Inspection on 23/05/05 for 22 Woodlands Road

This inspection was carried out on 23rd May 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

22 Woodlands Road 26/09/08

22 Woodlands Road 10/10/06

22 Woodlands Road 08/11/05

22 Woodlands Road 03/03/05

22 Woodlands Road 09/09/04

22 Woodlands Road 24/03/04

22 Woodlands Road 18/11/03

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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 22 Woodlands Road 22 Woodlands Road Sonning Common Reading RG4 9TE Lead Inspector Julian Griffiths Unannounced 23 May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 22 Woodlands Road Address 22 Woodlands Road, Sonning Common, Reading, RG4 9TE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01189 721460 Dysons Wood Trust Josephine Gatheri Care Home 3 Category(ies) of Learning Disability registration, with number of places 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 03 March 2005 Brief Description of the Service: 22 Woodlands Road is a care home which provides long term care for three people with autistic spectrum disorder and learning disabilities. It is an ordinary house in an ordinary residential street. The organisation which runs the home specialises in providing such services. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector was in the home from 4.15pm until 7.50pm on a weekday. All three residents were at home, all having returned from spending the weekend with their families. There were two staff members on duty and the atmosphere in the home was welcoming and relaxed. The inspector spoke with all the residents and staff members, visited all parts of the home, watched staff at work and looked at some written records. Whilst there were some matters to be addressed, the inspector’s overall view was that residents were being well cared for in a settled and comfortable home, and that staff were genuinely concerned for their welfare. Not all of the standards which apply to this home were checked at this inspection. All those standards which the Commission believes need to be checked every year will be inspected before 1st April 2006. What the service does well: The home was warm, clean, well furnished and comfortable. Whilst the decoration was looking a little tired in places the manager said that extensive redecoration was scheduled for the following week. The staff on duty were experienced and well trained and they responded to residents with warmth and respect. The way staff members responded to a resident was seen to be in accordance with that resident’s written care plan. The support given to residents was such that they appeared confident and at ease. The evening mealtime was a pleasant and sociable occasion. Residents were given the help and encouragement they needed and the meal was clearly enjoyed by all. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 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. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 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 standard(s) The standards in this section were not inspected on this occasion. EVIDENCE: 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 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 standard(s) 6 and 7 There was satisfactory individual planning for residents and each had a written care plan. It was clear that some aspects of care plans were being implemented; others weren’t, but this was not always within the home’s control. Residents could choose how they spent their time in the home but some activities were organised on a group basis and this was partly to do with staff and driver availability rather than individual’s needs and wishes. One kitchen cupboard is locked to prevent access by one resident and this prevents other residents gaining access to food. EVIDENCE: The inspector saw two residents’ care plans. One had been recently reviewed and clearly identified the person’s needs and wishes and the actions needed by staff to support her successfully. Observation and records clearly showed that some aspects of the plan were being adhered to. One element, weekly visits to the Jacuzzi, was not, and the home’s manager said that the Jacuzzi was currently under repair. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 10 Another resident’s daily diary recorded activities that were listed in the “Things I Like” section of her care plan, for example listening to music, walks, cooking, swinging and art therapy. The inspector saw that one food cupboard was fitted with a lock. A staff member said that this was sometimes used to prevent access by a resident who might otherwise eat or drink excessive amounts. The manager said that this restriction was not included in the resident’s care plan. This is not acceptable unless agreed as part of a written care plan and regularly reviewed. The needs of other residents to access the cupboard would also need to be taken into account. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14, 15 and 17 Residents have some opportunities for organised activities out of the house, and these were appropriate, but the fact that most of these were very similar for each person, and done as a group, gave the impression that the programme was not based entirely on each person’s needs and wishes. Within the house residents spent their time where and how they wished. All residents enjoyed close and continuing contact with their families. The home provides good food with plenty of variety and supports residents to eat and enjoy their meals. Residents themselves had not been directly involved in putting together the menu. The home does not provide annual holidays for residents and this needs to be reviewed and the outcome discussed with the Commission. