Care Home: Swallow Lodge

What the care home does well This service was registered with CQC previously however it re-registered in 2009 as the service moved into a newly built home. The staff and service users who use the respite service had transferred over from the previous service so most of the procedures and operations of the home continued as previously. We saw that when people entered the home they were made to feel welcome by the staff and they looked very relaxed and at home. We spoke with three people who use the service and they all told us that they are happy to stay at Swallow Lodge. One person said `I really like coming here and the staff are nice to us.` Each person has an individual care plan which describes their health and social care needs. This is stored in the office and one person told us that they would like their own copy of their care plan. On each admission to the respite service an admission checklist is completed where items brought into the home including any medication are recorded and signed for. The same procedure applies when people leave. People told us that they are provided with nice meals and all the food is freshly cooked by the staff. The service is currently planning to employ a cook so that staff can spend more time with the service users.We saw that people have access to community facilities whilst staying at the home and their is a range of activities organised to suit people`s individual needs. The staff were friendly in their approach and those that we spoke with said that they receive plenty of on-going training and support. What has improved since the last inspection? Although this is a newly registered service, the service operated from another setting. The new home has been specially designed to meet the needs of the people who use the service and the building is Eco friendly in design. The people who use the service helped to decide on the decor and helped design the garden. The home is spacious and well planned with specialist equipment in place to meet people`s needs. What the care home could do better: We have not found any areas of concern however we recommended that the people who use the service are offered a user friendly copy of their care plan which they can decide to store at the service or take home with them. Key inspection report Care homes for adults (18-65 years) Name: Address: Swallow Lodge Swallow Lodge Fen Lane North Hykeham Lincoln LN6 8UZ 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: Alison Jessop Date: 2 0 0 1 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 29 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 © (2010) 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 29 Information about the care home Name of care home: Address: Swallow Lodge Swallow Lodge Fen Lane North Hykeham Lincoln LN6 8UZ 01522555501 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Lincolnshire County Council Adult Social Care Name of registered manager (if applicable) Mrs Sandra Webb Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 7 0 care home 7 learning disability Additional conditions: The maximum number of service users who can be accomodated is 7 The registered person may provide the following categories of service, Care Home only, Code PC to service users of the following gender, either, whose primary needs on admission to the home are within the following categories, Learning Disability, Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home Swallow Lodge is a newly, purpose built, eco friendly home providing a respite service to up to 7 people who have a learning disability. The home is situated in the North Hykeham area of Lincoln and is approximately 5 miles from Lincoln city centre. There are local shops, a park and a pub within walking distance and the home is accessible by public transport. The home has 7 bedrooms, all of which are single. All bedrooms have ensuite facilities and one bedroom is specially designed to be able to provide a service to bariatric people. Some of the bedrooms are identically designed to provide familiarity as people may not be accommodated in the same bedroom for each respite stay. Each bedroom also has a sofa and television ariel point. Some of the bedrooms have ceiling tracking hoists and their is a specialist bath. There is a kitchen, dining room and communal lounge. A snoozelem room is also being planned for the future. The garden is fully accessible to people and has a seating area, raised flower beds, a green house and a shed. The service also has a flexible respite unit attached where people can use the communal facilities. There is a small training kitchen where service users can learn to develop their independent living skills. A copy of the service user guide and statement of purpose can be obtained by contacting the service. The fees range from £7.38 - £14.09 per stay. Tea visits and flexible respite is charged at £3.40 per session. In order to access this service people must be referred by the Care Homes for Adults (18-65 years) Page 5 of 29 Lincolnshire County Councils Adult Social Care Team. Care Homes for Adults (18-65 years) Page 6 of 29 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 Care Homes for Adults (18-65 years) Page 7 of 29 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced visit which formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of the people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission. The visit lasted approximately four hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. We also sent out surveys to a sample of residents and staff, the feedback we gained is included in this report. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of 3 people through their care records and assessing their care. We spoke to 3 people who use the service, and 3 members of staff. The registered manager was not present however the area manager and duty manager were available throughout the visit and the general outcomes of the visit were discussed with them at the end. Care Homes for Adults (18-65 years) Page 8 of 29 What the care home does well This service was registered with CQC previously however it re-registered in 2009 as the service moved into a newly built home. The staff and service users who use the respite service had transferred over from the previous service so most of the procedures and operations of the home continued as previously. We saw that when people entered the home they were made to feel welcome by the staff and they looked very relaxed and at home. We spoke with three people who use the service and they all told us that they are happy to stay at Swallow Lodge. One person said I really like coming here and the staff are nice to us. Each person has an individual care plan which describes their health and social care needs. This is stored in the office and one person told us that