Inspection on 17/11/09 for Slade House

This is the latest available inspection report for this service, carried out on 17th November 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Slade House 11/01/06

Slade House 19/07/05

Slade House 08/06/04

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Flint House

Hillview Farm

Dalewood Respite Care

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REACH Upton Court Road

The Cotswold Home

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Treloar College

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Slade House 17 Huckleberry Close Purley on Thames Berkshire RG8 8EH     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: Yvonne Souden     Date: 1 7 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Slade House 17 Huckleberry Close Purley on Thames Berkshire RG8 8EH 01189427608 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: rachelk@purleyparktrust.org Purley Park Trust Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users ot be accommodated is 8 The registered person may provide the following categories of service only: Care home only:(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) Physical Disability (PD) Date of last inspection Brief description of the care home Slade House is residential care home providing care and accommodation for adults with learning disabilities and is part of Purley Park Trust. The Trust comprises of eight residential care homes, and support facilities that includes horticultural therapy and a day care service. Social, recreational and leisure pursuits are provided within an on site club house. Purley Park is close to Reading town centre, and to public transport facilities. Parking is available within the grounds of Purley Park. 0 3 1 2 2 0 0 8 8 8 Over 65 0 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 quality rating for this service is 2 stars. This means the people who use this service experience Good quality outcomes. The operations manager of Purley Park Trust completed an Annual Quality Assurance Assessment (AQAA), which is a legal document provided, by the commission. The AQAA was used by the manager and provider to review their service and inform the commission of their findings. The AQAA was used as part of the evidence to inform this report. Other evidence used to inform the report included a 4.5 hour site visit to the service by two inspectors. This enabled the inspectors to observe care practises and speak to people who use the service, staff and management of the home. Other evidence used to inform this report was documentation viewed by the inspectors during the site visit. Care Homes for Adults (18-65 years) Page 5 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 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 6 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 7 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. People who want to live in the home have their needs assessed prior to their admission, and have their health and social care needs reviewed regularly following admission to the home. Evidence: There is a mixed age group of eight residents living within Slade House aged between twenty three and seventy eight. This clearly works well from our observation of residents and staff enjoying time together. Three of those residents recently came to the home to live following a thorough period of assessment that was evident from our discussions with staff and from records viewed. Staff spoke of the process of assessment that had taken place prior to a new resident coming to live in the home that involved visits to the persons previous home over a period of time, and visits made by the person to Slade House. Written assessments by the placing authority and by the operations manager gave the home the information they needed to make a decision on whether they could meet the persons individual needs. Records also demonstrate that existing residents have their personal, health and social care needs regularly reviewed. Care Homes for Adults (18-65 years) Page 8 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. People who use the service have a care plan that promotes their independence and decision-making, whilst risk assessments promote their safety within the decisions they have made. Evidence: The last key inspection by the commission in 2008 required the home to ensure that all residents have an up to date written plan as to how their health, personal and social care needs and goals are to be met. Care staff who are key workers to residents spoke of the residents care plan, and of reviews undertaken with involvement of the resident. A resident observed us looking at their care plan and was able to describe some of their care needs as detailed, clearly demonstrating their awareness and involvement of their care plan. Records of care planning that we viewed were well written clear and concise that included, for example, the persons essential life care plan that details the persons individual day to day preferences and routines, and a relationship map that identifies the people who Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: are involved in the persons life, for example family, friends and health and social care professionals, and all about me information that is individual to each resident and is used to help everyone who cares for the person to understand the persons special needs. Care plans and risk assessment demonstrate that the service promotes the residents chosen lifestyle around the decisions they have made. Risk assessments clearly outline how staff can support the person whilst minimising associated risks. It was evident from observation of staff assisting residents that they support choices made by the residents within a risk management framework; daily records written by staff also demonstrate that residents chosen daily activities are promoted. Care Homes for Adults (18-65 years) Page 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to maintain contact with family and friends, and are supported to maintain their chosen lifestyle. Evidence: Residents spoke of holidays and daytrips. One resident was very excited over the prospect of going to the theatre with relatives, and another spoke of going home for Christmas. One resident spoke sadly of friends who have passed away, and was reassured by staff in a compassionate and supportive manner. Residents and staff invited us to join them for lunch. Lunch was a choice of home made soup or sandwiches and was enjoyed by all. Menus are completed weekly and are discussed at the residents meetings to ensure residents have choice and are involved in menu planning. Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: We observed a very relaxed and friendly atmosphere between staff and residents at lunch time, all eager to tell each other of the morning events and plans for the afternoon. Staff and residents informed us that Tuesdays are generally busy for most of the residents as they attend college within the day centre, and grounds of Purley Park Trust. Professionals from Thames Valley University (TVU) visit the Trust for those people who cannot attend an external college placement to cover topics of numeracy, literacy and photography. The trust has a daycare service that employs a team of staff separate to those employed within the residential homes. Residents from Slade House and other houses within the complex attend the day care service not only to participate in various educational courses, but also to participate in structured daily and evening recreational activities. Records made within the homes diary demonstrate various activities planned for residents as supported by staff, for example bible studies, the gateway club and attendance to a gym. Care plans and six monthly review documentation details the residents chosen activity, and support they require to continue. Residents said that they are happy in the home and have a good relationship with staff and fellow residents. One resident spoke of support received from their key worker to become more independent within daily living tasks, and the key worker spoke enthusiastically of the success to date supporting the resident to become more independent around those daily living tasks. We observed that residents are able to access areas of the home freely and independently, and access the community with support to maintain a lifestyle that respects the choices they have made, within a risk management framework. Care Homes for Adults (18-65 years) Page 12 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. People who use the service receive support from staff to meet their health, psychological and personal care needs in a dignified and respectful manner, and as identified within their care plan. Evidence: The homes Annual Quality Assurance Assessment (AQAA) as required by the commission stated, Care plans for every resident are now in place and updated where necessary in accordance to all personal and healthcare needs. The AQAA stated that every resident receives full support for all medical appointments from making appointments, planning appointments, attending, talking to the professionals and passing on the information required to the staff team and other parties where relevant. Information within the files that we viewed and discussion with residents and staff evidenced the above statements within the homes AQAA to be a true account. Information within each file clearly records the health care needs of the resident and details the support they require to ensure their health care needs are met, for Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: example, diaries record residents health appointments and care plans, and a key worker system supports and enables residents to receive personal care in the way they prefer. Staff have received training so that they have the skill and knowledge to support the resident within their personal and health care needs, for example, training within epilepsy, first aid and administration of medication. Staff were observed to be polite, caring and respectful towards the residents and residents appeared well cared for and comfortable with staff. The homes AQAA states, Every one of the eight residents takes medication. The Trust as a whole uses the NOMAD dosage boxes and all staff who administer the medication receive training first and have to be signed off as competent to administer by the Training Manager or Operations Manager. It was evident from records viewed and discussions with staff that staff follow the homes medication policies and procedures to minimise the risk of mistakes happening within the administration of residents medication. Care Homes for Adults (18-65 years) Page 14 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. People who use the service are listened to and know how to make a complaint should they have a concern. Policies, procedures and staff training protect the people who use the service from abuse. Evidence: The home has a complaint procedure that is accessible to the residents, and is in a format that they can understand. Residents were observed to talk to staff at ease, and staff were observed to listen. There has been two complaints recorded within the homes complaint logbook since their last inspection by the commission in 2008, the complaints were managed within the timescale of the homes complaint procedure. The Care Quality Commission has not received any complaints about the service provided within the home. Staff said that they would not hesitate to protect residents from abuse, and know the procedures to follow to protect residents from abuse. The home has a copy of Berkshire Safeguarding Adults Policy and Procedures, and a whistle blowing policy. Staff have received training to protect the people who use the service from abuse. Care Homes for Adults (18-65 years) Page 