Care Home: The Ark Care Lodge

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Ark Care Lodge 94/96 Evington Lane Leicester LE5 5PP The quality rating for this care home is: two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Linda Clarke Date: 1 8 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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 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 Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 34 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 34 Information about the care home Name of care home: Address: The Ark Care Lodge 94/96 Evington Lane Leicester LE5 5PP 01162736950 01162736950 jaz_ark@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ark Care Lodge Limited care home 18 Number of places (if applicable): Under 65 Over 65 18 0 learning disability Additional conditions: The Ark Care Lodge is to operate two separate units each accommodating nine individuals under category LD, each with its own designated staff team The maximum number of persons to be accommodated within The Ark Care Lodge is 18 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 34 A bit about the care home Ark Care Lodge provides personal care and support for up to eighteen people who have a Learning Disability. The home is situated on a main road in Evington with access to community facilities including banks, shops, places to eat and a Post Office, there are good public transport links, and the bus journey to Leicester City Centre would take approximately 10 minutes. Care parking is available at the front of the home. The home comprises of two large semi detached houses, with no internal access between the two houses; each house provides a home for nine people. Each house has an open plan lounge and dining room overlooking the large rear garden, and a kitchen with a door leading onto the garden. The ground floor of the houses have one bedroom, with all other bedrooms being located on the first floor of the houses, fourteen bedrooms have a full en-suite facility, with two bedrooms having an en-suite comprising of a toilet and wash hand basin, the two remaining bedrooms sharing a bathroom. At the bottom of the garden, there is an activity centre for people living at the home to take part in recreational activities. Information is located on site detailing the range of services offered, which includes the Statement of Purpose. Ark Care Lodge has copies of the Care Quality Commissions inspection reports and that of its predecessor the Commission of Social Care Inspection. The current weekly fee is available by contacting the Registered Person. An individuals financial contribution to their care is dependent upon a financial assessment. Care Homes for Adults (18-65 years) Page 5 of 34 Care Homes for Adults (18-65 years) Page 6 of 34 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 34 How we did our inspection: This is what the inspector did when they were at the care home We as it appears in this Inspection Report refers to the Care Quality Commission. We did this inspection by visiting Ark Care Lodge on the 18th May 2008, we got to the home at 07:45 and stayed for 8 hours. Before we went to Ark Care Lodge we looked at the information the Manager had sent to us, this gives us information about the home. We sent surveys to people you live at the home and their relatives, and the staff who work at the home. We looked at the care plans and records of four people who live at Ark Care Lodge and we talked to many of the people that living at Ark Care Lodge and asked them what they thought of the home and living their. We also talked with staff and asked them how they help and support people. We have written about what we found out when we visited the home and what people told us. Care Homes for Adults (18-65 years) Page 8 of 34 What the care home does well When we got to the home in the morning we saw people getting ready to go out, we sat and talked to six people and they told us where they were going and what they would be doing. One lady told us she was going out for a meal, and one person said they were going to College. Other people told us that they were going to do arts and crafts. People also told us about what they do in the evenings, they said that they play football, play snooker, listen to music and eat out. This shows that that everyone goes out to do things they enjoy. Care Homes for Adults (18-65 years) Page 9 of 34 We saw that the staff were friendly with the people who live in the home. People who live at the home told us that they like the staff, and that they are helpful and kind. Everyone has a care plan, and staff sit down with people to find out what they would like to have written in their care plan, this helps staff to look after people in a way that the person wishes. Ark Care Lodge is nicely decorated, clean and tidy. Most bedrooms have an ensuite. The Manager of the home uses advocacy services to help people living at the home to make decisions and support them when others dont agree with them. What has got better from the last inspection Everyone who lives at the home has been given a copy of the Complaints Procedure, which has pictures included and the telephone number for Social Services. One Care Homes for Adults (18-65 years) Page 10 of 34 lady told us about the Complaints Procedure and understood what it was for. A copy of the Fire Procedure has been given to everyone, which has pictures in it to help people to understand. One lady told us that they have fire drills, and told us where they had to meet to make sure they were safe. What the care home could do better People who live at the home need to be helped to look after the money they have for spending, and know how much money they have to spend because it is written in a book. Staff who look after people living at the home need to have training which helps them protect people and understand what they should do when someone tells them Care Homes for Adults (18-65 years) Page 11 of 34 that they are being bullied or hurt. 