Inspection on 13/03/09 for 188 Whitley Wood Lane

This inspection was carried out on 13th March 2009.

CSCI found this care home to be providing an Good 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

188 Whitley Wood Lane 06/09/06

188 Whitley Wood Lane 04/10/05

188 Whitley Wood Lane 01/04/05

188 Whitley Wood Lane 31/01/05

188 Whitley Wood Lane 19/08/04

188 Whitley Wood Lane 27/02/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 188 Whitley Wood Lane 188 Whitley Wood Lane Reading Berkshire RG2 8PR     The quality rating for this care home is:   two star good 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: Mark Hemmings     Date: 1 3 0 3 2 0 0 9 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. that people have said are important to them: They reflect the things 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 32 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 188 Whitley Wood Lane 188 Whitley Wood Lane Reading Berkshire RG2 8PR 01189015347 01189015348 peter.gregor@reading.gov.uk www.reading.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Reading Borough Council care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home At any one time, six people who have a learning disability can stay in 188 Whitley Wood Lane (the Service). The Service is designed for people to stay for short periods of time running from a day or so to a couple of weeks. At the moment, about 35 people use the Service during the course of a year. They usually come to stay so that they can have a change of scene and so that members of their families can have time to do other things. The premises are a detached modern building that is all on the ground floor. Three different services have parts of the building. The other two are a Care Homes for Adults (18-65 years) Page 4 of 32 Over 65 0 6 Brief description of the care home day service and a service that calls to visit people in their own homes. All of the services are run by Reading Borough Council. Each person has their own bedroom. All of the bedrooms have a private wash hand basin. Three of them also have their own toilet and bath. There is a main lounge and an activity room. There are two shower rooms and a bathroom. There is also the kitchen, the laundry and an office. The Service is in a residential street thats in a suburb of Reading. Its quite near to some local shops. It doesnt have its own vehicle. People who might want to use the Service can contact their local social services officer. They can also speak with the Manager. They can also ask for a copy of the Service Users Guide. This is a brochure that outlines the main things available in the Service. There is also a document called a Statement of Purpose. This is more detailed than the Guide. Care Homes for Adults (18-65 years) Page 5 of 32 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: two star good 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 quality rating for this Service is 2 star. This means that the people who use this Service experience good quality outcomes. Since 1 April 2006 we have developed the way we do our inspection of care services. This inspection of the Service was a Key Inspection. We arrived at the Service at about half past eight in the morning and we were there for about seven hours. It was a thorough look at how well things are going. We took into account information provided by the Registered Provider in its self-assessment. This is called the Annual Quality Assurance Assessment (the Assessment). Further, we considered any information that we have received about the Service since the last inspection. We spoke with and generally spent time with four of the people who were staying in the Service at the time. Also, we spoke with the Manager and with four of the support workers. We looked at some key records and documents and we had a look around the Care Homes for Adults (18-65 years) Page 6 of 32 accommodation. Before we called to the Service we asked some of the people who stay there and some members of staff to fill out questionnaires for us. We wanted them to tell us how they think things are going in the Service. Five people who stay there and 10 members of staff kindly filled them in and sent them back to us. Later in our report well tell you some of the things that people are saying. The Registered Provider also asks people who stay in the Service what they think of 188 Whitley Wood Lane. Some of these questionnaires are filled out when people are about to go home. But theres also a more detailed questionnaire that some people are asked to complete every six months or so. We looked in some detail at five of these latter questionnaires. Again, as we go through our report well tell you some of the things that people are saying. 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 Care Homes for Adults (18-65 years) Page 8 of 32 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 32 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 10 of 32 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. Standard 2. People who might want to move in are asked about what support they want. They are then helped to settle in. Evidence: Most of the people who stay in the Service have been there before. This means that the Manager has a good idea of what support they need. However, he still speaks with the person and with their family to make sure that he is up to date with things. The arrangements are more detailed for someone who is staying in the Service for the first time. The Manager says that he will speak in detail with the person concerned and with their family to find out what support they want and what sorts of things they want to continue with when staying in the Service. He also speaks with care managers (social workers). This is done so that he can check out points of detail that help him to be clear about what is needed. As part of this process, the