Inspection on 11/12/08 for Glebe Gardens

This inspection was carried out on 11th December 2008.

CSCI found this care home to be providing an Excellent service.

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.

Other inspections for this house

Glebe Gardens 14/02/07

Glebe Gardens 25/01/06

Glebe Gardens 04/08/05

Glebe Gardens 17/02/05

Glebe Gardens 12/08/04

Glebe Gardens 08/12/03

Extracts from inspection reports are licensed from CQC, this page was updated on 29/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Glebe Gardens Reading Road Burghfield Reading Berkshire RG7 3BH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kerry Kingston     Date: 1 1 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Glebe Gardens Reading Road Burghfield Reading Berkshire RG7 3BH 01189835476 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Residential Community Care Limited The registered provider is responsible for running the service Name of registered manager (if applicable) Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 4 The registered person may provide the following category of service only: Care home only -PC to service users of the following gender: Either : Whose primary care needs are within the following categories: Learning Disability (LD) Date of last inspection Brief description of the care home Glebe Gardens is a residential home, which provides people with a learning disability with accommodation and services in a communal setting. Glebe Gardens is a four bedroom detached house with four single bedrooms and a staff bedroom. All other rooms in the house are to be shared with the other residents. There is a large garden Care Homes for Adults (18-65 years) Page 4 of 27 4 Over 65 0 Brief description of the care home with a patio and garden furniture. The home is within walking distance of some community facilities, is on a public transport route and has its own transport. Glebe Gardens is one of three homes in the local area operated by Residential Community Care Limited. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last Key Inspection of this service took place on the 14 February 2007. The current fees are 88,647 Pounds to 199,687 Pounds per annum. This is a report for the key inspection, which included a routine unannounced site visit to the service. This took place between 11.00 and and 3.00 pm on the the 11th December 2008. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Commission for Social Care Inspection and completed by the manager. Surveys were sent to the people who are supported by the service and other interested parties. Discussions with the area manager and two members of staff took place. Care Homes for Adults (18-65 years) Page 6 of 27 All three people who use the service were spoken to. Written records were seen during the course of the inspection visit. Any information collected by the Commission for Social care Inspection, since the last inspection has also been included in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensure that peoples needs are properly assessed, and the home is confident it can meet those assessed needs, before they are admitted to the home. Individuals are kept fully involved in the assessment and admission process and choose whether to live in the home or not. Evidence: The home has a comprehensive service user guide produced in several different formats, people visit the home prior to admission and are admitted with their and other people in the homes agreement. One person was admitted during last year from a home run by the same providers. The area manager explained that he had moved to the new home to give him more Independence and a nicer community setting, so that he could take advantage of his Independence more safely. There was evidence that a full assessment had been completed by the manager of the home, with the individuals involvement at every Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: stage of the process. The individuals care manager had also assessed the new home. The care plan and personal profile were up-dated in August 08 after a review to ensure that the placement was suitable (the individual moved in in July 2008). The individual said that he liked his new home and he has settled well, he liked living there and did more for himself. Surveys from two people, who use the service, said that they had a choice about whether to move to the home or not. One stated that he had never regretted his decision. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home make sure that people know their assessed and changing needs which are reflected in their care plans. People are encouraged to make as many decisions as they are able about their life and risk assessments support people to as much Independence as possible. Evidence: Care plans for the three [people, who are currently resident in the service, were looked at. All care plans are detailed and included peoples cultural, physical, emotional, religious needs. Care plans are developed for the individuals so meet any diversity or equality needs. They include every area of the persons life and goals and goal plans which can be easily monitored for development and to progress people towards a more independent lifestyle. Care plans include an essential Lifestyle Plan , which states what people do on a day to day basis, their preferences, likes and dislikes and how Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: staff support them with their chosen lifestyle. The general areas of support include, personal hygiene, physical ability, sensory needs, skills, social relationships and Independence skills. All care plans seen had been formally reviewed every six months or more often if needed, care plans are updated after the review has taken place. Key workers have a monthly meeting with the people who use the service to discuss their care plans, progress and or concerns. The home has monthly forums at which staff discuss with the people who use the service any new policies, procedures or general issues or changes that are to take place. They also are used to remind people of existing policies and to work on any new ones that they might like to be explained to them such as complaints, safeguarding and health and safety issues. People have a written agreement of limitations of freedom of choice, liberty of movement and decision making, they sign this agreement or it is indicated