Inspection on 06/03/06 for 1 & 1a Christchurch Gardens

This inspection was carried out on 6th March 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 & 1a Christchurch Gardens 25/07/06

1 & 1a Christchurch Gardens 19/11/05

1 & 1a Christchurch Gardens 08/03/05

1 & 1a Christchurch Gardens 21/04/04

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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 Julie Willis Unannounced Inspection 6 March 2006 08:00 th DS0000011049.V279764.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 DS0000011049.V279764.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. DS0000011049.V279764.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 DS0000011049.V279764.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th November 2005 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. DS0000011049.V279764.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 8 am and 12 noon on a Monday morning. The inspector toured the building, examined service users and staff records and observed care practice. Residents of this home are in the main non-verbal and were unable to provide verbal feedback to the inspector about the quality of care. The inspector met 4 of the current residents and spent the majority of the time observing what was going on in the home and how staff cared for the residents. The newly appointed Homes Manager and his Deputy assisted the Inspector during the inspection. The inspector had the opportunity to speak to staff on duty and the Operations Manager by telephone to whom verbal feedback was given about the outcome of the inspection. There were 3 outstanding requirements from the previous inspection and 1new requirement and recommendation arising from this inspection. What the service does well: What has improved since the last inspection? DS0000011049.V279764.R01.S.doc Version 5.1 Page 6 Since the last inspection all staff have received training in effective report writing to ensure that records are well written. The security of personal information is more robust. Chemicals that could be harmful to residents are kept locked away. The downstairs bathroom in House No. 1a has been converted to a walk-in shower for residents to use more safely and independently. 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. DS0000011049.V279764.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 DS0000011049.V279764.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): None of the above standards were inspected on this occasion. EVIDENCE: None of the above standards were inspected on this occasion. DS0000011049.V279764.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 Care plans need significant updating to ensure that they accurately reflect the needs of users and provide staff with enough information to provide proper care. Service users are provided with the information; assistance and communication support they need to make lifestyle choices and decisions about their own lives. EVIDENCE: Examination of 2 service user plans indicated that they were significantly out of date and no longer reflected accurately the current needs of users. Personal goals needed review and re-evaluation, weight charts had not been completed for 6 – 8 months, monthly summary sheets had not been completed since July 2005 and all risk assessments were out of date and needed review. This was a requirement of the last inspection and should be carried out as a matter of urgency. Observation of care practice concluded that staff were aware of the needs of individuals who had little or no intelligible speech. Staff were able to gauge a DS0000011049.V279764.R01.S.doc Version 5.1 Page 10 users individual response through skilled observation of individual residents behaviours and gestures. From discussion with management, staff and examination of the daily records it is clear that users are provided with the support they need to make decisions about their lives on a daily basis. Visual aids are provided to users to aid understanding. Staff work hard to establish users wishes in relation to the activities of daily living by offering appropriate choices and interpreting users non-verbal responses. Service users have recently been involved in choosing their holiday destinations for the summer. Staff were able to show the users photographs of different resorts and a variety of activities in order that they could select where they wanted to go. DS0000011049.V279764.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): 16 The homes routines are designed flexibly around the needs of its users. Service users are offered support in a manner, which promotes their rights as citizens to independence, autonomy and choice. EVIDENCE: It was clear that service users at the home live rich and fulfilling lives. They appeared relaxed and cheerful in the company of staff who treated them with dignity and respect. There was evidence in the daily records that the homes routines are flexible and responsive to service users individual needs. Service users are encouraged to be as independent as possible and to participate in the activities of daily living within the limitations of their capabilities. The daily records indicated that users are free to choose when they get up and when they go to bed. Service users were observed to choose when to be alone or in company. Freedom of movement in the home and back garden is unrestricted. DS0000011049.V279764.R01.S.doc Version 5.1 Page 12 There was evidence in care plans that all activities that could be hazardous to users were underpinned by risk assessments. However, these required review and updating to accurately reflect the current needs of users. DS0000011049.V279764.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): None of the above standards were fully inspected on this occasion EVIDENCE: None of the above standards were fully inspected on this occasion DS0000011049.V279764.