person and their family are invited to visit the Service. This is so that they can get a really good feeling of what Care Homes for Adults (18-65 years) Page 11 of 32 Evidence: 188 Whitley Wood Lane is like. We looked at some of the information that was collected for one person who started staying in the Service since our last inspection. Theres lots of important information. Such as about how the person can be supported in the bathroom and how the person needs to have special dining arrangements. The Manager and the support workers recognise that moving into a new place even for a short time is a big step for anyone to take. He emphasises that the Service wants to do everything possible to make the move a positive experience for the person and for their family. In our questionnaire for people who live in the Service we ask, did you get enough information about this home before you moved in so you could decide if it was the right place for you? Everyone answers that yes they did. One person adds, visited with social worker for look around and attended for some tea visits before staying overnight. We asked support workers about how things work when someone comes to stay in the Service for the first time. They say that they have met the person before they moved in. Also, that they were given lots of useful information about the support they need and about how the person wants this to be provided. One person summarises the general mood when they say, we know that even coming for a short time to somewhere new is stressful for the service users and the family. We always make people welcome and dont overwhelm them. After a time the service users get to know us and many of them see this as a second home after a while and parents tell us that they look forward to coming to stay here. Care Homes for Adults (18-65 years) Page 12 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7, 9 and 10. There are quite detailed individual written plans of support. People are helped to manage their money. Medicines are handled safely. There is a sensible approach to everyday risk taking. Evidence: People say that the support workers offer them all the assistance they need. There is a written individual plan of support for each person. These are important documents. This is because they are one of the means by which people can decide about the support they need. Also, they are a way for them to show their agreement with how this is going to be done. The plans are a source of information for support workers. This then helps them to provide support in the right way. We looked in some detail at three of these plans. They have information about a number of relevant things. For example, there is information about how to help the people say what they want and Care Homes for Adults (18-65 years) Page 13 of 32 Evidence: about how to support them in managing parts of how they go about things. There is information about how to help them with practical things such as getting dressed and using the bathroom. We spoke with three of the support workers about whats in these plans. They know it. They also know how to use the information in practice to give people the support they need. The plans are kept up to date so that theyre accurate. This involves support workers making daily notes about how things are going. There are also more organised meetings. These are when support workers, family members and care managers meet up with the person concerned to see how things have been going and to see if anything needs to be changed. All in all, theres a lot of written information. In the main its not written in a user friendly style. Most of the people who stay in the Service might find it difficult to understand. We think that more can be done to make it easier for people to use. This is important because it will further enable people to take an active part in making decisions about the things that are right for them. Most of the people who stay in the Service are helped by their family to manage their financial affairs. Usually, each person brings in some money with them so that theyve got enough for them to pay for things such as general shopping and meals out. Support workers generally hold this money for people so that it doesnt get lost. This is a sensible arrangement. Support workers keep a record of the various transactions involved to make sure that everything is above board. We checked parts of these records to make sure that the system is working okay. For example, we looked to see if there is a record of cash coming into the Service. We also checked to see that there are receipts for things said to have been bought for people. We then looked at the cash balance held for one person to see if it matches what the records say should be there. Everything is in order. At the moment, the Registered Provider says that support workers have to get a receipt for everything they help someone to buy for themselves. We think that this is going a bit too far. Its a bit odd for example to have to ask for a receipt at a fish and chip shop, or in the pub. It might make people feel awkward and different. We think that it might be possible to make other arrangements for these occasions. Sensible consideration is given to peoples personal safety. They are not over-the-top and so people are still free to do things that they want to. There are written plans that say what potential risk is being considered and what needs to be done. For example, one person needs to be supported in a particular way when the fire alarms sound so that they dont get too anxious. Again, this information is written in a management style that most of the people are likely to find difficult to use. We think that more can Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: be done to make it interesting and user friendly. Care Homes for Adults (18-65 years) Page 15 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 