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 Linda Clarke 33 Greycoat Street London SW1P 2QF 02079792000 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 Care Homes for Adults (18-65 years) Page 12 of 34 line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 13 of 34 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 14 of 34 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who may consider living at Ark Care Lodge would have their care needs assessed before they visit or move into the home. Evidence: Individuals who live at the Ark Care Lodge, have done so for several years. The Manager in the information we received before we visited the home told us that anyone who was considering moving into the home, would be encouraged to visit and look around. This would include meeting the people who already live at the home and staying for a meal and would include overnight stays. The introduction of someone new to the home would be tailored to meet their individual needs and circumstances. This would take place after a Social Worker had assessed the persons needs so that the Manager could look at the information and decide whether Ark Care Lodge and its staff could meet the persons needs, before someone was introduced to the home. Care Homes for Adults (18-65 years) Page 15 of 34 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Ark Care Lodge have their care needs met safely, and are supported to make decisions and personal choices. Evidence: We looked at the records and care plans of four people who live at the home. The care plans outline the individual care needs with regards to personal care, health care and daily living such as attending College or centres where activities are held. Person centred care plans are being developed with each person, and we were told that a member of staff sits with each person to find out whats important to them. The plans we looked at included information about how people spend their day and evenings, information about who is important in their lives along with peoples likes and dislikes. Risk assessments are completed for activities where their is a risk to someone, such as when undertaking ironing or going on public transport. Risk assessments support the person in undertaking these activities by identifying how the risk to the person can be reduced, without preventing the activity from taking place. Care Homes for Adults (18-65 years) Page 16 of 34 Evidence: We arrived in the morning and we spoke with six people before they went out. They told us about what they were going to do that day including the evening. One lady showed us her certificates and photographs of some of the things she had done at college and day care centres. There are regular meetings held, so that people who live at the home can talk about things, such as meals, going out, holidays and the Manager and staff can make changes. People we spoke with told us that they were hoping to go on holiday this year, one lady told us they were thinking about going to Barcelona. Care Homes for Adults (18-65 years) Page 17 of 34 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 living at Ark Care Lodge access a range of education and leisure activities that promotes choice and independence. A balanced Vegetarian diet is provided by the home. Evidence: When we arrived in the morning we sat in the lounge and spoke with people who live at Ark Care Lodge, and they told us where they were going and what they were going to do with their day along with their plans for the evening and later in the week. One lady was going to sew and play bingo in Oadby, whilst someone else told us they were going to College. Another lady told us she was going to art space where shed do pottery. One lady said she was going out for a meal and that later in the year she was going to start a college course about show business. One lady was going to the gym, whilst one gentleman told us he was going to play pool today, and bowling tomorrow. Several people told us that in the evening they were going to The Cedars, Care Homes for Adults (18-65 years) Page 18 of 34 Evidence: where theyd play football, snooker, listen to music and have a drink. We spoke with one gentleman who goes out independently, he told us he likes to use public transport and often uses buses and trains, and that he has travelled many miles and visited different places. One lady told us that she visits the Temple daily, and joins in the group activities held there and that she walks to and from the Temple. The home has a mini-bus which is used for taking people out, some activities transport is organised by the day care provider and in some instances people walk or catch the bus. One relative who returned a survey to us wrote Our son has the opportunity to join any many different and interesting activities during the week. People living at Ark Care Lodge have contact with their family, one lady told us that shed bought a new dress and she was attending her sisters wedding. Whilst someone else told us that earlier in the month they had gone on holiday with their parent, and had stayed in hotel. Records and care plans showed that relatives visit people at Ark Care Lodge, whilst in some instances people go to relatives houses often staying overnight. The care plans of the four people who we looked at told us that everyone has a weekly timetable, which is individual to them. The range of activities includes going to the library to use a computer, going out for meals and drinks, undertaking a wide range of art and craft activities and attending Colleges for a wide range of topics, some of which include numeracy and literacy skills. There are a range of evening