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Inspection on 26/04/05 for 1 Longmore Road

Also see our care home review for 1 Longmore Road for more information

This inspection was carried out on 26th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has a dedicated trained staff team who were observed to have patience and understanding for the clients, and are aware of the clients needs, promote client choice and involve clients in decision-making. Staff make sure clients are informed and are involved in the review of their care plans and planning menus and activities. To demonstrate this a client stated " I like going for walks, been to the town hall today, and last year we went to Butlins", "got my review Thursday and Heather will do the paperwork tomorrow" "I`m happy, very nice food, I like fish and chips best".

What has improved since the last inspection?

Improvements have been made to clients care plans and all identified risks to the individual client have an action plan in place to reduce the risk. The home has two staff vacancies and aims to use the same agency support worker so as to give continuity of care. As quoted by a support worker "I work four to five shifts a week and have done so over several months". The home has developed a survey to obtain the opinion of the service provided from the clients, clients` family/friends and other representatives of the clients.

What the care home could do better:

The home could improve on the initial information given to a client prior to them coming to live in the home, by producing a Service Users Guide. The back garden has lots of interesting mature plants and a fishpond but the home does not maintain it well; a requirement has been made to ensure a safe and tidy environment. The home has infection control procedures and staff have received training, however practice of infection control procedures are not strictly followed and this must be improved, as should the recruitment procedure and storage of cleaning materials, so as to safeguard the clients.