12, 13, 14, 15, 16 and 17. People can do occupational and social things that interest them. They are helped to keep in touch with their families. They can spend their days as they wish. Good quality meals are served. Evidence: Everyone who comes to stay in the Service has their own established lifestyle and this includes doing a range of ocupational and social things. Arrangements are made so that each person can carry on doing their usual things when they are living in the Service. For most people this will include going out to various day services where they can do work things as well as meeting up with friends. Other activities are organised by the Service. Some of these things involve people Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: helping out a bit around the house. They help with tidying up and they go food shopping with support workers. They also do more fun things. For example, they watch films, listen to music and go into town. We checked out who is doing what and when. We wanted to see that no one is getting overlooked. No one is. In our questionnaire for people who live in the Service we ask, can you do what you want to during the day, in the evening and at the weekend? Everyone says that yes they can. The Assessment says that more social activities are now being offered. It also says that the range of things that people can do will continue to be increased. It doesnt mention about the Service not having its own vehicle. We think that this must be quite limiting, especially for people who need to use a wheelchair. Support workers keep in touch with family members so that they know how things are going in the Service. This includes general discussions about how the persons stay has gone. It also includes them contacting family members if the person isnt well. This is done so that everyone can decide together how best to support the person. People say that they have good quality meals and that they have enough to eat. One of the people we asked about this summarises the general mood when they say, very nice like home. I like my food and we get good things. Support workers do most of the main cooking, but some people do help with bits of it. There is a weekly menu. However, its not too rigid. People can and do change it if they want something different. The Assessment says that the range of meals provided has been increased in the past year so that there is more variety and choice. We looked at the record of meals served. People are having normal things such as spaghetti bolognaise, chicken and roast beef. The Manager says that people are encouraged to eat a balanced diet and not have too much instant food. The Registered Providers questionnaire asks, (what do you think of) the meals that you get? One person says that theyre very good, four people say that theyre good. Care Homes for Adults (18-65 years) Page 17 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 18, 19 and 20. People are helped in ways that are right for them. They are helped to stay well. There are safe systems to manage medicines. Evidence: People are helped in ways that are right for them. Support workers are helpful without crowding people out. Their manner is informal and kind. The overall feeling is one normal family life. The people who live in the Service are relaxed in the company of support workers. They dont wait to be spoken with, theyre quite happy to say and indicate if they want something. They show by their manner that they see support workers as being their friends rather than being paid staff as such. Things are orderly without being too much so. When things look like they might be getting a bit too much, support workers gently point people in a different direction. This isnt done in an obvious or bossy way. For example, when we were there one person was getting concerned that they might be left behind when the others went out to a day service that morning. The support workers reassured her that this wouldnt Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: happen. People are helped to wear neat and clean clothes so that they can look how they want. In our questionnaire for people who live in the Service we ask, do you make decisions about what you do each day? and do the carers listen and act on what you say? Everyone says that they always do. People are helped to keep healthy. Support workers keep a tactful eye open so that a doctor can be called if someone is becoming unwell. Since our last inspection, people have seen their doctors as and when necessary. We looked in some detail about an incident when someone became unwell while staying in the Service. The records show that their family was contacted straight away and that arrangements were made for them see a doctor without delay. The Registered Providers questionnaire asks about this. Everyone says that they get very good health care support while they are in the Service. Support workers manage medicines for all of the people who live in the Service. We think that its reasonable for them to do this, because people will find it very difficult to do for themselves. There is a system to check that the correct medicines are received when the person comes in. Once in the Service, they are stored securely. There is a procedure for administering medicines. This is designed to double check that the right medicines are given to the right people at the right time. There is a record that is completed on each occasion that a medicine is given. We looked at one set of these records. They are correctly completed. One person has a special medical need. They sometimes have to have an extra medicine when they arent well. We looked in detail about how support workers are helping them to deal with this. There are quite detailed written guidelines to help support workers decide when to offer the medicine. We asked support workers about this matter