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 The home has a clear accessible complaints policy and procedure where users concerns will be listened to and acted upon. Service users are protected from abuse and exploitation by the homes policies and procedures. EVIDENCE: There have been no complaints recorded by the home or reported to the CSCI since the last inspection. Service users have access to the complaint procedure, which is explicit in the Service User Guide. It has been produced in a user-friendly format. Discussion with the Manager and staff indicated that feedback is actively sought from service users and their families on a regular basis. All staff receive training in abuse of vulnerable adults as part of their induction and additionally when gaining National Vocational Qualifications in which it forms a core module. The home has a copy of the Berkshire Inter-agency procedure on abuse of vulnerable adults of which all staff are aware. DS0000011049.V279764.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): This standard was not fully inspected on this occasion EVIDENCE: This standard was not fully inspected on this occasion DS0000011049.V279764.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 Service users at this home benefit from having a properly recruited, well trained and skilled staff team to meet their needs. EVIDENCE: Staffing levels at Christchurch Gardens are sufficient to meet the needs of users, some of whom have complex behavioural needs. The home has recently successfully recruited to all of its vacant posts and currently benefits from a full complement of permanent staff. On occasion the home employs bank workers to cover gaps in the staff roster due to sickness and annual leave. The staff on duty confirmed that they knew, understood and supported the aims and objectives of the home and fully complied with organisational policies and procedures. They were able to demonstrate an in-depth knowledge of service users needs and could appropriately interpret users non-verbal signals and communication. The relationship between service users and staff was observed to be relaxed, informal and positive. Examination of the staff files indicated that the selection and recruitment procedures at this home are robust and all essential checks are carried out on staff to protect users from abuse and exploitation. DS0000011049.V279764.R01.S.doc Version 5.1 Page 17 The staff have been properly inducted and have received training in core skills such as fire safety, first aid, manual handling, food hygiene, health & safety and infection control. All staff have received training in POVA (protection of vulnerable adults) as part of their induction and as a core module in NVQ training. Staff are encouraged to participate in further training to enhance their skills and knowledge and have either achieved or are working towards a National Vocational Qualification at level 2, 3 or 4. The inspector spoke to staff of the home that were able to confirm that they feel well supported by management and have the opportunity to express their views in the regular team meetings and in formal supervision sessions. There is a need however, to increase the frequency of one-to-one meetings, as there has been a recent shortfall in frequency of supervision sessions due to management shortages. DS0000011049.V279764.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): 39 The quality assurance system needs to be further developed to seek the views of service users, their families and other stakeholders. EVIDENCE: The views of family, friends and advocates are sought by the home on an annual basis. The home has carried out a satisfaction survey with resident’s relatives in the last year. The response was mixed but overall the home is considered to be providing a good service to its users. The Organisation needs to consider producing an annual development plan, which reflects on outcomes for service users. Ideally this would be by using a professionally recognised quality assurance system, which would actively seek the views of service users and other stakeholders. DS0000011049.V279764.R01.S.doc Version 5.1 Page 19 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 x 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 x 25 x 26 x 27 x 28 x 29 x 30 x 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 x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x x x 2 x x x x DS0000011049.V279764.R01.S.doc Version 5.1 Page 20 YES 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 YA36 Regulation 18 (2) Requirement Ensure that all staff receive formal one-to-one supervision at regular intervals, at least six times a year Ensure that all risk assessments in relation to service users are kept up-to-date The original date of 19/12/05 has been extended to enable compliance 3. YA6 15 (2) b Ensure that all care plans are kept up-to-date The original date of 19/12/05 has been extended to enable compliance 4. YA42 23 (4) a Ensure that in consultation with the Fire Authority locks that can be opened easily in the event of a fire be fitted to the front doors of both homes. The original date of 19/12/05 has been extended to enable compliance 06/06/06 06/04/06 Timescale for action 06/06/06 2. YA9 13 (4) c 06/04/06 DS0000011049.V279764.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations The Quality assurance system should be further developed to seek the views of users, their families and other stakeholders in order that the home can effectively measure its success in achieving its stated aim and objectives. DS0000011049.V279764.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 DS0000011049.V279764.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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