they would like their own copy of their care plan. On each admission to the respite service an admission checklist is completed where items brought into the home including any medication are recorded and signed for. The same procedure applies when people leave. People told us that they are provided with nice meals and all the food is freshly cooked by the staff. The service is currently planning to employ a cook so that staff can spend more time with the service users. Care Homes for Adults (18-65 years) Page 9 of 29 We saw that people have access to community facilities whilst staying at the home and their is a range of activities organised to suit peoples individual needs. The staff were friendly in their approach and those that we spoke with said that they receive plenty of on-going training and support. What has got better from the last inspection What the care home could do better We have not found any areas of concern however we recommended that the people who use the service are offered a user friendly copy of their care plan which they can decide to store at the service or take home with them. Care Homes for Adults (18-65 years) Page 10 of 29 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Alison Jessop CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 11 of 29 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 12 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are given the opportunity to become familiar with their surroundings before staying in the home for the first time. This helps to ensure that the visit is successful. Evidence: The service user guide and statement of purpose is in a pictorial version and includes a copy of the complaints procedure it also explains what people need to bring in with them when they come for a respite stay. Information is received from the practitioner team, then the senior carers then visit the person to complete an assessment to ensure that their needs can be met. The person is offered four tea visits initially which is followed by a review meeting with the service user and their carer/family to make sure that people are ready for an overnight stay. More tea visits can be arranged if necessary. The staff told us that when respite stays are booked, staffing levels are planned according to peoples needs and compatibility between staff and service users is also matched. Care Homes for Adults (18-65 years) Page 13 of 29 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. Peoples individual needs and choices are taken into account. Evidence: We looked at the care plans of three people who use the service. Each person had been assessed before being accepted into the service and a copy of this assessment along with the Lincolnshire County Councils Adult Care Services assessment was maintained on their file. We saw that an admission and discharge checklist had been completed for each visit, which gave a list of items that people brought in with them. This included any medication, money, valuable items and personal possessions. Each person had an individual care plan which outlines their care needs and any risks, along with an action plan on how to meet peoples needs and reduce any risks. We saw care plans on maintaining independence and life skills, personal care, mobility, health care needs, medication, communication, interaction and socialisation, nutrition, elimination, preventing ill health during hot weather, sleeping and religious needs. Where Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: people had specialist needs we also saw care plans and risk assessments such as for epilepsy, road safety, paying for a taxi and expressing sexuality. We spoke with thee service users who all said that they are aware that they had a care plan, however none had signed them and they were not provided to people in an accessible format. All the people we spoke with said they are able to make decisions about their care and felt that their preferences were taken into account. A new care plan that is currently being introduced includes a statement on the Mental Capacity Act and prompts staff to involve service users with making decisions and where people may not have capacity staff said they will complete a capacity assessment. We saw on one care plan that the service user had been encouraged to go out to the shops without being escorted by staff however a risk assessment had been completed on how to make sure that he was aware of road safety. Care Homes for Adults (18-65 years) Page 15 of 29 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. People are enabled to develop their social, emotional and independent living skills whilst visiting the home. Evidence: One service user said I like to come here as I get to see my best friend. Staff said that they try to encourage friendships between service users. People go to their usual day care facilities and then go straight to the home afterwards. Some of the service users were going out that evening to a club that they attend each week on a Wednesday. Transport was being provided and one person told us that he looks forward to this outing every week. Staff encourage people to use the local community facilities when they are staying at the service. Their is a pub nearby. The staff told us that one of the service users likes to go for a drink at the pub with a member of staff. People can also walk to the local shops and park. The majority of people attend the service at weekends so this is when a lot of activities and outings are planned. The staff recognised that people do not always want to Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: go out or do activities in the week when they have attended work or educational facilities all day and prefer to relax. Some of the activities that people can participate in include bowling, walks, trips to the cinema, shopping trips in town, football, BBQs, gardening, table football, outings to the library, board games and arts and crafts. One service user said that she just enjoyed watching video films in her bedroom and said that there is a wide range of films available in the home for people to watch. The people we spoke with said that they like the food that is served and that snacks are also available. The food is currently cooked by a member of the care team, however the manager told us that a chef is due to be employed so that staff can spend more tine with the service users. There is also a training kitchen in the flexible respite unit where service users can prepare food and meals with assistance from the staff. Care Homes for Adults (18-65 years) Page 17 of 29 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. Staff have information about peoples health care needs and an up to date care plan which explains how peoples needs are to be met. Evidence: We saw that information about peoples health care needs is