Care Home: Upper Ford Lodge

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What the care home does well Staff have now been recruited so the staff group is at full complement, this includes two male staff which replaces the male staff members who have left the service. The acting deputy manager has introduced a system where groups of the same staff work with the same people, to try to have a group of familiar people working together. The staff team have worked well to reduce the impact of the recent changes on people living at the home, which includes monitoring of any changes in people`s communication. What the care home could do better: The manager should make clear to staff what arrangements are in place to enable staff to tell them of any bad practice in the service. Staff would benefit from an update to their safeguarding training provided by the local authority or other external training provider, which includes information on whistle blowing and the Public Interest Disclosure Act 1998. The manager should continually review the rota arrangements to ensure people using the service receive the maximum support at times to suit them and their chosen lifestyle, particularly in the evenings. Staff should be supported to move on from the serious incident at the home earlier in the year. This could be achieved by a more visible and supportive management presence. The registered manager has now been away from work for eight months. The Care Homes Regulations 2001 state that the service provider must register a manager for the service. We will be writing to the service provider to request information about their plans to register a manager for the service. Random inspection report Care homes for adults (18-65 years) Name: Address: Upper Ford Lodge Ford Lane Droitwich Spa Worcestershire WR9 0BQ two star good service 20/10/2008 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Emily White Date: 0 4 1 1 2 0 0 9 Information about the care home Name of care home: Address: Upper Ford Lodge Ford Lane Droitwich Spa Worcestershire WR9 0BQ 01905779949 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) : autism. west midlands care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 8 The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 8 Date of last inspection Brief description of the care home Upper Ford Lodge is in a rural area on the outskirts of Droitwich. It consists of two properties, one house providing the residential accommodation and one offering linked day centre facilities for people using the service, set in a large secure garden area. The service is currently registered to provide for 8 people accommodated in 8 single bedrooms on 3 floors, with a kitchen, dining room and two communal rooms, plus staff offices. Weekly fee levels range from 1706 to 2077. The service provides residential care for up to 8 younger adults with autistic spectrum disorder. There are opportunities Care Homes for Adults (18-65 years) Page 2 of 9 2 0 1 0 2 0 0 8 Brief description of the care home for support for personal and social skills development and to ensure access to a range of social and leisure opportunities in both the home and community. The registered providers are autism.westmidlands. The Chief Executive Officer, Ms Carolyn Bailey, is the Responsible Individual. The registered manager is Mr Kevin Hayes. A residential services manager provides professional line management support and supervision to the registered manager on behalf of the providers. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: Following a serious incident at the home earlier in 2009 we have received several anonymous reports that staffing and morale at the home have been affecting the lifestyle of those who live there. Concerns that have been raised with CQC include: inconsistent support for people using the service from changing staff, a drop in activities, and a change in behaviour of some people using the service who need routine and familiar people in their daily lives. During our visit we spoke to the acting deputy manager, staff and looked at some daily diaries of people who live at the home. During our visit between 2 and 4PM the majority of people who live at Upper Ford Lodge went out to do various activities, but we were able to observe some people leaving and returning with their support staff. The acting deputy manager and staff confirmed that there had been a high use of agency staff in recent months due to a loss of staff and the need to recruit. This had been managed by using the same agency staff to try to ensure consistency. Staff have now been recruited so the staff group is at full complement, this includes two male staff which replaces the male staff members who have left the service. The acting deputy manager has introduced a system where groups of the same staff work with the same people, to try to have a group of familiar people working together. We spoke to staff who confirmed that this new system has just started, and they felt that this would be a good system in time. We asked staff about activities and changes in behaviour of people who live at Upper Ford Lodge. Staff told us that most people using the service had not been showing distressed behaviour and that the staff team had worked well to reduce the impact of the recent changes on people living at the home. Staff did say that due to staffing issues the amount of activities on offer had dropped and some booked activities had been cancelled. This was a particular concern in the early evening, people are now not able to go out in the evening for example to the pub. Staff also said that since the new permanent staff had been recruited there were more activities on offer and people are able to more things. Staff said they had started to include people in activities in the home such as cooking. One person was being assisted in the kitchen during our visit. Others had been swimming, to college and out on walks. We looked at some daily diaries for the past month which show people participating in varied activities during the day but very little in the evenings. Staff felt that two good things to have happened