Inspection on 25/07/06 for 1 & 1a Christchurch Gardens

This inspection was carried out on 25th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 & 1a Christchurch Gardens 06/03/06

1 & 1a Christchurch Gardens 19/11/05

1 & 1a Christchurch Gardens 08/03/05

1 & 1a Christchurch Gardens 21/04/04

Similar services:

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 1 & 1a Christchurch Gardens Reading Berkshire RG2 7AH Lead Inspector Jill Chapman Unannounced Inspection 25th July 2006 09:30 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 1 & 1a Christchurch Gardens Address Reading Berkshire RG2 7AH Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0118 931 2032/31 0118 931 2031 londonroad@tiscali.co.uk Milbury Care Services Limited ***Post Vacant*** Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th March 2006 Brief Description of the Service: 1 and 1a Christchurch Gardens are 2 adjacent detached properties situated close to Reading town centre. Each home provides care for up to four adults with learning disabilities. The current service users are all males aged between 18 and 65. Each Service User has a single bedroom. 2 bedrooms have en suite facilities. There are 2 bathrooms in each property. Each Service User has his own bedroom and there is a kitchen/ diner, lounge and office in each house. There is large garden to the rear. Service Users have a variety of needs and the service provides an individual approach to meet and review needs. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on a weekday over a period of six hours. The focus was to follow up progress from the previous inspection and to inspect the key standards. Time was spent looking at service user and staff records, speaking to the manager, staff on duty and both parts of the house were seen. All of the service users were seen during the course of the inspection. They are mainly non-verbal and were unable to give the inspector direct feedback about the quality of care. It was possible to observe some of the daily routine and three relatives helped service users fill in pre inspection surveys. What the service does well: What has improved since the last inspection? 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 6 A suitable manager has been appointed and there is continuity of care for service users. Risk assessments have been updated. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a system to make sure that service users would be assessed prior to admission to make sure the home can meet their needs. EVIDENCE: There have been no recent admissions but there is a Milbury admissions procedure which includes a full assessment. Feedback from service user surveys show that they had good information prior to moving into the home and that they had a choice about where to live. In discussion with the manager it was clear that she would make sure that an assessment is carried out for future admissions to make sure that the home could meet the needs of a new service user. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Some progress has been made to update care plans and risk assessments but other supporting care documentation is not up to date. Service users choices are respected. EVIDENCE: Four service users files, which included care plans, reviews and risk assessments were sampled. Daily records were also seen for four Service Users. There is an improvement in that the work to update care plans has been started and the manager is reorganising service users files to make them more accessible to service users and staff. Some annual reviews have been held and others are planned. A shortfall is that monthly summaries, which show that care plans are being reviewed, have not always been carried out. Weight charts are still out of date 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 10 as identified at the last inspection. The manager needs to monitor that staff are carrying out delegated tasks. There was evidence of choice being offered to service users from observation of practice and in records seen. Service users preferences are well documented in a Support Requirements document, which identifies their care needs and how they like to be helped. Communication passports help staff understand their wishes. Choice is only overridden to protect service users. An example is two of the service users are not are not taken out together because they don’t get on with each other. Advice was given that this risk decision needs to be supported by a written risk assessment A requirement to update risk assessments has been met. Risk assessments sampled show that they have been reviewed on 13/06/06. The manager is planning to review the format of risk assessments to make them more accessible. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users benefit from good access to day services, activities and holidays. They enjoy contact with families or advocates and staff support them to access their rights as citizens. They benefit from a balanced diet which they help choose. EVIDENCE: In discussion with staff and service users and from looking at records it was clear that the service users have formal day services. These include community awareness, trampolining, music and a meal group. They enjoy leisure activities in the local community which include going out for drives, walks, shopping, cinema, pubs and Ten pin bowling. Staff support ervice users to have a holiday, some prefer day trips but others have bee to or are planning holidays to holiday parks. One service user was going to Blackpool on the inspection day. It was clear from speaking to staff 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 12 that holiday risks had been assessed but these need to be backed up by a written risk assessment. Service users surveys and discussion with staff and service users show that they are supported to maintain contact with tgheir family and friends. Two service users have advocates because they have no family contact. In discussion with staff and service users it was seen that staff help service users access their rights as citizens, they are registered on the Electoral Roll and have free bus and cinema passes. Service users were seen to move freely around the house and thave access to all parts, including the study. One likes to sit with staff while they work. Staff support service users to open and deal with their mail and to collect their benefits. There was positive feedback from service users and parents about the quality of food. There was evidence of their individual choice on menus seen. Staff asssist service users by prompting if needed. Some service users can help themselves to drinks between meals and staff assist others to keep hydrated in the hot weather. Fridge Freezer temperatures are checked daily but the manager needs to make sure this is record. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users personal care is carried out according to their wishes. They are supported to keep healthy and to take their medication. EVIDENCE: On service users files sampled there was good information about how they prefer to be helped with their daily routines. There is detailed information for staff to show them how to help individuals with personal care, toileting, dressing, mealtimes and activities. Staff helped service users tell that they can choose when to get up, when to go to bed and what clothes they would like to wear for the day. There was good recorded evidence of health care needs being monitored and met. Routine health appointments are recorded and staff are trained to respond to service users special health needs. eg epilepsy. The system for the safe storage and administration of service users medication was seen and was satisfactory. In discussion with staff and from looking at records it was seen that staff are trained to make sure they are competent to give medication. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users and their families know who to contact if they have a complaint. Staff are trained to know how to protect service users from abuse. EVIDENCE: There is a Milbury complaints procedure in place and service users have access to this. Service users surveys show that they and their relatives would know how to complain.There has been one complaint made since the last inspection about staffing matters and records show that this has been dealt with appropriately. Records and discussion with staff show that they are aware of how to protect service users from potential abuse. All staff have attended POVA training and the manager has attended POVA training for managers. Feedback from relatives given on surveys is that they see that service users are well treated by staff. There is a system in place for the safekeeping of service users money and petty cash. Records and receipts are keptand daily checks are carried out. On the inspection day it was apparent that a system for accesssing petty cash in an emergency is needed. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The environment for service users could be improved if redecoration to communal areas and the replacement of communal carpets is carried out. The home is kept clean and hygienic. EVIDENCE: Both parts of the home were seen and some redecoration and recarpeting in communal areas is needed. There is damage to some walls and the communal carpets are stained. The worktops in the kitchen of house 1a needs repair or replacement. The manager said that alterations are planned to provide conservatories to each side of the home and this will improve the communal living space. Service users bedrooms seen were clean and the decoration was adequate. The home was found to be clean and hygienic. Staff confirmed they receive training in Basic Hygiene. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are supported by a staff team that have been checked for suitabilty and are trained to meet their needs. EVIDENCE: From looking at rotas and in discussion with the manager it was seen that there are four staff on daytime shifts, two in each area of the house. At night there are two waking night staff and one sleep in staff. Extra staff are sometimes on shift to support activities. The manager said that there are 150 hours per week vacant at present but that from recent interviews four full time staff may be appointed. There is minimal use of agency staff with Milbury bank or regular staff do overtime to cover vacant shifts. Staff appear to get on well with each other and were seen to relate well to service users and relatives. Regular staff meetings are held. There is a Milbury recruitment procedure in place and staff files sampled showed that appropriate checks and references are carried out. Staff files sampled show that staff have LDAF Induction and Foundation Training.There is a programme of NVQ in place, three staff already have level 2 or above and four are taking this. Staff confirmed that they had received training relating to service users needs eg Epilepsy. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 17 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. A suitable manager has been appointed and there is continuity of care for service users. The manager needs to monitor that delegated health and safety checks are carried out properly and appropriate action taken if needed. EVIDENCE: A new manager has been appointed from 6th June 2006. She was previously the deputy manager and acting manager and has worked in the home for over eight years. She is due to start her NVQ level 4/Registered managers award in September 2006. It was evident from seeing the development of care and staff systems that her appointment has ensured continuity of care for service users. There is a need for the manager to monitor that delegated tasks are being carried out. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 19 There is a quality assurance system in place that includes seeking the views of service users. There are systems in place to monitor health and safety. Health and safety records were sampled but some were not up to date. The record of weekly hot water temperature checks in both parts of the home showed that high temperatures were recorded for some outlets. There was no evidence of action being taken to rectify this situation. 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 (2) b Requirement Ensure that all care plans are kept up-to-date The original date of 19/12/05 has been extended to enable full compliance 2 YA42 13(4 )c The manager needs to monitor that delegated health and safety checks are carried out properly and appropriate action taken if needed. 25/09/06 Timescale for action 25/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 1 & 1a Christchurch Gardens DS0000011049.V292128.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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