activities which take place, which include going to The Cedars on a Monday evening, Southfields on a Wednesday evening, Fosse Disco on a Thursday evening and attending the Gateway Club on a Friday evening. Everyone we spoke with spoke enthusiastically about their weekly timetable. We noted that everyone attends the same evening events as a group, which does not support person centred care, and therefore may not recognise and develop personal interests, hobbies and pursuits. We discussed this with the Manager who told us that people who live at Ark Care Lodge enjoy the routine and become upset and distressed when changes are made. We asked that in the developing of person centred care plans, people who live at the home have the opportunity to discuss other activities which they may like to participate in, and that individuality be encouraged. Peoples decisions and views need to be recorded to ensure that the care and support they receive is reflective of their wishes, choices and expectations. One survey we received from a relative of someone who lived at the home wrote I feel all the staff are very positive about their attitude towards the people and their care, they offer support and help when needed and encourage independence in home skills and caring for themselves. Ark Care Lodge provides a vegetarian diet, although many people living at the home are not vegetarian, individuals and their family are told before moving into the home Care Homes for Adults (18-65 years) Page 19 of 34 Evidence: about this. The Manager told us that when people go out they are welcome to eat meat products, but they are not purchased and prepared by the staff of the home. The Manager has looked at menus the home provides, and has expanded the range of meals available, which have been discussed with people living at the home. When we visited the home the Manager and two people who live at the home, went to the local supermarket to undertake the weekly shopping, people volunteered to go and returned with the shopping and helped to put it away. Care Homes for Adults (18-65 years) Page 20 of 34 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Ark Care Lodge have access to a range of health care services and professionals, who promote their health and wellbeing. Evidence: A majority of the rooms at the home have an en-suite facility which includes a shower and/or bath, for others they have access to a shared bathroom, personal care is provided by care staff for those who need help. Care plans reflect the support people who live at the home need, and who is to deliver the care. Care plans also include information about the specific needs, which include reference to cultural needs such as hair products, and the frequency of showers. We received a survey from a health care professional, which asked what does the service do well, they wrote:The service delivers a high standard of care. They have a realistic and admirable philosphy of care. The home appears welcoming and clean. The overall environment I have seen to be calm. Attention to promtoing good health care is great. We observed that the staff group reflects the diverse and cultural backgrounds of Care Homes for Adults (18-65 years) Page 21 of 34 Evidence: people living at the home, this enables staff to provide personal care and support to people of the same cultural background where an individual has requested this. Everyone at Ark Care Lodge has a health action plan, which includes information about their health, including routine checks for optician and dentist visit. The health action plan also includes information about specific health care needs including health care appointments with specialists within a hospital setting. Daily records detail contact with health care professionals, and any actions staff at the home need to follow to promote the health and wellbeing of the person. The medication and medication records of three people were viewed and found to be in good order. Recent changes to legislation mean that care homes need to provide appropriate storage facilities for Controlled Drugs, Ark Care Lodge does not have this equipment but no one at the home is prescribed a Controlled Drug. Staff who administer medication have received training. Care Homes for Adults (18-65 years) Page 22 of 34 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 . People living at Ark Care Lodge are confident in raising concerns and know how to make a complaint, and are protected from harm, abuse and neglect by staff who have an understanding of the vulnerability of people in their care. Evidence: A copy of the complaints procedure is displayed in everyones bedroom, and is supported by signs and symbols to promote the understanding to the reader, and includes the telephone number for Social Services. We accompanied one lady who wanted to show us her room, we noticed that on the wall of her bedroom was a copy of the complaints procedure, we asked her what it was, she was able to explain what it was about and read out the telephone number of Social Services to us. People living at the home have access to a telephone and some people at the home have a mobile phone, this enables people to to contact someone if they are unhappy or worried about something. The Manager told us that one person until recently, whilst one person continued to use an advocate, this was to support them in ascertaining their views, where their views were different to others who had a say in their lives. We also read in someones review involving Social Services where someones capacity to make decisions had been considered and had involved an independent health care professional. This shows that the home supports people in making decisions and encourages those living at the home to be heard and their views listened to and acted upon. Care Homes for Adults (18-65 years) Page 23 of 34 Evidence: The open and friendly atmosphere of the home enables people who live there to talk to staff about any concerns or problems they have, in addition some people living at the home have regular contact with their family, which provides an opportunity for people to talk about things they are worrying them. We have not received any concerns or complaints about Ark Care Lodge, since the last Key Inspection, information provided by the Manager of the home told us that the home has received four complaints. We looked at the complaints and found that they had been recorded, along with the outcome of the complaint investigation and any action the home and staff were taking to make changes. We noted that 79 of staff have attained a National Vocational Qualification (NVQ) In Care, part of the qualification looks at how vulnerable people could be at risk of abuse, and the forms abuse may take. Care Homes for Adults (18-65 years) Page 24 of 34 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Ark Care Lodge live in a homely and well-maintained environment, which is suitable to their individual and collective needs. Evidence: Ark Care Lodge is decorated to a good standard, and is clean and comfortable, people who live at the home have personalised their bedrooms to a style of their choosing. The home comprises of two semi-detached houses, with no internal access between the two properties. On the ground floor each house has bedrooms, an open plan lounge and dining room with patio doors leading into the garden, both houses have a kitchen with a back door which leads into the garden. Access between the two houses is via the backdoor and by walking outside and using the garden space. Lounge areas have a television and comfortable chairs for relaxing. All other bedrooms, of which a majority have a full en-suite consisting of a toilet, wash hand basin, shower and/or bath are located on the first floor, bathing and shower facilities are available on the first floor, for those bedrooms that do not benefit from an en-suite. The home has a large rear garden, at the bottom of the garden their is a building that Care Homes for Adults (18-65 years) Page 25 of 34 Evidence: can be used for activities. The garden has a large lawned area, beds for plants and shrubs along with a large patio areas equipped with tables and seating. The garden could be improved by regular maintenance, including the cutting of the grass and weeding of beds, and by the introduction of more plants, and shrubs to make the garden more attractive. The home has a domestic scale laundry, and some people who live at the home are involved in their washing of their own clothes. Care Homes for Adults (18-65 years) Page 26 of 34 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at Ark Care Lodge are supported by a consistent team of staff, who are employed in sufficient numbers that enables people to live an active lifestyle. Evidence: The people living at Ark Care Lodge appeared to enjoy a positive relationship with the staff on duty at the time of the site visit. Staff were seen conversing with people and ensuring they had everything they needed before going out for the day. People who stayed at home continued to be supported by staff and were included in conversations. Ark Care Lodge has a consistent staff group which means that people who live at the home know the staff well, and feel confident about the care and support they receive. We looked at the staff records of the two members of staff who were on duty when we arrived, and found that the records included a completed application form, two written references and a Criminal Record Bureau (CRB) disclosure, which enables the Manager to find out whether potential staff have any convictions which may mean they are not suitable to work with vulnerable people. One relative in the survey we sent them wrote I have always had a very good relationship with the staff and feel i can trust them to pass on information that I need to know. Care Homes for Adults (18-65 years) Page 27 of 34 Evidence: The Manager told us that the home had not recruited any new staff since we last inspected the home, and therefore people who live at the home have not been involved in interviewing people as we had suggested at the last inspection. The Manager did say that the home had been approached by someone who was interested in doing voluntary work, and that three people who lived at the home had asked them questions. The information provided by the Manager before the site visits stated that 79 of staff have a National Vocational Qualification (NVQ) in Care, records we looked at showed that since we last visited the home some of the staff have attended training in managing bereavement, epilepsy and person centred care plan writing and health facilitor training. Records we looked at included planned training for June, September and October where other staff will receive the same training. We looked at the staff rota and during the day their is a minimum of two staff on duty in each house, when everyone is at home, the staffing rota for the week varies dependent upon the activities people are involved in and the number of people who will be at home at anyone time. The flexibility in staffing enables peoples to go out and take part in activities, some people living at the home receive additional funding that enables them to receive one to one support from a member of staff. Observations made during the site visit and discussions with staff on duty demonstrated they have a good awareness of peoples needs. Staff were confident to support people living at the home, and were aware of the importance of continuity and consistency of care. We saw there was a relaxed and open culture, where staff morale appeared to be good, which promotes teamwork that benefits people living at the home. Staff said they attend regular meetings