that it has been explained to them. People who use the service told me that the home had been recently re-decorated and they chose the colour of their rooms and the paint colours for the communal areas. Notes of the monthly forum showed that people had been asked about menus, furniture, where to keep the complaints book and whether to have a rota for people to help staff with food preparation. The people who use the service have comprehensive risk assessments which encourage Independence in as safe a way as possible. Each individual has risk assessments , appropriate to their individual needs such as community presence, travelling in vehicles, going to church and performing household tasks. Those seen were up-to-date and amended as necessary when any changes occurred or need changed. One person had specific risk assessments for using the community independently and being left alone in the house for periods of time. People who use the service said they enjoyed doing things independently, one person said that he now attends college without staff support. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home enable people to be involved in a variety of interesting activities that include being part of the community. People are encouraged to keep in contact with family and friends and their rights and responsibilities are fully respected. The home provide a well balanced diet and people are as involved as possible in choosing and preparing their food.. Evidence: The essential lifestyle plans include day care profiles these include literacy, numeracy, sensory, relaxation, art, music, sport, cookery and household tasks. The day activities enhance the programmes for developments for individuals such as one person working Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: voluntarily,twice a week to enhance his Independence. Residents join with any staff training that is appropriate for them. Peoples day care programmes are varied to meet their diverse needs and include external and internal activities, they include household chores and helping with meals as part of Independence programmes. People have good access to the community, including risk assessments so that people are able to visit the community independently. There were records of people having meals out, going to the pub,into town shopping and making use of the leisure centre for bowling and trampolining. One person told me that he often goes to the local pub for a drink on a Friday. All three people said that they have plenty to do and that they enjoy their daycare. People help in the kitchen and are involved in household tasks. Contact with families and friends is encouraged and the home have positive relationships with the family and friends of the people who live there. Two people go to stay with families and both said that they are visiting families this Christmas.The type of contact with families is noted in peoples notes and important family dates such as birthdays and anniversaries are also noted, people are helped to keep in contact as is appropriate. People are assisted to have appropriate relationships with others, one person was discussing his girlfriend and another said he would like a girlfriend. The home has a service user charter which includes giving people a quality of life with respect for their individuality, independence and choices, confidentiality and privacy and safeguards from discrimination. It also includes the responsibilities of the people who live in the service and what is expected of them. People choose their menus and help with the preparation and production of the meals. The menus seen were well balanced and very good quality ingredients were seen on the day of the visit, the menu also clearly recorded peoples preferences and alternative foods if they did not like the food on the menu. The kitchen has been recently refurbished. People have weight charts, if appropriate and the home aware of any nutritional needs of people, one person has recently begun to have his weight recorded. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meets the needs of people in the way they they prefer. Peoples emotional and physical needs are effectively met and medication is administered safely. Evidence: Care plans include peoples preferences and individual needs and choices. The home also has the service user charter which sets out peoples rights and the care they should receive. People were seen being treated with respect and dignity and staff had a good knowledge of people and how their care should be delivered. Staff were observed interacting very positively with the residents allowing them choice and time to express themselves. People have a health Action Plan which describes the health needs of the individual, it also includes healthcare notes and any charts needed to monitor ongoing health such as weight. The people choose their own G.P and currently all use the same surgery. The home seeks advice from psychologists, psychiatrists, community nurses and any other health care specialists, as is necessary. Peoples care plans are reviewed quickly if there are any issues about their health or emotional well being. Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: The home use a Monitored Dosage system provided by the local pharmacy, to administer medication, the pharmacist visits the home once a year to ensure they are administering correctly and are always available to offer help and advice, as necessary. The regulation 26 visitor and the area manager also monitor medication records on a regular basis. Staff do not administer medication unless they are trained, and judged as competent, to do so. The area manager advised that there had been no medication errors reported in the last year and the medication storage was seen to be secure. