Inspection on 23/06/05 for Courthouse Road

This inspection was carried out on 23rd June 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

Courthouse Road 22/08/08

Courthouse Road 24/08/06

Courthouse Road 01/11/05

Courthouse Road 08/03/05

Courthouse Road 21/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 237 COURTHOUSE ROAD Maidenhead Berkshire SL6 6HF Lead Inspector Sue Burton Unannounced 23 June 2005 @ 09:30 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. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 237 Courthouse Road Address Maidenhead Berkshire SL6 6HF 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) 0208 5699131 Owl Housing Limited Mrs Jacqueline Lewis Care Home 4 Category(ies) of Learning Disability registration, with number of places 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 08/03/05 Brief Description of the Service: 237 Courthouse Road provides accommodation and care to four service users who have a learning disability. The Proprietors of the home are Owl Housing Ltd. The home is a domestic style four bedroom detached house in a residential area of Maidenhead. It is situated near to local shops and the town centre with easy access to the M4 and M40.Accommodation is provided in single bedrooms on the first floor. There is a lounge/dining room and a quiet lounge. There is a large mature rear garden and car parking to the front of the house.The home is staffed by a team, which comprises of a manager, deputy manager and support workers. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which took place on Thursday 23rd June 2005 between the hours of 09.30 am and 13.15 pm. The inspector met all four residents only briefly during the inspection, only one of which had verbal communication who left shortly to attend the day centre along with two other individuals from the home. The Manager and Deputy Manager were available throughout the inspection along with two support staff and a supernummary nursing student on placement within the home. The inspector focused on the homes management standards, the environment of the home and the documentation and care plans of the resident who had remained in for the day. What the service does well: What has improved since the last inspection? The organisation of the homes records has improved; the home was clean and tidy with no odours. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 6 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. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 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 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 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) 2,3 The home has had no new admissions since 1998 and has a stable group of residents. The home is able to meet the resident’s needs and aspirations. EVIDENCE: The home has in place support guidelines for each resident which give detailed evidence of the staffs efforts to ensure their individual physical and social needs are identified with the necessary action required to achieve the desired outcome. Each individual’s habits and behaviours are documented along with their likes and dislikes, activity choices and health needs. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 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 in part, 7,8,9,10 Residents have individualised plans in place, which detail their care needs. Residents in the home with non-verbal communication are enabled by the staff team to make decisions wherever possible. Residents are encouraged and enabled to participate in aspects of life within the home. Detailed risk assessments are in place, which identify hazards and actions required to reduce those risks. Records are kept secure within the home. EVIDENCE: One resident’s care plans were reviewed in detail. Health needs were assessed on a specially designed form. The home has recently redecorated each resident’s bedroom; individuals were taken shopping to choose the colour scheme and fittings for their own room. Staff know the residents well and understand their non verbal communication signs which allows them to enable choice in meals, clothes and activities. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 10 Detailed and appropriate risk assessments were seen in place for a wide range of potential hazards. The home has a separate office with secure filing cabinets for the resident’s personal information to which only the deputy and manager have access. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 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) 11,13, 14, 16, 17 The residents are provided with opportunities for personal development. Individuals participate in the local community and make use of a wide range of activities. The staff ensure that each resident has a choice of leisure pursuits appropriate to their needs. The routines in the house are relaxed and appropriate to the abilities of each individual. Meal times are relaxed and flexible to where and when individuals eat their meals. EVIDENCE: Most of the residents attend the local day centre, which provides a programme of activities suited to each individual’s needs and ability. Two residents attend church led activities every month. Evening activities outside of the home are provided and day trips and holidays. Photographs provided evidenced of a wide variety of venues and places that individuals had visited. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 12 Professional, specialist resources are called in by the staff when more support is required. One resident enjoys bowling and the staff ensure that transport and resources are provided for her to continue with this activity. Photographs of family and friends are displayed and family contact is welcomed and encouraged by the staff team. The staff team on duty during the inspection were observed and heard treating the residents with sensitivity and respect. Routines appeared flexible to allow individuals to have their breakfast in bed if wished. There is no set menu and staff rely on their knowledge and experience of residents likes and dislikes to decide on the choice of main meal. The staff team supports individuals with specific nutritional needs, actions required by them are recorded. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 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) 19 The health care needs of the resident at home on the day of inspection were seen to be met. EVIDENCE: The records seen on the day of inspection for one individual evidenced that a thorough health check/assessment had been carried out. Information had been recorded on weight, medication, pain management, mobility needs, mental health needs, and lifestyle risks. There was a health action plan in place with actions required by the staff team and this was seen to be kept under regular review. Records of significant events are recorded. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 in part Only one of these standards were inspected on this occasion. The home has an effective whistle-blowing policy and procedure in place that staff can use. EVIDENCE: Evidence was seen of the staff being aware of the homes whistle-blowing procedures and the manager acting appropriately in response to concerns raised. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 15 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) 24,25,26,27,29,30 The home was comfortable, bright and cheerful. Bedroom sizes were suitable for the residents. There are no shared rooms. Furniture and fittings were appropriate to the needs of the residents and were of a good quality and modern design. The homes bathroom and toilets meet the residents needs and give privacy. The home had some adaptations in place for individuals. The laundry floor requires impermeable flooring. EVIDENCE: The home has recently been redecorated and on inspection was seen to be bright and cheerful, clean and free from any odour. The four bedrooms were all individually decorated with different designs and colour schemes. Bedrooms were decorated to each individual’s personality and taste and displayed the individual’s personal possessions. Furniture in the house and bedroom were modern, comfortable and suitable for purpose. The home has a small downstairs toilet, a bathroom upstairs with toilet and one bedroom has a small ensuite. Facilities were clean and tidy and had no odours. Rails and raised toilet seats are provided for the residents. A rail is provided on the exit form the TV lounge to the garden but not at the kitchen door exit. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 16 The home has a small laundry area situated within the external garage. The area has been decorated and contained a small sluice style sink; hand-washing resources were not prominent and there were no displays of good hand washing techniques. The laundry floor was damaged and did not have a impermeable finish which is needed for cleaning and to prevent and cross infection. Staff have not received training in infection control, which is recommended. The home has a very long garden, the majority of which was a little overgrown and did not appear to be used. Residents have a small patio area only. There are no level pathways around the garden, which residents could use for exercise and enjoyment. Staff are expected to maintain the garden within their rostered hours, which may not always be a priority. Staff had made some efforts to provide a planted area with bedding plants close to the house, which will add some colour to the garden. The garden area was not seen to be fully utilised to the benefit or enjoyment of the residents. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 17 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) 31,32,33,35,36 Staff members in the home have clearly defined roles. Staff members were seen to have competencies and qualifications appropriate to the residents needs. The numbers of staff on duty on the day of inspection provided an effective staff team. The staff team has a range of training opportunities provided for them. Staff supervision takes place and issues are recorded. EVIDENCE: All staff are provided with job descriptions. Evidence was seen in the minutes of staff meetings that any new policies and procedures are discussed and explained to staff with signatures recording that staff have read them. The Deputy has achieved NVQ3 in care and promoting independence. On the day of inspection the Manger and Deputy were on duty plus two support staff and one supernummary student nurse on placement within the home. There is one waking staff on night duty. The organisation has recently started a new initiative where by managers visit other managers homes during the night to monitor performance and provide support to night staff that is most commendable. Training in First Aid and Health & Safety is being provided for staff next month. Some have already completed this training. Some staff have had bereavement 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 18 training. The manager has also completed a moving and handling course for people with special needs, which she intends to renew this year. Supervision records evidenced that support staff are appropriately supervised on a one-to-one basis on a reasonably regular basis. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 19 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) 37,38,39,40,41 The manager of the home is competent and experienced to run the home. The management approach created an open, positive atmosphere. Feedback from residents or their representatives was not actively sought. The home has copies of its organisations policies and procedures in place. The homes fire risk assessment needs to reflect the vulnerability and mobility needs of the residents. The health and safety of the residents appeared on the day of inspection to be protected. EVIDENCE: The manager has completed her Registered Managers award but did not have the confirmation to validate its successful completion as yet. The registered manager communicated a clear sense of direction and organisation that gave an open and positive atmosphere to the home. The home does not appear to actively record feedback from resident’s families or other stakeholders, which is recommended. The organisation has regular meetings of “quality groups” to look at quality assurance issues. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 20 There is a new procedure in place in the home that staff now sign to confirm they have read the policies and procedures. Records were seen to be kept secure (see Standard 10) Records in the home confirmed that service contracts for gas, electric and water maintenance are in place. A Fire officer from Royal Berkshire Fire & Rescue Service had visited the home on 17th March 05 and had had issued a notice of fire deficiencies, which advised that there were issues with the homes fire procedures which needed attention. This included the homes fire risk assessment, which was professionally done but did not address the vulnerability and mobility needs of the residents. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 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 3 3 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 x 3 2 Standard No 11 12 13 14 15 16 17 3 x 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 237 COURTHOUSE ROAD Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 2 3 2 3 3 2 3 H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 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. 2. Standard 30 42 Regulation 13 (4)a 23 (4) Requirement The laundry floor is to have an impermeable finish The homes fire risk assessment is to meet Fire Authority guidelines and reflect the residents vulnerability and mobility neeeds. A copy is to be CSCI. The home is required to meet the advice and guidleines of the Fire Authority. Timescale for action 23/9/05 23/9/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 24 39 30 Good Practice Recommendations The home is to review the access and design of the garden to ensure it is suitable for the needs of the residents. Feedback from residents families or other stakeholders is to be recorded. Staff in the home are to be provided with training in infection control. 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 237 COURTHOUSE ROAD H52-H01 46684 237 Courthouse Road V228946 230605 Stage 4.doc Version 1.40 Page 24 - 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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