were that people had been on holidays and the arrival of a new resident had been very successful. Staff said that one person using the service had been displaying some different behaviour to usual in recent months. The daily diary confirmed that this had been happening, and that staff had been dealing with this appropriately. Behaviour monitoring and personal care plans were not looked at at this inspection but will be part of the next inspection. It is important for the service to be able to show that they are monitoring unusual or distressed communications for all people who are using the service, to ensure that everyone is receiving the care and support they need. Following a serious incident at the home earlier in 2009 we asked the acting deputy manager and staff what had been done to reinforce staff knowledge of safeguarding and whistle blowing procedures. We were told that there had been staff meetings, posters Care Homes for Adults (18-65 years) Page 4 of 9 about adult protection had been put up, and staff had received an information booklet recently. The staff we spoke to during our visit showed a good understanding of the adult protection and safeguarding policies. We spoke to a new member of staff who said that he was booked to attend some training on this. However some staff told us that following from recent events at the home they did not understand or felt nervous about whistle blowing policies. In light of recent events at the home it is important that the manager makes clear to staff what arrangements are in place to enable staff to tell them of any bad practice in the service. We asked the acting deputy manager for a copy of the most recent training matrix, which he was not able to provide that afternoon. In light of recent events at the home, staff would benefit from an update to their safeguarding training provided by the local authority or other external training provider, which includes information on whistle blowing and the Public Interest Disclosure Act 1998. We spoke to the acting deputy manager and some members of staff during our visit, who confirmed that although the service has been short staffed and agency staff have been used, there is now the full complement of staff. We asked the acting deputy manager for an example of the current rota which he could not provide at the time but which was sent through to us. Staff confirmed that the system is now a three week rolling rota and staff and people using the service are familiar with who will be working on what days. The main concern raised by staff was that there are fewer staff in the evenings and this has prevented people using the service from being able to go out in the evenings. It will be good practice for the manager to continually review the rota arrangements to ensure people using the service receive the maximum support at times to suit them and their chosen lifestyle. The acting managers have introduced a new team based system of working. We spoke to staff who confirmed that this new system has just started, and they felt that this would be a good system in time, but it had not been in place long enough to comment. Supervision and team meetings for support staff are lead by team leaders (senior support staff). Team leaders are supervised by the managers. Support staff told us that they felt that they had not been fully supported since the incident earlier in the year. All staff told us that they felt they needed to be debriefed and that a visible and supportive management presence would help staff and the wider service to move forward. Following a serious incident at the home the registered manager has not been working at the home since March 2009. Interim arrangements have been in place and the home is being managed by an acting manager and deputy manager who run a supported living service owned by autism.westmidlands. The registered manager has now been away from work for eight months. The Care Homes Regulations 2001 state that the service provider must register a manager for the service. Following from the incident earlier in 2009 we have been made aware of concerns that staff morale is low and staff have not felt supported by a strong management presence at the home. During our visit to the service we spoke to the acting deputy manager who confirmed that he and the manager usually run a supported living service in Birmingham and are dividing their time between the two services. We were not able to confirm how much management time the acting managers have been able to spend at Upper Ford Care Homes for Adults (18-65 years) Page 5 of 9 Lodge but the acting deputy manager told us that either he or his colleague visits the service every day. Staff tell us that they find the acting managers approachable and that they have started to make some changes to the way things are done. However staff also said that due to working shifts there are times when they may not see a manager from several days. What the care home does well: What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 23 The service should continue to carefully monitor unusual or distressed communications for all people who are using the service, to ensure that everyone is receiving the care and support they need. Staff would benefit from an update to their safeguarding training provided by the local authority or other external training provider, which includes information on whistleblowing and the Public Interest Disclosure Act 1998. The manager should make clear to staff what arrangements are in place to enable staff to tell them of any bad practice in the service. The manager should continually review the rota arrangements to ensure people using the service receive the maximum support at times to suit them and their chosen lifestyle, particularly in the evenings. Staff should be supported to move on from the serious incident at the home earlier in the year. This could be achieved by a more visible and supportive management presence. Page 8 of 9 2 23 3 23 4 33 5 36 Care Homes for Adults (18-65 years) Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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