and they know what theyre doing. Care Homes for Adults (18-65 years) Page 19 of 32 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. Standards 22 and 23. People are free to make a complaint if they want to. People are kept safe. Evidence: There is a written complaints procedure. This uses some pictures to make it easier to use for the people who live in the Service. The Assessment emphasises that peole who live in the Service are actively encouraged to say what they think about the support they receive. Its best for complaints to be sorted out locally. This is so that it can be done quickly and efficiently. Indeed, the Registered Provider has a duty to deal with complaints in this way. However, people do have the right to tell us if theres something thats concerning them about the Service. This right is not fully explained in the complaints procedure. The Manager is going to make the necessasry change by 1 May 2009 so that everyone is clear that they can contact us if they want to. In our questionnaire for people who live in the Service we ask, do you know how to make a complaint? Everyone says that yes they do. We also ask, do the staff treat you well? Everyone says that they always do Since our last inspection, the Registered Provider has received seven complaints. Theyre from family members and are about different things. For example, one persons parent was concerned that an item of clothing hadnt been laundered before it was packed to go home with them. The records show that the Manager looked into Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: what had happened. The item had been packed by the person themselves who was being encouraged to be as independent as possible. The Manager explained this to the parent. He reassured them that in future, support workers will help the person concerned check more carefully when packing up for themselves. The other complaints are about similar relatively minor things. The records show that the Manager promptly sorted them out. He says that they are no complaints outstanding at the moment. We havent received any complaints about the Service since our last inspection. People say and show by their relaxed manner that they feel safe staying in 188 Whitley Wood Lane. The Registered Provider has a written policy and procedure that tells support workers what to do if they become concerned about someones wellbeing. For example, if someone is not being treated kindly. We spoke with two support workers about this. They know what to look out for and who to contact if they become concerned. They say that they havent seen or heard anything to worry them. Indeed, they are confident that the people who live in the Service are safe and are well supported. In our questionnaire for staff we ask, do you know what to do if a service user has concerns about the home? Everyone says that yes they do. Care Homes for Adults (18-65 years) Page 21 of 32 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. Standards 24, 29 and 30. People live in a comfortable setting. In general, the accommodation promotes peoples independence. The kitchen is clean and well equipped. There is a separate laundry. Evidence: The accommodation is comfortable. In general, its like anyones home is. Its got a lived in feeling and things arent too fussy. People say the place is kept pleasantly warm. The central heating was on when we arrived and it was still on when we left. The radiators are fitted with guards. This has been done to reduce the risk of someone being burnt if they fall against one. The hot water is temperature controlled. This is to help reduce the risk of someone being scalded. We tested a few of the hot taps. The water isnt too hot. The gardens are quite level. There is a patio table and chairs that people can use when the weather is fine. The Assessment says that it is hoped that some raised flower beds can be created in the near future. These will enable some of the people who use the Service to be come involved in growing things. There is only a limited amount of car parking. One part of the drive way has got quite Care Homes for Adults (18-65 years) Page 22 of 32 Evidence: a tight curve on it. Over time, vehicles have obviously not been able to manage the curve. Theyve had to go up onto the lawn and this has churned it up. The road in this area is partly covered with mud and stones from the lawn. Also, there is general rubbish blowing around and caught in the bushes nearby. All in all this area of the building looks run down. After we visited the Service, the Manager told us that the Registered Provider plans to sort out all of these problems in the near future. The building is fitted with an automatic fire detection system. This provides a high level of fire safety protection. We understand that the Berkshire Fire and Rescue Service says that the fire safety measures in place meet the national standard. The Registered Provider has prepared a fire risk assessment. This has been done to ensure that the fire safety system continues to work as intended. For example, it looks at things such as whether or not the the exit routes are clear. The local Department of Environmental Health last called to the Service in May 2008. It gave the kitchen three out of possible five stars. The report says that in general the food safety arrangements in the Service are good. The report recommends that a number of relatively minor improvements be made. These include things like mending a broken tap in the kitchen. The Manager says that all of the recommendations have been done. We looked at the kitchen and we noted that the tap has been fixed. Theres a system to make sure that the refrigerators are cold enough to store foods safely. Checks are also done to make sure that things like meat are properly cooked through. Sensible steps are taken to promote good hygiene. For example, support workers know about the importance