CARE HOME ADULTS 18-65 LONGMORE ROAD 1 Longmore Road Shinfield Park Reading Berkshire RG2 8QD Lead Inspector Yvonne Souden Unannounced 26 April 2005 15:00 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 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 Stationary 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. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Longmore Road Address 1 Longmore Road Shinfield Park Reading Berkshire RG2 8QD 0118 986 7457 Telephone number Fax number Email 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 (LD) registration, with number of places LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20/10/04 Brief Description of the Service: 1 Longmore Road is a detached property within a secluded residential area in the town of Reading; the home is close to the M4 motorway and is subject to the associated noise levels. The home provides care and accomodation for up to seven people who have learning disabilities and may have associated physical disabilities. There are local shops nearby, and recreational and shopping facilities within the town of Reading are within a ten minute drive. The home has its own unmarked vehicle and public transport is also available. Service Users have single bedrooms, 3 bedrooms are located on the ground floor. There is a lounge, kitchen, conservatory style dining room and secluded rear garden. The Service Users are aged between 18 and 65 LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection on a Tuesday afternoon from 3pm to 8:30pm. The inspector spoke to three clients who had verbal communication skills and spoke to three staff members. 50 of the inspection was in discussion with clients and staff and observation of care practice. The remaining 50 was spent examining records. 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. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 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 standard(s) 1 Representatives of the service user are informed, however with one vacancy and no Service User Guide in place the home does not enable prospective service users to make an informed choice. EVIDENCE: The home has reviewed their Statement of Purpose that details the service provided and the home’s philosophy of care. The home has not submitted a copy of their Statement of Purpose to the Commission for Social Care Inspection. A Service User Guide has not been developed. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 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 standard(s) 6, 8 & 9 Care plans and risk assessments promote independence, and support service users to make decisions about their health and social care needs, whilst ensuring associated risks are minimised. EVIDENCE: The inspector viewed detailed care plans and risk assessments of three service users, written using a person centred approach. The care plans demonstrate decisions made by the service user in the delivery of their health and social care needs, whilst risk assessments have an action plan in place to minimise associated risk. Records seen and discussions with service users and staff identify that health and social care professionals are involved in meeting and reviewing the health and social care needs of the service user, with service user involvement Discussions with a service user and with a staff member demonstrated that the service user was aware of a forthcoming review and of what this entailed, and observation showed positive staff and service user interaction as staff promoted the choices and decisions of the service users. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 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 standard(s) 16 & 17 Staff respect service users privacy and their chosen daily routine, and menu planning considers the individual dietary needs of the service users whilst ensuring choice of a nutritionally balanced diet. EVIDENCE: Service users were observed to freely enter all communal rooms, including the office when unlocked and all had a key to their own bedroom. Staff were observed to interact with service users in a friendly and respectful manner as they assisted service users to make choices, and joined the service user in their evening meal whilst offering assistance as and when required. Person centred care plans promote the service users choice within their daily routine and a separate record identifies service user daily choice within recreational activities, going out and meals/snacks. The home has a four-week nutritionally balanced menu, and fresh fruit, salad & vegetables were observed. Recordings show that provisions are in place to meet the specialist dietary needs of two service users. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 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 standard(s) 18 & 19 Service users are supported within their personal and healthcare needs as they are enabled to access and maintain links with health and social care professionals. EVIDENCE: A service user informed the inspector “I’ve got one doctor, went to the Royal Berkshire Hospital for a scan and went to the dentist ”, this was evident within health care plans seen. The same service user said “I’ve got nothing planned tonight, I will have dinner and then a bath”, and another service user was observed telling a staff member that she was off to have a bath. It was evident from observation that that service users are supported in their decisions around their personal care needs. Records and health care correspondence show that service users are supported to attend health care appointments with outcomes and dates for future appointments identified. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 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 standard(s) 23 Service users are protected from abuse. EVIDENCE: The home has policies and procedures on the protection of vulnerable adults that are accessable to staff. Records show staff has received training on nonviolent crisis intervention, abuse awareness and protection of vulnerable adults; staff were able to explain to the inspector what this training entailed. Financial records checked matched money held on behalf of the service users. A copy of the homes regulation 26 report dated 5/03/05 identified inaccuracies within a service users financial transaction documentation; the home has investigated to ensure protection of service user monies and accurate records kept. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 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 standard(s) 30 The home is clean and free from offensive odours but systems in place jeopardise infection control and environment safety within the back garden. EVIDENCE: The back garden was untidy and overgrown with weeds. Rubbish was piled high in one corner consisting of boxes, a mattress and other forms of rubbish. The home has a contract for dealing with clinical waste however the clinical waste bag in one bathroom was overfull. Protective gloves were observed within the bedrooms of those service users who require assistance within continence care, however small bags to transfer the clinical waste to the clinical waste bin was not available, and liquid soap and paper towels were not available within these rooms or within the communal bathrooms. Staff explained the process followed to dispose of the clinical waste and washing their hands; the practice is to transfer open continence waste from the bedroom to a clinical waste bag within a communal bathroom and to walk through the lounge, hall and into the kitchen to wash their hands. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 13 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34 The staff rota and training in place ensures staff numbers are sufficient, and that staff are competent and skilled to meet the needs of the service users. Complacency within the homes recruitment procedure does not ensure service users are protected by their policy. EVIDENCE: Discussions with staff confirmed that 50 of staff has an NVQ in care, however certificates were not available to evidence this. Staff skill profiles’ detail mandatory and specialist training received with certificates in place, and a training schedule dated 2005/06 details forthcoming training. It was demonstrated from discussions with two permanent staff and one agency staff that staff is competent and fully aware of the needs of the service users. The home has two vacancies covered by agency staff and ensures consistency of agency staff used; an agency staff member interviewed confirmed that the home always asked for the same agency staff when booking, and that she has worked full time within the home for several months. The recruitment records of two recently employed staff members were examined; one record identified a gap within employment history and had no record to demonstrate that a CRB disclosure had been obtained. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 14 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 Audit control systems in place ensure the views of the service user and their representatives are obtained. COSHH procedures are not followed. Health & Safety checks are maintained. EVIDENCE: Following a requirement made at the previous inspection the home has developed a questionnaire to obtain the views of service users, family/friends of service users, health and social care professionals and staff. The audit control has taken place with the outcome yet to be finalised. Audit controls within Health & Safety are maintained and the Commission for Social Care Inspection receives a monthly copy of the homes regulation 26 reports, and monthly audit programme. Fire records maintained demonstrate completed fire safety checks and staff training. On the day of the inspection staff did not ensure substances hazardous to health were safely stored; cleaning products remained in the communal bathroom and products were stored in an unlocked cupboard despite a lock being in place. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 15 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 2 x x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 1 Standard No 11 12 13 14 15 16 17 x x x x x 3 3 Standard No 31 32 33 34 35 36 Score x 2 3 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 LONGMORE ROAD Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 1 1 H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 16 no 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 1 Regulation 5 Requirement The home must develop a Service Users Guide and in a farmat that is suitable to the service users. The home must ensure various discriptions of rubbish is not stock piled high within the back garden, and that the garden is maintained to ensure an environmentally safe area for the servic eusers. The home must ensure paper towels and liquid soap is provided for staff use in all areas where personal care is provided to service users. The home must ensure they follow infection control procedures in the storage and transfer of clinical waste The home must ensure evidence within the recruitment records of staff demonstrate an employment history with no gaps, and demonstates that a CRB /pova disclosure has been obtained. The home must ensure all recruitment checks have taken place and evidenced prior to offering a position of Timescale for action 26/06/05 2. 30 23.(2)(o) & 13.(3) 26/05/05 3. 30 13.3 03/05/05 4. 30 13.3 03/05/05 5. 34 19, Sch 2 26/05/05 6. 34 19, Sch 2 26/04/05 LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 17 employment to prospective staff. 7. 42 13 The home must ensure the safe containement of substances hazardous to the service users health. 26/04/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 1 32 Good Practice Recommendations The home should submit an updated copy of their Statement of Purpose and Service Users Guide to the Commision for Social Care Inspection. The home should ensure it has copies of staff certificates, to demonstate their achievement in obtaining a National Vocational Qualification in Care. LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading 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 LONGMORE ROAD H52-H01 11354 Longmore Road V211091 260405 Stage 4.doc Version 1.30 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!