Inspection on 16/11/05 for 1 Abell Gardens

This inspection was carried out on 16th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Abell Gardens 10/09/08

1 Abell Gardens 22/09/06

1 Abell Gardens 14/06/05

1 Abell Gardens 28/01/05

1 Abell Gardens 18/10/04

1 Abell Gardens 10/02/04

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Fairways

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

CARE HOME ADULTS 18-65 1 Abell Gardens Furze Platt Road Pinkneys Green Maidenhead Berkshire SL6 6PS Lead Inspector Stewart Mynott Unannounced Inspection 16th November 2005 11:00 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 1 Abell Gardens Address Furze Platt Road Pinkneys Green Maidenhead Berkshire SL6 6PS 01628 789658 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) Owl Housing Limited Miss Susan Gilbert Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: 1, Abell Gardens is a single story purpose-built care home situated in a quiet residential road on the outskirts of Maidenhead. Accommodation is provided in single bedrooms. The bungalow has a secluded rear garden that is for use by the residents of the property. There are a limited number of car parking spaces on the property and in the access road. Owl Housing Ltd, a non-profit making charitable society is registered to provide accommodation, support and personal care for up to six younger adults who have learning and physical difficulties. The aim of the home is to create a warm, friendly atmosphere in which people are enabled to achieve their personal objectives and reach their full potential. The homes objectives are to promote the individual rights to privacy, dignity and respect; to facilitate the achievement of personal objectives through appropriate educational and employment opportunities; to provide access to relevant organisations and information in pursuit of meeting each persons spiritual and cultural needs; to promote ways and means to extend social networks to achieve prominence, social standing and a sense of belonging within the community; to encourage participation in regular communication with family and friends; to encourage the use of generic services, building and maintaining viable working relationships to meet the individuals health care needs; and to support and enable each person to contribute to all aspects associated with daily life activity. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection occurring during the day lasting for four hours. The initial part of this inspection was spent in the lounge with four service users who were spending time with two of the staff on duty. During this time observation and discussion about the home and daily life routines took place. The service users present had difficulty communicating verbally directly with the inspector and staff assistance was necessary to assist in this area. A service user and the deputy manger conducted a full tour of the building. Time was also spent during the inspection with the registered manager, deputy manager and all staff on duty. One relative who was visiting was also spoken to gain their views about the service. Time was also spent examining some of the care records and other records relating to the functioning of the home. What the service does well: What has improved since the last inspection? What they could do better: There is a comprehensive recruitment and selection policy in place, which the registered manager clearly follows. However the recruitment “staff record sheets” for the last three staff members examined, were incomplete and unsigned to evidence all checks and records to protect service users are in 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 6 place for new staff. This is not in line with the current agreement with the CSCI and it is a requirement that the agreed records are maintained and kept within the home to evidence this standard. 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 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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 and 4 The home ensures appropriate assessments are undertaken to ensure all prospective service users needs will be met. Introductory visits are arranged for service users to test-drive the service before admission. EVIDENCE: A service user has moved into the home since the last inspection. The service user was unable to effectively communicate their views about this experience. The registered manager discussed the process for admission in detail. This included an assessment visit with a care manager and discussion about a transition plan. The registered manager confirmed that there had been short visits arranged to introduce the home to the service user. The relatives had also been involved. Care records contained the care management assessment completed prior to admission. The second review in this trial period was taking place on the day of the inspection. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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 and 9 There are detailed individual plans in place, which establishes how assessed needs will be met and the support required by staff to achieve them. Service users independence is encouraged where possible and supported through a risk management framework. EVIDENCE: Each service users has an essential lifestyle plan, which is central to the way in which their needs are assessed, planned, monitored and met. Three such individual plans were examined and were seen to provide detailed and clear information recorded in a person centred manner. The plan is reviewed by the link worker on a regular basis through “house review meetings” and copies of these are kept in the care file for each individual. There are annual reviews involving the service user and their support network including their care manager. There are detailed risk assessments recorded on each service users care file to support service users to be as independent as possible. Three service users were focused on and assessments in place covered all significant areas in sufficient detail and had been kept under review. A service user who had recently moved in had detailed assessments in place to ensure their safety. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 10 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 and 16 Service users are fully supported to have an enjoyable and fulfilling lifestyle, which includes suitable activities and opportunities to follow leisure pursuits. The daily life in the home is relaxed and inclusive with service users support needs always taking priority. EVIDENCE: The staff at the home described the lifestyle and opportunities made available for each of the service users at the home. A very wide variety of occupation, community activities and leisure pursuits are available and tailored to individual choices. The staff at the home demonstrate an excellent understanding of each service users preferences and are clearly committed to locate appropriate activities for each service user. Three service users have access to a local college and take part in appropriate activities of their interest and choice. All service users have access to local day centre services. Facilities and activities in the local community are utilized and these include shopping, use of local leisure centre as well as more specialist activities. The home has its own transport, which is always available. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 11 Service users are supported to pursue their own interests and hobbies including music concerts and sporting events. Holidays and short breaks and day trips are also regularly organised throughout the year. The home encourages and supports service users to maintain family links and friendships. One visiting relative confirmed that they are always made to feel welcome, included and involved in the daily routines at the home. The home also organises events within the home for service users and their visitors and efforts have been made to include local neighbours. The daily routines in the home were observed during the inspection and were relaxed promoting individual choice and freedom of movement. Staff were seen to be friendly, warm and caring at all times. Staff interacted very well with service users demonstrating a clear understanding of service users needs during the day. Personal care and support was offered discreetly and staff were respectful as evidenced by knocking on doors before entering and addressing service users by their name appropriately. Service uses appeared relaxed and happy with the daily routines within the home. The atmosphere within the home was warm, inclusive, relaxed and calm with service users always taking priority. It is clear that the team works well together. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 12 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 and 19 Service users personal, physical and healthcare needs are fully supported and met by a committed and caring staff team. EVIDENCE: Most service users are not able to communicate verbally and rely on staff to interpret their needs and provide personal support. Service users were observed to make some of their wishes known to staff who were able to interpret body language, gestures and verbal sounds. Staff were observed to clearly understand service users behaviour as well as their care and support needs. Staff were seen to support service users in a professional yet relaxed manner. Four service users require assistance with moving around the home and staff were clear on techniques to support this. One service user has benefited from specialist assessments to provide equipment to help them move and rest comfortably. A staff member was able to explain the use of a “sleep system” and confirmed that they also explained this to agency staff when needed. Care records documented preferred daily routines, which included likes and dislikes and individual requirements and support needed by staff. There was detailed information regarding the communication needs for each service user. Staff spoken to were knowledgeable about these documents and reviewed 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 13 them as part of their link worker duties during individual “house review meetings”. The registered manager described the healthcare arrangements for the home. The home uses a local GP surgery and the manager confirmed good access to all local NHS healthcare facilities. Service users have annual reviews by their GP. Service users have also benefited from specialist input such as physiotherapy and mobility clinics, which were organised as required. Care records for three service users were examined and a clear record had been maintained for all healthcare appointments and visits. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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): Standards 22 and 23 were not assessed during this inspection. EVIDENCE: 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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, 26, 27, 28, 29 and 30 Service users are able to enjoy a homely, comfortable, safe, clean and hygienic environment. EVIDENCE: A service user and the deputy manager gave a full tour of the premises, which covered all areas. The home is modern and purpose built with a homely and comfortable feeling. The home was seen to be well maintained, very clean and tidy and free from offensive odours. The premises were observed to be fully accessible to all service users. The registered manager confirmed that the home was due for some redecoration to communal areas as part of a cyclic maintenance program. The manager had actively sought appropriate and homely colours to choose from for these areas. Furnishings and fittings within the home are of good quality and domestic in nature adding to the homely feeling. The communal areas consist of a lounge and dining room, which service users were seen to enjoy during the inspection. These areas are comfortable and appropriately furnished. Staff spoken to were enthusiastic about plans to redevelop the rear garden for service users, which is currently in progress. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 16 All service users bedrooms were well maintained clean and decorated to individual tastes. Two bedrooms had been identified by the staff team as requiring redecoration as part of the cyclical maintenance program. One service user has chosen a mirror and colours from this have been chosen to decorate the room. All furnishings within bedrooms were of a good quality. Since the last inspection a new bath has been installed appropriate for service users requirements. The laundry facilities were examined and found to be clean and clear. Staff explanation and observations during the inspection confirmed there are systems in place to prevent the spread of infection and maintain an excellent level of hygiene throughout the home. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 17 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): 34 There is a comprehensive recruitment and selection policy in place, which the registered manager clearly follows. There is insufficient evidence kept in the home to evidence that all recruitment checks are completed in line with current agreement with the CSCI and the provider’s policy in regards to access. EVIDENCE: The registered manager and deputy manager discussed the arrangements for the recruitment of staff for the home. There is a comprehensive recruitment and selection policy and procedure with the registered manager clearly understood. There is good support from the providers human resources department that coordinate the process including all necessary employment checks. The registered manager and deputy confirmed that they routinely examine necessary recruitment records including identification. There is currently a local agreement that recruitment records are held centrally and not within the home. As part of this agreement evidence is to be kept at the home by means of a signed “staff record sheet” to verify that all checks are complete and in place. This procedure is also detailed in the provider’s policy “for allowing registration authorities access to Staff HR records”. The recruitment staff record sheets for the last three staff members were to be examined, however one record was not available within the home. Two other staff record sheets were incomplete and unsigned by the human resources manager to evidence all checks are in place. This is clearly in breach of the current agreement and it is a requirement that the agreed records are maintained and kept within the home to evidence this standard. 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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): Standards 37 - 43 were not assessed during this inspection. EVIDENCE: 1 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 2 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Abell Gardens Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000046772.V268449.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? No 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 YA34 Regulation 17(2) & 19 Requirement That the registered persons ensure that the recruitment evidence kept within the home is in line with the current agreement with the CSCI. The minimum accepted document as part of this agreement is an appropriately signed “staff records sheet” that must be kept for all new staff in line with the Provider’s policy “allowing registration authorities access to staff HR records”. Timescale for action 31/12/05 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 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 21 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 Abell Gardens DS0000046772.V268449.R01.S.doc Version 5.0 Page 22 - 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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