of washing hands. In particular, if theyve been doing other things like working in the laundry. Some of the people who stay in the Service need to use wheelchairs and they also need to be assisted using a hoist. Although the accommodation is purpose built, it hasnt really been designed for these people. The corridors are quite narrow as are the doors. Things like plugs and work surfaces arent at the right height for these people to be able to use them in comfort. There isnt an obvious answer to this and in general support workers feel that they can manage well enough at the moment. There are various things to help people who have difficulty getting about. In addition to the mobile hoist, there is a bath that has a special seat. This goes up and down and also it swivels. This means that you can sit on it outside the bath and then be raised and lowered into the bath. There are also two showers. Theres a special shower trolley that can be used by people who cant stand to use a shower. However, this special facility is in another part of the building and it isnt really part of the living space reserved for the Service. The Manager recognises that having to get to another part of the building isnt a good idea. He is planning to install a new special wet room in one Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: of the Services own bathrooms which will include the shower trolley. There are other things such as assistance poles near to toilets. These are fitted to the wall so that theres something to hold onto. Support workers have looked carefully at the help each person needs to get about. This has been done so that they know how best to make sure that the person is safe and comfortable. The laundry has got a washing machine and a dryer. These are working okay and support workers are getting through everyones laundry without too much difficulty. Care Homes for Adults (18-65 years) Page 24 of 32 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. Standards 32, 33, 34 and 35. There are support workers around to make sure that people get the help they need. Security checks are completed on staff. Support workers know what they are doing. Evidence: There are at least two support workers on duty in the mornings and in the afternoon when people come home from being out at their various day time activities. At weekends there are at least two support workers on duty all day. There is always a waking staff presence at night. These members of staff are supported by special security arrangements. We looked at the roster to see if the various shifts are being filled reliably. We found that they are. The Registered Providers questionnaire asks what people think of the support they get in the Service. One person says that its very good, three people say that its good and one person says that its okay. In our questionnaire for support workers we ask, are there enough staff to meet the individual needs of all the people who use the Service? Only four people say that there always are enough with the remaining eight people saying that there usually are. One of these latter people says, we have enough staff to provide a good service but in order to become more flexible and person centred we may need more staff. Another person adds that, it can be stretched due service users needs, staff sickness Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: or annual leave. Its very important that all of the support workers are honest people who can be trusted to spend lots of time with the people who live in the Service. With this in mind, the Manager says that the Registered Provider completes a number of security checks for new support workers. These include checking the persons identity and their employment history, getting references and doing a police check. We werent able to check any of the records relating to this matter. This is because the Registered Provider keeps them at its head office. However, we were able to speak with someone who has just been appointed. They confirmed that the Registered Provider did ask them for the information it will need to do the checks we have mentioned. In future, the Registered Provider will need to copy to the Service a summary of the security checks that have been done for each new support worker. This is so that we can be more clear that the necessary checks are indeed in place. New support workers have introductory training before they begin supporting people. After their introduction to the Service, they start completing a more detailed training programme. This involves them doing various courses on subjects such as how to administer medication, how to safely assist people who have difficulty getting about, how to handle food and how to keep people safe. In our questionnaire for support workers we ask, are you being given training which helps you to understand and meet the individual needs of service users and keeps you up to date with new ways of working? Everyone says that yes they are. One person adds, I have found the establishment particularly supportive of any training requests relevant to our roles and we are encouraged to attend and feedback information. This is shared via team meetings and emails. The Assessment says that all support workers are encouraged to complete a relevant National Vocational Qualification (NVQ). This is a good idea because the qualification is designed to support people being helped in ways that are right for them. At the moment, there is a total of 23 support staff including the deputy manager and the senior support workers. Sixteen people already have the qualification or an equivalent and one person is completing the award. When we spoke with support workers we asked them about points of detail to do with their work. They have a sound understanding of important things. Such as about how people who use the Service prefer to express themselves, what sorts of