Inspection on 11/10/05 for 1 Longmore Road

This inspection was carried out on 11th October 2005.

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 Longmore Road 18/09/07

1 Longmore Road 01/06/06

1 Longmore Road 26/04/05

1 Longmore Road 20/10/04

1 Longmore Road 25/05/04

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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 Longmore Road Shinfield Park Reading Berkshire RG2 8QD Lead Inspector Yvonne Souden Unannounced Inspection 11th October 2005 08:00 1 Longmore Road DS0000011354.V253513.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 Longmore Road DS0000011354.V253513.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 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 1 Longmore Road Address Shinfield Park Reading Berkshire RG2 8QD 0118 986 7457 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) Milbury Care Services Limited Mrs Chunrong (Heather) Li Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: 1 Longmore Road is a detached property in a secluded residential area within the town of Reading. The home is close to the M4 motorway and is subject to the associated noise levels. There are local shops nearby, and within a 10 Minute drive is Reading town centre where shopping and recreational facilities are available. The home has an unmarked vehicle and public transport is available. The home provides care and accommodation for up to seven people who have a learning disability and may have an associated physical disability. Service users have single bedrooms; three bedrooms are located on the ground floor and four bedrooms on the first floor. There is a lounge, kitchen and a conservatory that is used as a dining room. The home has a secluded rear garden with a garden swing, large fishpond and a patio area where seating is provided. 1 Longmore Road DS0000011354.V253513.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 undertaken by one Inspector on a Monday morning/afternoon. The Inspector observed care practice, staff and client interaction, and assessed the environment and records kept. The Inspector spoke to management, four staff members, and briefly with two residents who were ready to leave the home on the morning of the inspection to attend daycare services. What the service does well: What has improved since the last inspection? 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 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 6 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 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 7 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 5 Prospective service users needs are assessed prior to their admission but this is not strictly supported by documentation in place. Service users have a written contract. EVIDENCE: One service user has been admitted to the home since the last inspection. There was no documentation in place to evident that the home or the service users care manager had carried out a full needs assessment prior to the service users admission. The operational manager who was present at the time of inspection confirmed that herself and a behaviour management specialist within Milbury Care Services had carried out the assessment and that the records are filed within another office, also confirming that the home should have a copy of the assessment in situ. Review documentation in place show that the service users needs have been reassessed twice since admission with health and social care involvement, and discussions with staff demonstrate their awareness of the service users needs. The Inspector viewed service users contracts that detailed the rights and obligations of the provider and service user. The home has recently reviewed the format of their contract and should ensure the notice period required by the home and the service user is detailed within the contract. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 8 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 and 9 Service users care plans identify their changing needs and associated risks, and staff respect service users right to make decisions within a risk management framework. EVIDENCE: Care Plans viewed identified the service users health and social care needs and associated risks, and had an action plan in place to meet those needs and minimise the risk. Behaviour management guidelines have been developed to support the individual service user and protect the service user and others from harm; discussions with staff identified their awareness of the individual service users behaviour management guidelines. The minutes of service user reviews confirmed health and social care involvement and identified changing needs that were reflected within the service users care plan. A service user spoke of favourite activities and of support received from staff to participate. The service user had a change of mind with regards to the choice of clothes worn that morning and was observed to have chosen another outfit, and another service user with non-verbal communication skills was observed to be supported by staff to choose breakfast and an activity. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 9 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 and 15 Service users are supported to take part in appropriate activities with their peer group and within the community, and receive support to maintain links with family and friends. EVIDENCE: Systems are in place to support service users to attend daycare services, for example, Milbury daycare services, The Wokingham Resource and Occupational Centre and RECT (Reading Educational and Training Centre), and other activities that are held within the local community with their peer group. For those service users who were not attending a day care facility on the day of the inspection, staff was observed to support the service users within a chosen activity for example, a walk within the local area and a trip to the shops using the homes vehicle. Records shows that service user have an individual activity list. Group outings take place for example service users recently visited the London eye and the zoo. Discussions with service users and records seen demonstrate that service users are supported by staff and management to maintain links with family and friends. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 10 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 20 Technical aids and equipment are in place to ensure service users receive personal support in the way they prefer and require, and service users are protected by the homes policies and procedures for dealing with medicines. EVIDENCE: The service users individual plan of care is reviewed regularly and ensures the service users preferred way in meeting their personal care needs is respected. Discussions with staff demonstrate their awareness of the service users needs and of how those needs are to be met, and also confirmed that a key worker system is in place. Specialist equipment has been provided to ensure the personal care needs of the service users are met with comfort, dignity and respect, for example a service user who has a physical disability has been provided with a specialist bed, wheelchair, shower trolley and hoist. Staff administer the service users medication from a monitored dosage system as dispensed by the pharmacist, and stock in place matched records kept. The home has medication policies and procedures in place and staff have received administration of medication training. