Care Home: White Moon Lodge

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What the care home does well Residents feel at home and relaxed at White Moon Lodge because members of staff meet their individual needs and wishes. They benefit from being supported by staff who know them well since moving into the home seven years ago and who they get on well with. The stability of the staff is valuable as two residents have an autistic spectrum disorder which means that it takes them longer to make relationships. The home has an experienced manager who keeps in close touch with both residents and relatives. Residents have frequent visits from relatives and in one case a resident regularly stays with their family.The manager has a good rapport with the consultant psychiatrist and the residents` social workers so that the home quickly responds to and meets the changing needs of the residents. Residents are helped by staff to take part in a range of activities when they are at home. A high priority is given to training so that members of staff are as competent as possible in their support of residents. What has improved since the last inspection? At the previous inspection there had been 5 areas that the home had to improve. The home has taken action on all areas. regular supervision of staff updating of the service user guide. Recording of complaints. person centred training updating of risk assessments. Residents enjoyed their holidays to Cornwall. Residents enjoy more music channels. What the care home could do better: Two areas where the home could be doing better were discussed and agreed with the manager. 1) to ensure that there is a system in place to monitor maintenance checks. 2) The risk assessment should include a contingency plan for additional staff support to deal with aggressive behaviour if this is required. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: White Moon Lodge 156 Philip Lane London N15 4JN     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: Diaman Balraj     Date: 1 2 0 1 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. the things that people have said are important to them: They reflect 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. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: White Moon Lodge 156 Philip Lane London N15 4JN 02083764246 02083764246 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Sona Beezadhur care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home White Moon Lodge is run by Mr Sona Beezadhur who is both the owner and registered manager. It is a small care home for up to three people with learning disabilities. The home is close to local facilities and shops. The house is a terraced property situated in a residential area. Upstairs there are three bedrooms for residents and a small office for staff. Downstairs there is a kitchen-diner, lounge, bathroom with toilet, shower room and another office that is also used for staff sleeping in. There is a small back garden which residents make use of in warmer weather. The home provides support to people who have complex needs, including autistic spectrum disorders, and behaviours that can be challenging. There is a minimum of one staff member available throughout the daytime and sleeping in on the premises at night. The home aims to provide as ordinary a life as possible for residents and to encourage them to be as independent as possible. The current range of fees is between £750:00 to £800:00 per week. White Moon Lodge makes inspection reports and other important information about the home available to residents, their families and professionals. 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 24 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 peterchart Poor Adequate Good Excellent How we did our inspection: The unannounced inspection took place over one day and lasted 5 hours. The member of staff on duty and the manager of White Moon Lodge were interviewed and helped with the inspection. We toured the building and all three residents were seen and spoken to briefly. It was not possible to have any detailed discussion with the residents about their care because of their communication difficulties. The interaction between the 3 residents and a member of staff before they went to the day centre was observed. A variety of records, including care plans and Health and Safety documents were looked at. The overall impression from the inspection was of a home that is providing a good standard of care to people with complex needs within a homely and supportive environment. Care Homes for Adults (18-65 years) Page 5 of 24 Care Homes for Adults (18-65 years) Page 6 of 24 What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 24 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 8 of 24 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. The home is good at assessing and meeting the needs and wishes of residents. The service user guide was accurate and told people about the home and what they can expect. Evidence: From the evidence seen and discussion with the manager we are satisfied that the home undertakes a thorough pre-admission assessment from which a care plan is developed with input from the resident where possible, family members where appropriate, and health and social care professionals. The service user guide reflected the actual service that was provided. Care Homes for Adults (18-65 years) Page 9 of 24 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. Residents benefit by having care plans which detail how their needs will be met. Residents are supported by staff so that wherever possible they make decisions for themselves. The home ensures that residents have detailed risk assessments to ensure their safety. Risk assessment reviews must include a contingency plan for additional support if this is deemed necessary. Evidence: All three residents appeared settled in the house. We observed that they looked forward to going to the Day Centre and waited for the Day Centre transport to pick them up in the morning. The care plans are detailed and cover all aspects of the residents life. The daily schedule of activities was person centred, based on the individuals preferences. One resident likes to do sums and was given the opportunity to add and multiply. Care Homes for Adults (18-65 years) Page 10 of 24 Evidence: The residents at the home all have high needs and staff are skillful in interpreting these needs. The member of staff interviewed appeared to have a good knowledge of residents likes and dislikes and was adept in meeting their choices. Residents are supported to make decisions about what they want to eat and how they spend their time at the home. The manager had completed detailed risk assessments for each resident. Residents benefit from being supported to be as independent as possible whilst minimising risks to their welfare. However the risk assessment should include a contingency plan for additional staff support if this is required. Care Homes for Adults (18-65 years) Page 11 of 24 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. Residents enjoy a good quality of life as a result of taking part in a range of stimulating activities including community activities. Residents benefit from the home facilitating close contact with family and friends. Residents benefit by staff enabling them to make choices and to have as much control over their lives as possible. Residents benefit from having a healthy and varied diet. Evidence: Residents take part in a variety of daytime activities, including attending day centres. Outings and short break holidays are also provided by the home. Residents are also encouraged by staff to help with domestic tasks in the home such as cleaning. The manager and staff stated that residents access their local community, including going shopping, to the cinema, local cafes and leisure centre. Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: A staff member described the regular contact each resident had with their family. In one case the resident has regular stays at their family home. The home supports residents to keep in touch with their families. Interviews with the manager and staff indicated how the home empowers residents and increases the choices they can make. Residents are supported to indicate their preferences at breakfast and meal times. We noted that great emphasis was placed on residents having a healthy and varied diet that takes into account cultural preferences. Staff know what residents like to eat. Records confirmed that residents enjoy the meals provided by the home. Care Homes for Adults (18-65 years) Page 13 of 24 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 support residents according to their wishes. The physical and emotional needs of residents are met. Residents benefit from effective arrangements regarding the administration of medication and medication reviews. Evidence: We observed that residents were relaxed and felt supported in the presence of staff. The family- like atmosphere of the home and staffs knowledge of residents were conducive in helping residents with challenging behaviours and high anxiety levels to feel more relaxed. A care staff member was observed supporting the residents getting ready for the day centre. The residents were guided on what they needed to do in terms of what they had for breakfast and putting coats on before going out. The residents responded well to their care worker and appeared comfortable with her support. One resident who tends to get agitated at times was gently supported and became more relaxed. The medication cabinet and medication records were looked at and were satisfactory. Medication profiles corresponded to what was on the administration sheet. The home Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: used the monitored dosage system( blister pack). Regular reviews of medication by the Psychiatrist and annual optical and dental checks are carried out. Care Homes for Adults (18-65 years) Page 15 of 24 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. The home deals well with complaints so that residents and relatives feel confident their complaints and concerns will be listened to and acted on. The residents benefit from effective adult protection measures which ensure their safety. Evidence: The home has a satisfactory complaints procedure. The last complaint recorded in the complaints book was on the 26.10.2007. The complaint had been satisfactorily resolved. It was observed that residents were treated with respect and received good support from staff. Staff have attended training courses on how to protect vulnerable adults from abuse. The member of staff on duty demonstrated good knowledge of how to deal with challenging behaviour and had followed the safeguarding adults course. Care Homes for Adults (18-65 years) Page 16 of 24 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. Residents at White Moon Lodge enjoy an attractive, comfortable and clean living environment that enhances their quality of life. Evidence: White Moon Lodge has a homely and comfortable environment allowing residents to be be relaxed in their bedrooms or in the lounge. The home was in good decorative order with bedrooms reflecting the individual taste and preferences of each resident. On the day of the inspection the home was tidy and hygienic. Care Homes for Adults (18-65 years) Page 17 of 24 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. Residents are supported by committed and experienced staff who are able to meet their needs. The home has a rigorous recruitment policy. The recruitment process ensures the protection of residents. Residents benefit from being supported by staff who are supervised on a regular basis. Evidence: Staff at the home are familiar with the needs and wishes of residents and learnt how best to meet the complex needs of all three residents. It was apparent that when speaking to both the manager and the member of staff that residents benefit from stable and supportive environment. Staff meetings are held by the manager so that members of staff can raise issues regarding the welfare of residents and the running of the home. White Moon Lodge has three full time staff with support as needed by the manager. Staff files were looked at and contained the information needed to confirm that all new staff in the home had undergone the appropriate checks. Members of staff have undertaken appropriate NVQ training in Health and Social Care for adults. Specialised training to equip staff to work with the current group of residents has been undertaken, including ways of managing challenging behaviours. Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: Staff files showed that members of staff have supervision meetings with the manager on a two monthly basis although the manager is available on a daily basis to discuss any issues pertaining to the welfare of residents. Care Homes for Adults (18-65 years) Page 19 of 24 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. Residents experience a good quality of care at White Moon Lodge because the home provides a service designed to meet individual needs. Residents preferences influence the operation of the home. Records are in order. Evidence: In analysing the quality of care provided it was evident that staff placed emphasis on encouraging residents to pursue their interests . Staff purchased numeracy books to help a resident with his hobby. A number of improvements have taken place based on reviews of residents needs. A residents haircare is now more culturally appropriate. Music channels have been introduced to allow residents who enjoy singing or dancing to engage in these activities. An annual survey is carried out to get feedback from residents, relatives and professionals. These surveys contained positive feedback about the home. It was noted that there was positive feedback from relatives. Relatives were also able to raise Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: concerns directly with the home. Records were checked, including health and safety and accident reports. These records were detailed, up to date and accurate. Fire safety procedures and checks were in order. The electrical wiring system check was last done on the 5.10.04 and was valid for three years. This was discussed with the Proprietor/registered manager at the time of the visit. He has confirmed that an electrical wiring system check has been scheduled for the 28.1.09. The Proprietor/registered manager must ensure that a system is in place to monitor when checks are required. Care Homes for Adults (18-65 years) Page 21 of 24 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, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 2 6 42 It is strongly recommended that risk assessments include a contingency plan for additional staff support if required. There should be a system in place to monitor maintenance checks. Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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). 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