activities they like to do and what they like to do for themselves. Throughout our time in the Service we saw them using this knowledge so they were supporting people in ways that are right for them. Care Homes for Adults (18-65 years) Page 26 of 32 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 37, 39 and 42. The Service is reliably managed. People are asked what they think about how things are going, but this could be a bit more developed. Peoples health and safety is promoted. Evidence: The Manager has a good knowledge of how things are going in the Service. He has one of the two formal qualifications that are recommended by the Standards and he is currently studying for the second one. These qualifications are important. This is because they are intended to help managers ensure that people receive high quality residential care services. Various things are done to help staff work as a team. There are handover meetings at the beginning and end of each shift. These are when support workers say how things are going and what needs to be done on the next shift. Also, there is a system where each support worker meets with someone senior to look at how their work is going. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: Support workers say that there is good team work. We saw plenty of evidence of this. Support workers check out with each other who is going to do what, with whom and when. Also, they plan their work in advance so that they use their time to the best effect. For example, they know who needs the most support when they go out and they organise themselves accordingly. In our questionnaire for support workers we ask, do you feel you have the right support, experience and knowledge to meet the different needs of the people who use the Service? Seven reply always and three people answer usually. One of the former people says, I work in a very supportive team of managers and staff. Staff get good support and have access to all the training they need. The other person says, I have lots of people around me that can support me to support others if I feel that I am lacking in my own experience or knowledge. We also ask, do the ways you pass information about people who use the Service between staff (including the manager) work well? Only two people say that they always work well, with eight people saying that they usually do. It would be a good idea for the Manager to look into why some members of staff think that things could be improved. People who live in the Service are asked about how well they think things are going in their home. These include informal everyday discussions. There are also house meetings every week. At these meetings people talk about things like what to have on the menu and what social things they might like to do. Weve already mentioned the questionnaires that people who live in the Service are invited to complete. We think that more can be done to make them user friendly. For example, some of the wording of the questions is quite complicated. The Assessment says that this work is underway, with people who use the Service being asked for their advice. We also think that more can be done to tell people who use the Service what has been said. Also, there should be more focus on letting people know what is going to be done to respond to any improvements that may have been suggested. The Registered Provider arranges for a senior person who is not based in the Service to call each month to see how things are going. We looked at the records of one of their recent visits to see what sorts of things they look at. These include things such as any accidents that have happened or any complaints that have been received. They also check health and safety things. Support workers are regularly checking that the fire safety equipment is in good working order. Also, there are more detailed checks of the system that are done by a contractor. There are unannounced fire drills each month. Theres also a system for each member of staff to have regular fire safety training. However, this training isnt Care Homes for Adults (18-65 years) Page 28 of 32 Evidence: being done frequently enough. This is very important because the level of fire safety protection in the Service largely depends on members of staff doing the right thing at the right time. It seems that this oversight has been the result of a genuine misunderstanding on the part of the Registered Provider. The Manager says that he will put this right by 1 May 2009. The Manager says that an engineer has had a look at the gas appliances in the Service and has said that theyre in a good condition. The same applies to the mobile hoist. The electrical wiring installation has also been passed. The paperwork relating to these checks is not kept at the Registered Providers head office. In future, it will need to be copied to the Service so that we can double check that everything is okay. We looked at the record of accidents and other untoward events that have occurred in the Service this year. There is nothing out of the ordinary. The Manager checks into what has happened for each accident. This is so that if necessary he can do something to stop them happening again. The Registered Providers health and safety officer checks the place over about once a month to make sure that theres nothing broken that needs fixing. Also, he looks out for hazards that might cause someone to have an accident. He hasnt noticed anything major so far. We kept our eyes open while we were walking around. We didnt see any obvious hazards either. Care Homes for Adults (18-65 years) Page 29 of 32 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 30 of 32 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 31 of 32 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) 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. 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