Inspection on 20/09/05 for 12 Middle Green Road

This inspection was carried out on 20th September 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 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

12 Middle Green Road 04/04/07

12 Middle Green Road 15/02/06

12 Middle Green Road 21/12/04

12 Middle Green Road 21/12/04

12 Middle Green Road 21/12/04

12 Middle Green Road 21/12/04

12 Middle Green Road 01/07/04

12 Middle Green Road 01/07/04

12 Middle Green Road 01/07/04

12 Middle Green Road 01/07/04

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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 12 Middle Green Road Langley Slough Berkshire SL3 7BN Lead Inspector Jill Chapman Unannounced Inspection 20th September 2005 10:40 DS0000011276.V249004.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 DS0000011276.V249004.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. DS0000011276.V249004.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 12 Middle Green Road Address Langley Slough Berkshire SL3 7BN 01753 532415 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 Ms Iona Campbell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000011276.V249004.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st December 2004 Brief Description of the Service: 12, Middle Green Road provides twenty-four hour care for up to four people with learning disabilities who are encouraged to participate in a variety of life experiences and day care activities to enable service users to lead fulfilled lives underpinned by “ The Five Accomplishments To Ordinary Living” (John O’Brien). The aim at Middle Green Road is to provide a high quality residential service underpinned with comprehensive care planning and risk assessing to reflect individual needs and preferences of the people living there. We are committed to working to the highest professional standards on a multi disciplinary basis to offer real community living. The objective is to provide an environment where people with learning disabilities are enabled to develop independence and to enjoy the everyday experiences and opportunities that the wider community enjoys and be seen in society as valued individuals. DS0000011276.V249004.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on a weekday morning over a period of three hours. The visit coincided with the three residents being away on holiday. Because of this the standards relating to care, health and activities will be covered at the next inspection so that residents’ views can be taken into account. Standards covering admissions, protection, premises, staffing and management were covered on this visit. Discussion took place with a Senior Support Worker and the Registered Manager. Records were seen and a tour of the premises was undertaken. What the service does well: There is an admissions procedure which ensures that the home only accommodates residents whose needs they can meet. Occasional emergency admissions are monitored to make sure that they cause minimum disruption to permanent residents. Staff have coped well with an unexpected death of a resident and have supported residents to grieve. There are systems in place to help residents make complaints and to help staff protect them from abuse. Residents’ benefit from a well cared for home that is near to local facilities. The home is kept clean and hygienic. Staff are well trained to meet residents needs and there are enough staff on duty to meet current needs. The home is well managed by a qualified and experienced manager. The views of residents and relatives are sought at Annual Reviews of the service. Regular health and safety checks and services make sure that residents are kept safe. DS0000011276.V249004.R01.S.doc Version 5.0 Page 6 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. DS0000011276.V249004.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 DS0000011276.V249004.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&4 The home has an admissions policy, which includes an assessment to make sure that the home can meet residents’ needs. Staff make sure that emergency admissions do not cause disruption to the permanent residents. Routine admissions give residents the chance to ‘test drive’ the home. EVIDENCE: There is a Milbury admissions policy in place and this covers the areas required in the standard. Recent admissions have been on an emergency basis. The records of this admission were seen and the process discussed with staff. Written information from the care manager and telephone discussions sought as much information as possible to help the home know whether they could meet the residents needs. There is written evidence of detailed daily notes, ongoing assessment, development of care plans and risk assessments. The placement was reviewed regularly to make sure it was suitable. Another emergency admission proved to be too disruptive to the home and so the home asked for the resident to be moved. Although pre placement visits were not possible for the emergency situations, they are specified in the policy and staff confirmed these are part of a routine admission to the home. Advice was given to include the homes policy on emergency admissions in the Statement of Purpose. DS0000011276.V249004.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): Not inspected on this visit. EVIDENCE: DS0000011276.V249004.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): Not inspected on this visit. EVIDENCE: DS0000011276.V249004.R01.S.doc Version 5.0 Page 11 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): 21 Staff coped well with an unexpected death of a resident and supported residents to grieve. EVIDENCE: Staff described how they handled the unexpected death of a resident. This included liaison with family, other professionals and the residents about funeral arrangements. There is a Milbury procedure to help staff and local health professionals helped them access a local grief counselling service. Staff said they worked with residents to help them with their grief process by using photos and reminiscing about past events. DS0000011276.V249004.