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 11 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 and 23 Systems are in place to ensure the views of the service users and of their representatives are listened to, and systems are in place to protect service users from abuse, neglect and self harm but some staff are not strictly aware of the procedures in place. EVIDENCE: The home has a complaint policy and procedure that is accessible to the service users and their representatives. Records show that the home has received three complaints since the last inspection and that the home had investigated and responded to the complaints within appropriate timescales. The home has policies and procedures on the protection of vulnerable adults, and has a whistle blowing policy in place. Some staff were not fully aware of abuse awareness policies and had limited knowledge of what to do in the event of witnessing or suspecting abuse, but were clear that they would report any concerns they had to management. Training records identify that most staff have received abuse awareness training and that new staff in post have received abuse awareness within their induction. Management confirmed with the Inspector on the day of the inspection that those staff who have not received formal abuse awareness training have been scheduled to undertake this training on the 25th of November 2005. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 12 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 and 30 Service users would benefit from systems in place to ensure the home is clean and safe. Service users live in a homely comfortable environment with infection control systems in place. EVIDENCE: The Inspector observed that the home has improved systems of infection control since the last inspection and has implemented the use of paper towels and liquid soap within the communal bathrooms, laundry, kitchen and bedrooms of those service users who require assistance within personal care. COSHH (Containment of Substances Hazardous to Health) policies and procedures are in place but were not strictly followed on the day of inspection as the Inspector viewed the laundry to be unlocked and substances that would be harmful to the service users accessible to them. The home was comfortable and homely but some communual areas within the home were dirty and had cobwebs that had evidently been there for a longer period than just a few days or weeks. Particular reference is made to the downstairs toilet, first floor bathroom, and in general to skirting boards and walls. The first floor bathroom is in need of refurbishment/redecoration and management confirmed that this has been identified within the business plan and should be completed within the financial year. The Inspector observed a 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 13 stockpile of rubbish within an area of the rear garden next to the house; this had been addressed at the previous inspection and action had been taken with regards to the rubbish that had stockpiled at that time, but the practice of stockpiling rubbish appears to have continued. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 14 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): 35 Staff are supported within their training needs to meet the individual and joint needs of the service users. EVIDENCE: Records show that a training programme is in place to ensure staff undertake mandatory and specialist training and that this is updated as and when required. Staff have individual skill profiles that identifies at a glance the training staff have received and training required to enable them to meet the needs of the service users. Staff are supported to undertake NVQ in care and over 50 of staff have attained this qualification. The home has an induction programme in place. Staff have not received formal training on effective communication with service users who have non-verbal communication skills, and management confirmed that they would review their training programme to facilitate this need. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 15 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 Service users benefit from quality assurance systems in place but results of surveys undertaken is not accessible to them or to their representatives. EVIDENCE: Management confirmed with the Inspector that audit control systems are in place to ensure the views of the service users and their representatives are sought, but as reported at the previous inspection the results of the survey continue not to be available for inspection. The home has a robust audit control system in place and ensures CSCI receives a copy of the homes monthly audit program that addresses finance, operations, care and support and details objectives and timescales set. The operation manager undertakes a monthly visit to the home under regulation 26 of the Care Homes Regulations and sends a copy of the results to CSCI. The record identifies that the operation manager interviews service users and staff, and assesses the environment and records kept; the operation manager was undertaken a regulation 26 visit on the day of the inspection. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 16 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 1 x x 2 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Longmore Road Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x DS0000011354.V253513.R01.S.doc Version 5.0 Page 17 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 YA2 Regulation 14, Sch 3 Requirement The registered manager must ensure she has completed a full needs assessment and obtained a copy of assessments undertaken by a suitably qualified or suitably trained person, so as to enable the manager to evaluate whether the home can meet the needs of the service user prior to their admission. Management must ensure the assessment referred to in regulation 14.1 is filed within the care home. Timescale for action 11/11/05 2 YA24 13 & 23 The registered manager must 31/11/05 ensure the safety of the service users by storing COSHH products securely. The registered manager must ensure systems are in place to ensure the cleanliness of the home and ensure the disposal of accumulated rubbish. 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 18 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 YA2 Good Practice Recommendations The home should ensure the notice period required by the home and the service user is detailed within the newly formatted contract. Management should ensure staff who have not attended formal abuse awareness training attend the confirmed abuse awareness training date on the 25th of November 2005 as was arranged on the day of the inspection. The registered manager should ensure the results of surveys undertaken to obtain the views of the service users, their family/representatives and professionals are made available to the service user and available for inspection to evident that those views are sought and taken seriously. 2 YA23 3 YA39 1 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 19 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 Longmore Road DS0000011354.V253513.R01.S.doc Version 5.0 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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