and that the Manager observes their work practices. Staff do not receive a formal one to one supervision, where the Manager and a member of staff spend time discussing work practices, training needs, and topics which support the care of people and day to day running of the home, this is an area for improvement. Care Homes for Adults (18-65 years) Page 28 of 34 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 . Ark Care Lodge is managed in the best interests of people who live at the home by involving them in the day to day running of the home, documentation does not in all instances record the achievements of the home. Evidence: Ark Care Lodge has a Manager who has been in her current position for two years, prior to this they worked at the home as a member of care staff. The Manager has attained the Registered Managers Award and told us that later this year she will be undertaking a course entitled First Line Management Initiative, since we last visited the home the manager has undertaken one day courses in Person Centred Care planning, bereavement and epilepsy. The Manager when we last visited the home told us that they attended to apply to us to become the Registered Manager, but we have not received an application, the Manager reaffirmed her intention to submit a Registered Manager application to the Care Quality Commission. Prior to the site visit the Manager submitted the homes self assessment tool (AQAA), this was not comprehensively completed and did not reflect the service the home provides, and contained minimal information as to planned developments in the Care Homes for Adults (18-65 years) Page 29 of 34 Evidence: service provided to people who live at the home. Documentation within the home needs to improve to reflect the services provided to people, we found that conversations with people who live at the home, staff and the Manager show that the home is run well and that the interests of people living at the home are promoted, but this is often not documented. We received a survey from a health care professional which asked them what the service could do better, they wrote:The service has poor communication between management and staff for example some staff are unaware of advice I have passed onto other staff. A thorough handover would resolve much of the communication problems. Surveys we received from some relatives also felt that communication was sometimes poor, with information not being passed on between staff. The home has developed a quality assurance system, which involves sending questionnaires to people who live at the home, but there was no evidence as to how the information gathered from surveys was acted upon or used to develop the service. There are regular meetings for people who live at the home to discuss their views, these are facilitated by staff. Information supplied by the Manager before the site visit details the home is run in a manner which promotes the health, safety and welfare of people living at the home by the ongoing maintenance, and checks to systems in the home, including electrical appliances and fire equipment. A lady who lived at the home asked us to look at their bedroom, we noticed on the wall was a laminated copy of the homes fire procedure, which was supported by pictures and symbols. We asked the lady what it was, and she was able to tell us about the fire procedure, which included where the meeting point was and stressed to us that theyre not to worry about personal possessions as they can be replaced, and the important thing was being safe themselves. The lady also told us that they have practice fire drills. Care Homes for Adults (18-65 years) Page 30 of 34 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 31 of 34 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 1 7 17 The Registered Person to 30/06/2009 ensure their is a clear financial audit trail for all monies managed on behalf of or where support for the management of service users finances is provided. To ensure that service users finances are managed well to avoid exploitation. 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 1 7 The Manager to have a clear audit trail, which evidences how service users manage their spending money, with a record of incoming monies and expenditures that reflect the money kept on the premises on behalf of the service user. The Manager to include within service users care plans the arrangement for the management and support of service users finances, which includes their wishes, whilst Page 32 of 34 2 7 Care Homes for Adults (18-65 years) promoting choice and independence. 3 16 The Manager to discuss with people who live at the home, their views about group evening activities and find out whether anyone wants to access activities independently or in smaller groups. To ensure that people received individual and tailored care and support as they wish and prefer. The Manager to find out what drugs are considered to be Controlled Drugs and how they are to be stored, and give consideration as to whether the home should have a Controlled Drug storage facility, which complies with legislation in the event of someone living at the home being prescribed medication which requires Controlled Drug storage. Staff to attend training which enables them to understand the types of abuse that vulnerable people are at risk from, and their role and responsibility in responding to and report abuse or neglect. The Manager to review the current communication systems to ensure effective communication amongst all staff. 4 20 5 23 6 38 Care Homes for Adults (18-65 years) Page 33 of 34 Helpline: Telephone: 03000 616161 or Textphone : 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 © (2009) Commission for Social Care Inspection (CSCI). 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. 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