15 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. People who use the service live in a comfortable, homely and hygienic environment that has adaptations to meet their diverse needs. Evidence: On the day of the inspection a tour of the premises took place. The home is purpose built, and very spacious. It is easily accessible for those with walking aids, wheelchairs and motorised vehicles. The home offers a safe and comfortable environment for residents that is bright, fresh, homely and clean throughout. Furnishings and fittings are domestic in character. Television and music facilities are fitted in the lounge area and residents are able to access a paved and furnished patio area from the lounge and dining room. Residents have personalised their bedrooms and all have en suite facilities. Infection control procedures are used to promote infection control, for example, protective clothing was available for staff to use when assisting residents with personal care, and to use within the laundry and kitchen. Staff have received training within food handling, infection control and fire safety. Regular checks of fire extinguishers, fire alarms and emergency lighting takes place, Care Homes for Adults (18-65 years) Page 16 of 24 Evidence: and the homes fire safety risk assessment is regularly reviewed. On site maintenance staff and gardening staff ensure the premises and surrounding gardens are well maintained. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a trained staff team who are caring, enthusiastic and sufficient in numbers to support and meet the needs of the people who use the service. The homes recruitment procedures protect the people who use the service. Evidence: Staff were observed to be very caring and attentive towards the people who use the service that contributed to a happy and homely atmosphere. The homes annual quality assurance assessment (AQAA) as required by the commission states that staff are supported, trained and guided to respect residents. Their inductions cover knowledge about various disabilities and illnessses that are relevant. The AQAA also stated that all staff, except two in the home, either have or are working towards NVQs relevant to their role and that an increase of staff numbers to allow for staff to spend more quality time in supporting needs, activities and behaviours of residents much more effectively. Again information within the files that we viewed and discussion with residents and staff evidenced the above statements within the homes AQAA to be a true account. Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: The training and supervision records of staff identify that care staff are supported to meet their training and development needs by accessing internal and external training. Records show that most staff have an NVQ, or are in the process of completing an NVQ with exception to new staff. We looked at the file of two new carers employed by Slade House. Records within each file demonstrate that the service follows a thorough recruitment process that includes a criminal record bureau check (CRB), and references from previous employers to evidence the persons suitability as a carer, and to protect the people who use the service. The staff rota identifies three staff on duty throughout the day, and sleep in staff at night. The manager is aware that the rota needs to clearly identify the full name of staff on duty, to include sleep and waking night staff, and confirmed they will undertake to amend the rota to demonstrate staff on shift over a 24 hour period. 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. The manager is a competent and caring manager who has the qualifications and experience to ensure the safety of the people who use the service and staff team, and to promote continual improvement of the service provided. Evidence: A new manager was appointed in December 2008 and has the qualifications and experience to effectively manage a care service. The manager is in the process of registering with the Commission to become the registered manager. The inspection in 2008 made six requirements that were mostly in relation to documents and quality assurance systems that monitor procedures within the home. Within two days of the inspection the commission received a detailed improvement plan from the operations manager detailing how they would meet the requirements, and by which date. This was further followed by a letter from the service to the commission in February 2009, to confirm that all requirements had been met. The manager said that he receives the support he needs from his line manager to Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: manage the service well, and spoke of the changes they have made to improve records and to demonstrate an effective and good service. Regulation 26 visits are undertaken either by the operations manager, responsible individual or by a person who is a member of the Board of Trustees and reports are written of their findings. Records show that regulation 26 inspections have been undertaken regularly as part of the homes quality assurance monitoring. Other quality assurance procedures are in place to gain the views of the people who use the service and stakeholders to ensure the views of the residents are listened to, for example, surveys and residents meetings. Policies and procedures are regularly reviewed and an annual development plan is in place to promote the aims and objectives of the service provided. Health and safety checklists are completed to ensure the safety of residents, staff and visitors that include fire safety. Staff attend health and safety training and training within for example, non-violent crisis intervention, minimal handling, food and hygiene and fire and extinguishers training. 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 Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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