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Staff and residents have information from the procedure to help them make or respond to complaints. Staff are trained to help them know how to protect vulnerable adults. EVIDENCE: There is a complaint procedure in place and this is also in a user-friendly format for the residents. Each resident has a copy of the procedure and staff have explained this in residents meetings. If residents have a problem staff said that the complaints procedure is routinely offered. The complaints record shows that there have been no complaints received since 2004. The Commission has received no complaints about the home. The home has relevant policies to inform staff about how to protect vulnerable adults. These include whistle blowing, No Secrets and the local procedure. The manager confirmed that are well trained in this process. Following a past incident of poor staff practice a detailed induction pack has been developed and each staff member has a copy for reference. DS0000011276.V249004.R01.S.doc Version 5.0 Page 13 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 & 30 The home provides well cared for and homely accommodation. Refurbishment plans for the kitchen and bathrooms will improve these areas. Staff are trained to make sure they keep the home hygienic and know how to prevent infection. EVIDENCE: The home is a converted bungalow in a residential area of Slough and is in easy reach of local facilities. Staff have made this a homely environment for residents. A Senior Support Worker was repainting a bedroom while the residents are on holiday. The kitchen is due to be refitted during this financial year. The bathroom is in need of refurbishment and the manager said that this is planned for the future. In the meantime and new flooring has been laid and minor repairs have been carried out. In consultation with the Occupational Therapist the manager is looking at whether it is possible to convert a downstairs toilet into a shower room. There is a suitable laundry and there is a washing machine with a sluice facility. Staff are trained in infection control during LDAF induction and NVQ training. The manager said that staff practice is monitored. There is a contract for the disposal of soiled waste. DS0000011276.V249004.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): 32, 33, 34 & 35. Staff are well trained to meet the needs of the residents. There appear to be enough staff on duty to support the current needs of the residents. Staff deployment is flexible to residents needs. And the home has made an extra effort to provide consistent night care. There is a recruitment procedure in place to make sure that only suitable staff are employed. EVIDENCE: The staff training record shows that staff undertake LDAF induction and training. Core training is also carried out and the training record shows that this is updated when required. Staff also receive training specific to residents needs. A programme of NVQ is in place and the home have met the target for 50 of staff achieving NVQ 2 or above by 2005. A recent appointment means that the staff team will be complete. Rotas were sampled and show that on weekdays there are four staff on an early shift and two on a late shift. Two of the four staff support an ex resident in the community. At weekends there are two staff on an early and late shift. At night there is a waking night and a sleep in staff. It is the policy of the home is that day staff also work nights for one week on an eight-week rotation. This is to prevent the need to use agency staff and provide consistent care for the residents. The commitment of the manager and staff to continue this practice is seen as exceeding this standard. DS0000011276.V249004.R01.S.doc Version 5.0 Page 15 There is a recruitment policy in place. In discussion with the manager and from looking at records it was seen that the procedure is followed. Recruitment checks include CRB, POVA, Visa/Passport, health questionnaires and two references. DS0000011276.V249004.R01.S.doc Version 5.0 Page 16 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): 37, 39 & 42 There is an experienced and well-qualified manager in charge of the home. An Annual Review seeks feedback from residents and their relatives. There are systems in place to make sure that residents are kept safe. EVIDENCE: The registered manager has considerable experience in residential and nursing care and the field of learning disability. She has a City and Guilds in Advanced Management and Care. She has recently completed her NVQ 4 Registered Managers Award and is an NVQ Assessor. There is a quality assurance system in place. An Annual Review was carried out in January 2005, which takes into account the views of residents and their relatives. Health and safety records were sampled. These show that equipment is regularly serviced. Records show that hot water temperatures, fire systems and food safety are monitored weekly or daily. COSHH (Hazardous) substances are kept locked for safety. Monthly health and safety audits highlight any repairs or hazards that need attention. DS0000011276.V249004.R01.S.doc Version 5.0 Page 17 DS0000011276.V249004.R01.S.doc Version 5.0 Page 18 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 x x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 4 3 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x 3 Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x DS0000011276.V249004.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action 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 DS0000011276.V249004.R01.S.doc Version 5.0 Page 20 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. 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