training and consultation with those living at the home. Evidence: The Registered Manager of Stonesby Lodge has worked at the home for many years, and they are attending a course relevant to their role entitled Leadership and Management of Care Services Award. The Registered Manager has a good understanding of the needs of those living at the home, and since we last undertook a key inspection has began to review and update care plans, people living at the home told us of their affection for the Registered Manager. We sent surveys to staff, which asked them if they receive support from their Manager, and whether this includes discussing how well they were working, all indicated that this took place. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: The Registered Manager facilities regular meetings with staff and carries out individual supervisions/appraisals with staff. Resident meetings are also facilitated by the Registered Manager and take place on a monthly basis. This enables those living and working at the home to be consulted, and provides an opportunity for ideas and views to be shared, which can bring about change. The Registered Person continues to visit the home regularly and undertakes quality monitoring visits, which are documented, and include any action required by them or the Registered Manager, this enables parties to be clear as to what action needs to be taken and ensure that the home is operating as it should be. We found that requirements made at the previous key inspection have been met, continued improvement is required to sustain and improve the service provided, which includes reviewing institutional practices and monitoring the effectiveness of staff training, and its impact and outcome on the lives of those living at Stonesby Lodge. Care Homes for Adults (18-65 years) Page 27 of 31 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person to 01/01/2010 ensure that all service users have an up to date care plan, which is regularly reviewed, and includes information as to a persons goals and aspirations, and includes guidance for staff as to how support is to be provided. Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person to ensure that all service users have an up to date care plan, which is regularly reviewed, and includes information as to a persons goals and aspirations, and includes guidance for staff as to how support is to be provided. To promote the health, care and welfare of those living at the home. 26/02/2010 2 7 12 The registered person shall 26/02/2010 so far as practicable enable service users to make decisions with respect to the care they receive, which is to include the reviewing of institutional practices with reference to the management of cigarettes and matches/lighters and requests made by service users of staff for activities linked to their daily lives. Page 29 of 31 Care Homes for Adults (18-65 years) 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 To promote the rights and autonomy of those living at the home. 3 24 23 The registered person shall 30/04/2010 having regard to the number and needs of service users ensure the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. The registered person to modernise and decorate the bathroom on the first floor and the shower room on the ground floor. To improve facilities within the home that benefit the comfort and lifestyle of those living at the home. 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 30 of 31 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 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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