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 12 EVIDENCE: Residents’ activity records for the period 2nd to 16th May were inspected. These showed a variety of activities in and out of the house and links could be readily made with residents’ care plans. However, many of the out-of-house activities - drives, cookery, keep fit, jacuzzi, allotment – were the same and took place at the same time for all residents. The manager said that this was partly because of the lack of availability of staff drivers. During the inspection the inspector saw residents spending time in communal and private areas as they wished and doing what they wanted, supported by staff as necessary. Daily diary records indicated that this was usual. Some of the activities the inspector saw were listed as preferences in residents’ care plans. At the time of this inspection the manager said that all residents visited their families regularly, and that all had stayed with their families over the previous weekend. One resident received a phone call from a relative during the inspection, and records seen showed that this was usual. The inspector was present during the evening meal of curry and rice followed by yoghurt for dessert. All residents and staff sat down to the table together. The meal was plentiful and well presented and eaten with great relish. Cutlery suited to individual need was provided and support was given as needed. Residents were encouraged and enabled to be as independent as possible. The menu showed a good variety of dishes. The staff said that residents’ disabilities prevented them from direct involvement in selecting dishes for the menu. Whilst this would not be straightforward, the manager should consider ways in which this involvement could be promoted. The manager said that there were no special dietary requirements and residents appeared to be happy with all the food provided. The kitchen was well stocked with food. Before this inspection a resident’s care manager had contacted the Commission to express concern that the Dysons Wood Trust was not providing the resident with an annual holiday, which is a usual expectation. The manager of the home confirmed that this was the case and that a recent change of policy by the Trust was as a result of its concern over carrying out risk assessments for holiday locations. The manager did not have the full facts concerning this and said that she would need to discuss the matter with her manager. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 The quality of communication between staff and residents was good and staff responded promptly and attentively to residents’ needs and requests. The home’s procedure for administering medicines to residents was defective with regard to the management of medicine cabinet keys. EVIDENCE: Residents communicated in a number of different ways, verbally and nonverbally and communication was often not immediately clear. Staff, however, showed that they knew and understood residents and were able to respond as needed. The manager showed and explained the objects of reference used by one resident as an aid to communication. Methods of communication were seen to be included in one resident’s care plan and staff were seen to follow this. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 14 The inspector looked at the administration of prescribed medication after the evening meal. The keys to the locked medicine cabinet were kept on a general bunch which the manager took from the kitchen. The Royal Pharmaceutical Society guidelines state that medication keys “should not be part of the master system for the home”. The Dysons Wood Trust’s own written medication policy states:”The keys to the cabinet…..should always be kept by the senior person on duty”. The keys to the medicine cabinet should be kept separately from other keys and on the person of a responsible staff member. One staff member dispensed a resident’s medication into a pot in the office and this was witnessed by a second staff member. The second staff member then took the medication to the resident in the next room and administered it. Afterwards the first staff member signed the administration record having neither administered it nor actually seen it administered herself. The process was then repeated for another resident’s medication. This practice is not acceptable. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The standards in this section were not checked on this occasion. EVIDENCE: 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 28 and 30 The inspector looked at all parts of the home and, with the exception of some rather tired and tatty décor and defective toilet seats, found the accommodation to be pleasant, homely, clean and comfortable in all parts. EVIDENCE: Overall the residents’ home was warm, comfortable, well furnished and well decorated. In places the décor was looking a little tired and tatty. The manager said that redecoration was to take place the following week. All parts of the home appeared clean and odour free. The inspector did not see any problems with safety or access. However, one resident had recently lost her sight and the inspector was told that this might prove permanent. Her needs with regard to the physical layout of the home were not assessed in detail, but the manager said that the resident knew the layout of the home very well. Clearly any adaptations that prove necessary for this resident will need to be provided. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 17 All residents have their own comfortable and suitably furnished private bedroom, one with en-suite shower and WC. Bedroom doors were fitted with suitable locks. With one exception older, unsuitable locks had been blanked off so that they could not be used. In addition to the en-suite bathroom there was another, communal bathroom and WC, and a separate WC on the ground floor. All had suitable locks fitted. Sitting rooms had large comfortable sofas and easy chairs. There were plenty of different spaces for residents to be, so that they could choose to be alone or with others, and different and incompatible activities could take place at the same time. Carpets and curtains looked to be in good condition. There were sufficient bathrooms and WCs, but two of the toilet seats were loose and one was cracked. There is a pleasant garden with swings which, the inspector learned, were very popular with at least one resident. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 36 There were enough staff to meet the needs of residents, though some long shifts were sometimes being worked. Additional staff would reduce the need for this and allow more flexibility for residents’ activities. The home needs more staff who are drivers to enable more activity opportunities. The staff on duty at the time of this inspection were caring and attentive in their dealings with residents, and they promoted communication and independence and a relaxed domestic atmosphere. The staff group was stable so that staff members and residents were able to get to know each other well and make good relationships. The Dysons Wood Trust enables its staff to receive comprehensive training and ensures staff are well managed, though better records of staff meetings need to be kept. Food hygiene training for staff who prepare residents’ meals should be provided as part of their induction. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 19 EVIDENCE: There were two staff members on duty at the time of the inspection, one of whom was the registered manager. The manager said that this was the usual staffing level during the day (8 or 9am – 8pm), and the duty rota bore this out. In order to sustain this some shifts were long, for example 8 or 9am – 8pm, or 3pm – 8am the next morning. The manager said that an additional staff member was being recruited in order to provide more flexibility in the rota. This would enable more occasions when there would be three staff on duty, enhance activity opportunities and reduce the need for long shifts. The manager said that the home was very short of staff members who were drivers. Records seen showed that the Trust’s handymen were having to be used in this capacity. The manager said that this was an important consideration when recruiting new staff. The atmosphere in the home was quiet, calm and relaxed and there was lots of communication between residents and staff. Facial expressions and body language indicated that residents liked and were at ease with staff members. Staff members spent their time with residents listening to music, talking or doing puzzles or games but residents could and did choose to be alone when they wished. Staff members responded promptly to residents’ needs. At the mealtime residents were positively encouraged to do things for themselves. The manager showed the inspector the objects of reference that one resident used as an aid to communication. Amongst the items were ones which referred to cooking, swimming and visits to MacDonald’s. The manager said that the newest staff member had worked in the home for nearly 18 months. This indicated a good level of stability. She herself had worked four years in the home. The inspector looked at the training record of a staff member on duty. This was impressive and included core as well as specialist skills. A staff member who was preparing the evening meal said that she was to attend food hygiene training in two weeks time; she had worked in the home for 18 months. There was an annual appraisal record and evidence of periodic supervision meetings with the manager. The manager said that staff meetings were held at two-monthly intervals, but there were not sufficient records to demonstrate this. The manager said that she met with each staff member for individual supervision at about six week intervals. Evidence of supervision being booked was seen in the staff communication book. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The standards in this section were not checked on this occasion. EVIDENCE: 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 21 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 x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 22 Woodlands Road Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement Ensure that the medication administration record is signed by the person who actually administers the medication. Two of the three toilet seats were very loose and one was cracked. These need to be put right. Ensure that the locking of the kitchen food cupboard is agreed, written and reviewed in a residents care plan and that any necessary measures are taken to ensure that other residents are not adversely affected by this restriction. Timescale for action 23/05/05 2. YA24 23(2) 31/05/05 3. YA7 17(1)(a) Schedule 3(3)(q) 30/06/05 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA12 and 13 YA17 YA20 Good Practice Recommendations Review the programme of out-of-house activities to make sure that it meets the individual needs of each resident as written in their care plans Consider whether there are ways of involving residents more actively in the menu planning process The inspector strongly recommends that the keys to the medicine cabinet be kept by the responsible staff member on shift and separately from other keys, in accordance with published guidance and the homes own written policy Ensure that all staff meetings are fully recorded and the records dated and kept for reference The home’s policy of not providing residents with an annual holiday needs to be reviewed and the outcome discussed with the Commission. One of the residents’ bedroom doors still has a deadlock fitted which has not been blanked off. This needs to be done so that the lock cannot be used. 4. 5. 6. YA33 YA14 YA24 7. 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Burgner House, Cascade Way Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 22 Woodlands Road H57-H08 S13224 Woodlands Road V229184 230505 Stage 4.doc Version 1.30 Page 25 - 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. 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