Inspection on 15/11/06 for 29 Briants Avenue

This inspection was carried out on 15th November 2006.

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

29 Briants Avenue 24/10/08

29 Briants Avenue 29/11/05

29 Briants Avenue 14/06/05

29 Briants Avenue 30/11/04

29 Briants Avenue 07/06/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

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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 29 Briants Avenue Caversham Reading Berkshire RG4 5AY Lead Inspector Kerry Kingston Unannounced Inspection 15th November 2006 3:00pm 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 29 Briants Avenue Address Caversham Reading Berkshire RG4 5AY 0118 947 9795 0118 972 3479 dw@disabilities-trust.org.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Disabilities Trust Ms Shanta Sharma Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: 29, Briants’ Avenue is part of The Disabilities Trust. The home provides twenty-four hour residential care for three adults (male and female) with Autistic Spectrum Disorder. Service Users are encouraged to overcome the disabling effects of their Autism and associated conditions, by participating in a variety of daytime activities and life experiences that promote and develop independence. The home is a three bed roomed semi-detached house, sited near the centre of Reading with local shops and facilities within walking distance. The home has its’ own transport and easy access to the public transport system. Fees are £1,154 to £1,173 per week. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on the 15th November between the hours of 3.00 pm and 7.30pm. The purpose of the visit was to collect information to inform the key inspection report. Information for this inspection was collected by means of a Pre-Inspection Questionnaire and service user surveys, completed by service users with staff help (all three surveys were returned) prior to the visit. On the day of the visit the inspector toured the building, observed care practice, spoke with two staff members and all three service users. Service user care plans and other records were looked at. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 Quality in this outcome area is good. If the home adheres to the admissions policies and procedures, when a service user is admitted, it would ensure that it would only admit service users whose needs it could meet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions to the home since 1989. There is a cmprehensive admissions policy and procedure in place, which includes criteria for admission, a detailed assessment and advice about pre-admission visits. There are very good , deailed service user contracts in place, these are signed by the manager and the service users and are up-dated as necessary. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent. The home fully understands and meets the needs of the service users. Staff support and encourage service users to make as many decisions for themselves and to remain as independent as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have a very detailed care plan , which contains excellent information. They include how service users communicate, what it is appropriate for them to choose and how they make those choices, what environments they prefer i.e. noise levels and crowds,physical needs, interactions with staff and other service users,theraputic activities, how they relax, calming techniques that staff can employ,listening techniques that staff can use and service users’ sensitivities. Care plans are signed by service users and the staff team and are all up-to-date. There are additional guidelines if individuals have any specific behaviours such as alleviating anxieties. Service users development plans include short and long term goals and progress is reviewed. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 9 Monthly summaries are completed from the daily notes to identify if there are any issues arising throughout the month. Care plans are reviewed by staff regularly and an annual review is held by the care management teams. Service users fully participate in the review process and are able to talk about the result of their reviews. A written note was submitted to the reviewing officer prior to review to express one of the service users feelings. Action is taken as a result of the review process ,evidenced by a speech and language assessment completed for a servie user on 08/08/06 as recommended at his review 06/07/06 to optimise communication skills. Service users are encouraged to make decisions, by staff being clear how they make choices and what it is appropriate for them to make choices about. Group discussions are held every month,the discussions include activities and what is going on in the house such as the new kitchen, service users were asked if they liked the agency staff working with them, they are asked if they have any problems and if they are happy living in the home. Risk assessments are very comprehensive and cover all aspects of daily living to ensure that the service users can be as independent as possible. Staff were observed encouraging and assisting service users with their daily activitiess. One service user has had a risk assessment and programmecompleted to enable her to travel indepenantly to one of her activities.Risk assessments are reviewed reglarly and are all up-to-date. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. The home ensures that the service users have a very positive and enjoyable lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have an activity programme which includes sessions of external day care, college courses, work experience (for one service user) and in-house day care sessions such as computer lessons, craft work,piano lessons,violin lessons. Many of the external activities need 1:1 staff support, which the home provide. Service users are also encouraged to do some household chores as an activity such as ironing,cleaning bedrooms and shopping. Daily notes record service users being assisted with handicrafts,reading,gardening, cookery and church visits in the evenings and at weekends. All the servcie users said that they had enough to do and ‘never got bored’. Only one staff on duty can effect service users’ choices and spontanious community activities, this was mentioned by a 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 11 service user on a survey he said that ‘he could not always do what he wants as he has to fit in with others’. A staff member described how the group make choices and compromises and how group outings and trips are usually successful. Additional staff are rota’d on duty if there are any special occasions or activities planned. A service user said that they cant use the car much in the evenings as agency staff cant drive it, it ocassionally causes a problem if they want to go out for a drive. All service users have contact with families and one was observed being phoned by her family. Families were seen to be involved in reviews and a record is kept of all contacts with families and when service users visit family and friends. One service user discussed his Christmas arrangements and detailed his visit to his family for that period. The home appeared to have very good relationships with families, this was confirmed by staff members and service users. The Disabilities Trust has a written charter that outlines the responsibilities of the service users and the Trust, this includes dignity,respect,equality and diversity. A staff member said individuals are helped to understand their responsibilities by discussion with their key worker and group discussions. One service user understood he had to fit in with others (see above) and another talked about her responsibility to go to college or lose her place. One service user was overhead explaining to another service user why they should not be looking into another service users bedroom. One service user was observed using the key to his bedroom whenever he left his room. Menus seen were adequate and service users said they had lovely food, they described how they help to do the menus on a Monday night and that they like this activity. Two people also described how they help with the preparation of meals. The cake that was being eaten after the main meal had been made by one of the service users at cookery class during the day (the recipe was being discussed as a topic of conversation.) A staff member was observed attempting to explain, sensitively to a service user why second helpings were not a good idea. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. The home ensures that the personal and healthcare needs of the service users are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal needs of service users and the support they need is well detailed in care plans. The home has good support from psychologists and speech and language therapists, as necessary. A correspondance between parents and a service users’ psychologist shows that everyone works together to achieve good outcomes for them. Strategies are in place (supported by written guidelines) to enable staff to deal with specific individual needs and behaviours. Service users are comparatively young, fit and well (physical needs detailed in care plans) but physical health is not focussed on. Some healthcare check ups have not been recorded this year. There were records of service users seeing their G.P. , if necessary. Only one service user has medication, The administration process was observed and the records seen were accurate. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Service users are protected from most types of abuse and staff listen to them and act on their views, as far as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home have recorded no complaints since the last inspection. The Comission for Social Care Inspection has received no information about complaints or adult protection matters. One service user said she would to speak to staff if she was not happy, she also knew other managers within the organisation who she kew well and would be able to talk to. Staff confirmed that they have vulnerable adults training and were able to fully explain how they would deal with a complaint or vulnerable adults issue. Service users cash records were accurate and cash is kept in locked boxes in a locked cupboard. One of the service users’ bank records showed large withdrawals and deposits and the home had no receipts or explanations for these. The manager expalined that the organisation deal with benefits and payments and there was an issue around one individuals benefits but this was not clear on the written records. The bank records of the service users did not show any payments in of benfits or personal needs monies. There needs to be clarity with regard to how, when and what amounts of money is being deposited/debitted from accounts. There are detailed behavioural guidelines in place to ensurethe protection of service users. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The home offers the service users a pleasant living environment and they are encouraged to feel that it’s their home and have some responsibility for its’ upkeep. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well maintained, clean and hygienic. One service user survey said that if it wasnt always clean and tidy he could do something about it. All surveys said that the home was always clean and tidy. The house is small but well thought out to make sure that service users have room to relax and pursue activities (there are two downstairs rooms one living/dining room and one music/computer/activities room.) Service users bedrooms are individualised and they are supported to maintain them to high standards of cleanliness. Kitchen and communal areas are very clean and tidy. The kitchen has recently been refurbished (September 06.) Two service users expressed their pleasure at the result of the refurbishmnent. Service users said that they help keep the house clean and tidy and were observed helping with all the daily chores. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is good. The home has a well trained, qualified staff team and enough staff are deployed to meet the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home, currently, has two full time and one part time staff member (permanent) .There are two staff vacancies and shifts are covered by agencies, known to the service users. A resident discussion meeting minuted service users being asked their views on the agency staff member. There is a minimum of one staff on duty and a staff member said that there is an on-call system that works very efficiently. Two staff are deployed, if necessary, to make sure service users can access their daily activities and extra staff are rota’d on duty if there any special outings,activities taking place in the evenings or at weekends. The staff team is all female,the service user group is 2/3rds male with one service user having some issues about appropriate behaviour towards females. It may be good practice to consider a male staff member when recruiting new staff. All permanent staff have N.V.Q. 3. Training records could not be seen but staff confirmed that they have good opportunities for further training and their Health and Safety training is now up-dated regularly. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 16 Staff recruitment records could not been seen (manager not available) but no new staff have been recruited,recently and robust policy and procedures (as previously) are still in place. Service users confirmed that there are always staff available to help them whenever they need it. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. The home is well managed and well organised for the benefit of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is registered with C.S.C.I she has been working in the home for several years and the home is well organised. Elements of the Quality Assurance system were seen, there are regular regulation 26 visits,an annual position statement is published by the organisation that details achievements and developments. The home has a business plan for 06/07 and a review of provision but it is not clear how the service users contribute to the review of provision or what influence(if any) they have on the business plan. All health and safety maintenance records are up-to-date. Water outlets have control valves fitted and the water temperatures are tested daily by using a 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 18 thermometer, fit for the purpose. Staff confirmed that all health and safety training has been updated (the records were not available as the manager was not in the home.) An up-to-date gas safety certificate was seen, a public liability insurance certificate was displayed on the office wall and Fire safety training is now recorded. The fire officer visited 14/12/05 and made four recommendations,three have been complied with and one has not.Radiators are not covered and were very hot on the day of the inspection visit, they need to be risk assessed or covered. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 19 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 Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 3 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 20 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 3 Standard YA23 YA39 YA42 Regulation 13.6 24 13.4 Requirement To ensure deposits and debits to service users accounts are properly recorded. To further develop the quality assurance system. To assess the risk from the hot surfaces of the radiators in the home. Timescale for action 01/01/07 01/04/07 01/01/07 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 Refer to Standard YA33 Good Practice Recommendations To consider the gender of service users when recruiting new staff. 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 29 Briants Avenue DS0000011069.V318259.R01.S.doc Version 5.2 Page 22 - 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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