included in the initial needs assessment and then a care plan is drawn up which explains how peoples needs are to be met. Each file included the persons medical history and contact details of health care services that the person may need to access. As this is a respite service, people usually attend medical appointments with their family, however medical services may need to be accessed in an emergency and therefore staff had information about peoples medical history available. Peoples health is closely monitored and records were seen that where problems had been identified they had been reported to the appropriate person. The service had reported two medication errors recently however action had been taken to ensure that staff are re-trained and their competency had been assessed. All medication that comes into the home is checked in by two staff and is then locked in a secure place. Only senior staff who have been trained can administer medication and all records were double signed. There is a separate procedure for the storage and Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: administration of controlled drugs. Care Homes for Adults (18-65 years) Page 19 of 29 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. There are clear systems for reporting concerns which is appropriately accessible to the service users. Evidence: The service has a pictorial complaints procedure which is included in the Service User Guide. People are given a copy of this before they start to use the service. We spoke with two people who told us that they know how to raise a concern. One person said I would speak to the staff I wasnt happy. The duty manager told us that the service has not received any formal complaints, however we saw several compliments recorded in the complaints record. There has not been any adult safeguarding investigations about this service. We spoke with two staff who told us that they have received training on how to recognise and report concerns of abuse or neglect. We also saw training records that confirmed this. Staff were also aware of how to use the whistle blowing procedure. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well designed to meet the needs of the people who stay there. Evidence: The home is newly built and is built to an Eco friendly design. It has solar powered heating and lighting and all lights are on sensors. The staff told us that service users were involved in planning the decor and designing the garden. The home is spacious and each bedroom has access to en suite facilities. There is specialist equipment and one bedroom is designed to meet the needs of a bariatric person. There is an overhead tracking hoist which runs from the bedroom to the shower room. Their is a specialist bath in one of the bathrooms. The people that we spoke with said they like the new home. Some of the bedrooms are designed to the same specification so that people can feel familiar with their surroundings as they may not be able to stay in the same bedroom on each visit. The duty manager told us that they are planning to get pictures or paint murals on the walls to make the place look more homely. People can bring in personal possessions with them when they stay in order to help them feel at home. The staff said that although there were some initial teething problems with the new building, most of these have been resolved or are planning to be resolved in the near Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: future. They said that the home is fully functional with small changes being made to adapt the home to meet peoples individual needs. The home looked very clean and tidy throughout and staff were aware of safe infection control procedures. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is staffed by an experienced team who provide caring and kind support to people. Evidence: We spoke with three service users who all said that they like the staff that work in the home. We saw that the service users were relaxed with the staff and seemed to have good relationships. Staff communicated well with people in a caring and kind manner. One service user said yes, I like all the staff, they are nice and friendly. Another service user was pointing to the photos of the staff team and said their name as he pointed out each person. We asked him do you like that person and he said yes to each one. We spoke with two staff who work at the home. Both said that they receive a lot of training both mandatory and other courses that they request. One carer told us I have done some training on the use of sign language which I found helpful. Other specialist training courses that staff have attended includes epilepsy, Mental Capacity Act, recording and reporting and one person had attended a course on how to manage staff. All staff said that they feel supported by the management systems and said that they attend regular team meetings and receive regular one to one supervision. All the staff also said that when the registered manager is not on duty, there are good support systems in place and that some of the senior care team are very skilled and experienced Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: to manage the home. The service has not recruited any new staff since it registered as all of the staff were transferred from the previously registered service. We were therefore unable to look at staff recruit records however no issues were identified during previous inspections of the previously registered service. Care Homes for Adults (18-65 years) Page 24 of 29 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. Peoples opinions and views about the service are sought through effective quality monitoring systems. Evidence: The registered manager was not working on the day of the inspection however management cover was being provided by another manager from a Lincolnshire County Council service. The regional manager was also visiting the home and the staff spoken said that in the absence of the manager they felt supported by the systems in place. One carer said some of the the senior carers are so experienced and are more than capable of managing the home. A quality assurance survey had been conducted in April 2009. The results of this were very positive and out of the 17 people that responded, 100 of people said that their needs had been fully met and that they had been treated with dignity and respect. The service has a comprehensive health and safety policy where data is kept of safety checks. We also saw that risk assessments had been completed. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 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 28 of 29 Helpline: Telephone: 03000 616161 or 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 © (2010) Care Quality Commission (CQC). 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