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that peoples views are listened to and acted upon and are protected from all forms of abuse. Evidence: The home has a robust complaints policy that is produced in a variety of formats that were developed with residents involvement. Surveys noted that people know how to make a complaint and who to talk to if they were not happy. Two people confirmed this on the day of the inspection visit. People can also talk about or indicate any concerns they have at the various house meetings that occur regularly. The home has no recorded complaints in the last twelve months and the area manager confirmed that they had not received any. The area manager confirmed that there have been no safeguarding concerns about the home, in the past twelve months. All staff receive safeguarding (Protection of Vulnerable Adults) training during their induction and are further trained during their first few months of service. Staff spoken to were reasonably clear about the Safeguarding procedures and about their responsibilities to protect and keep safe the people they work with. The Commission has received no information relating to complaints or Safeguarding issues. People have their own bank accounts and their benefits are paid into them directly, the Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: care plan notes how much support people need with their finances and how the staff ensure their financial safety. Financial records were not looked at , on this occasion. The home does not use restraint but staff are trained to use de-escalation techniques, restraint is included in the training but would only be used in emergency situations. Care Homes for Adults (18-65 years) Page 19 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensure that they provide a pleasant environment that meets the needs of individuals and the group. It is kept clean and hygienic Evidence: The home has been recently re-decorated with the kitchen being refurbished,. People who live in the home told me that their bedrooms had been redecorated and they had chosen the paint colours for their rooms and the communal areas. People said their rooms were very comfortable and how they wished them to be. The house was very clean and tidy on the day of the visit and people explained how they were involved in keeping it nice. No-one has any special needs regarding equipment for their day to day living. There is a separate laundry facility, which is used by the staff and individuals. The outside area is well kept and residents are also involved in external maintenance. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home have a competent and well trained staff team who are able to meet the specific needs of the people who use the service. The home has a robust recruitment policy to ensure that staff are safe to work with the people who use the service. Evidence: The people who live in the home are offered a large degree of Independence and the staffing levels reflect this. There is one staff member per shift, two in the day to accommodate activities and one person sleeping in. People who use the service said that there is always staff around to help you if you need it. One person said but you have to do more for yourself than in some homes. Surveys noted that people liked the staff because they are kind. Staff have generally been working in the home for a number of years or have transferred from other homes by the company, the two recruitment records seen included all the necessary information and a thorough interview process, which people who use the service are involved in. Four of the six staff have N.V.Q. 2 or above or an equivalent qualification. The people who use the service were observed to be interacting with confidence and Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: humour with the staff on duty. Training records were well kept and showed that all the necessary training topics had been completed such as medication, safeguarding adults and Health and Safety issues. Staff confirmed that there were good opportunities for training and that all courses were repeated, as necessary. All staff, including ancillary staff, complete the necessary training and people who use the service participate, if appropriate. Staff have regular supervisions and appraisals and felt that the management was supportive. One staff member explained that working alone carried extra responsibilities and it sometimes made you feel less supported but added that staff are paid a premium for working alone and only experienced staff are employed in the homes where you worked alone. Staff from various cultural backgrounds employed and extra effort is made to ensure there is at least one staff from same background as residents. the home has also managed to appoint a full time male member of staff for the all male resident group. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is properly managed with the full involvement of the people who live there. People are kept as safe as possible by adherence to Health and Safety Policy and procedures. Evidence: The management of the home has not changed, the manager is very experienced and has a Registered Managers Award. The manager was not available on the day of the visit and had been on an extended break for some weeks but the home is very well organised and standards were being adhered to in her absence. The home was being supported by the area manager and staff felt that they were being well supported and there were no issues with the manager being away. Staff spoken to said they get good support from the manager . There is a robust Quality Assurance system which includes regular visits by a person on behalf of the provider (regulation 26 visits), a monthly residential forum, resident meetings , staff meetings and questionnaires sent out to all interested parties. An annual development plan is produced when the questionnaires are returned and other information is collated from the various forums Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: where people can air their views. The annual development plan is audited prior to the next set of questionnaires being sent out. There have been several developments since the last inspection including the , kitchen refurbishment and house redecoration. The home has not had an environmental health or fire officers visit for some time but are expecting them at any time. The area manager confirmed that all the Health and Safety maintenance schedules are adhered to. Staff receive all the necessary Health and Safety Training which is up-dated at appropriate intervals. The home keeps detailed accident and incident forms, there is no written evidence that these are audited by the manager but one person who was having frequent falls was reviewed and their accommodation was changed because of their increased needs. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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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