Inspection on 06/06/06 for 30 Broad Lane

This inspection was carried out on 6th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

30 Broad Lane 19/08/08

30 Broad Lane 24/08/07

30 Broad Lane 16/01/06

30 Broad Lane 25/07/05

30 Broad Lane 21/02/05

30 Broad Lane 17/05/04

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

CARE HOME ADULTS 18-65 30 Broad Lane Upper Bucklebury Nr. Reading Berkshire RG7 6QJ Lead Inspector Tracy McGuire Brown Unannounced Inspection 6th June 2006 08:50 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 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 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 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. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 30 Broad Lane Address Upper Bucklebury Nr. Reading Berkshire RG7 6QJ 01635 871191 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) londonroad@tiscali.co.uk Milbury Care Services Limited ***Post Vacant*** Care Home 6 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4), Physical disability (2), of places Physical disability over 65 years of age (2) 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th January 2006 Brief Description of the Service: This service provides care and accommodation to five residents, of both genders aged between 18 and 65 with learning and some physical disabilities. The Milbury group operates the home. The service aims to enable service users to live a fulfilled life underpinned by The Five Accomplishments of Ordinary Living (John O’Briens). The home operates is a two storey detached house in situated in Upper Bucklebury. The house is located on a main road but is set back from this; it is close to local amenities. The home has a good-sized rear garden and ample parking to the front of the property. The new unit manager commenced in post in July 2005. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service was inspected over a period of 4 days between 18th May and 8th June with a visit to the establishment taking place on 6th June between 8.50am and 3.15pm pm. An additional visit was made to Broad Lane on 8th June to give feedback. The Inspector spent some time observing and talking to some service users, staff, local authority outreach day care workers and management. Resident files and care plans were seen. Information from providers, other professionals and inspection records were used. The Inspector toured the building and observed practice throughout the visit. What the service does well: What has improved since the last inspection? Since the previous inspection recruitment has continued and the home has only one staff vacancy currently. Up to date care plans have been reviewed and developed for each individual service user. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 6 Individual activity plans have been further developed and there are plans to continue to develop activity opportunities further. The home has been greatly improved by the purchase of new furniture, redecoration of many areas and new carpets. Service users were seen making active choices and decisions and being supported by staff. Out reach workers spoken to from the local authority commented that the home has improved since the new Manager has been in post. One worker stated that there has been a positive effect for the service users “with more continuity and better communication” the workers commented that one service users is “more settled and responds well to staff members” another service user has “improved assertiveness”. 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. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. EVIDENCE: There have been no new service users admitted since the previous inspection. Current reviews were seen for service users with the up to date care management assessment documentation to support the annual review. Support plans have been developed and are in place for each service user. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good EVIDENCE: Since the previous inspection work has been undertaken to develop up to date “support plans for each service user” the inspector examined these. The support plans are broken down into sections and include: communication personal care and support, dressing and undressing, diet, medication, health care, day care, leisure, finances, night care identifying risks, decision making and maintaining links. The plans seen were developed and reviewed in May 06.This was a requirement of the previous inspection, which has been met. Each service user has a key worker (detailed on the notice board); a senior staff member supports each key worker. Guidelines are in place on file for specific issues, some of these need to be dated and signed. Practice observed reflected detail in the support plans. The Manager informed the Inspector that they are currently awaiting speech and language assessments to be completed for each service user; this was a recommendation of the previous report, which has been addressed. Service users were observed being supported to make decisions about their daily lives; these are also detailed on their support plans and in their “communication passports” due to complex needs and communication issues. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 10 At breakfast time one service user led the inspector to a specific box of cereal and bowl clearly indicating choice of breakfast and was later seen to indicate when a hot drink was wanted. Milbury is currently appointee for all the service users in the home. Risk assessments have been developed alongside the care plans, the Inspector discussed with the Manager the need to continue to develop and add to these, this will be a recommendation of this report. One service user, for example, has had a new risk assessment developed to allow her to bath more independently with more privacy in line with her choice, this is a positive development for the service user 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 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 the following standard(s): 12,13,15,16 and 17. Quality outcome in this area is good EVIDENCE: Activity plans have been developed for each individual service user and these were seen. Although there are some gaps in each the Manager explained this is reflective of the need for flexibility and to give the opportunity to offer further activities for each service user. This was requirement of the previous inspection which has been met The Manager has introduced activity forms to record when a new activity has been tried, blank forms were seen, these have not been put into practice yet. Service users in the home have complex needs and the home is working hard to access services. The local authority outreach service currently provides 2 service users with some day care. Staff in the home support service users to do trampolining and swimming at a local leisure centre. The Manager informed the Inspector of plans to access a local sensory room, try gym and horse riding sessions and consider offering music and aroma therapy in house. It will be a recommendation of this report that these plans are undertaken to offer service users more activities. Domestic activities no longer form the major part of the activity programme as noted at the previous inspection.3 service users were observed going out to trampolining, 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 12 one service user went out with the outreach team and another was in the garden using the swing. Service users are supported to access the local community; the Inspector was informed they access the local shop, G.P’s, banks, hairdresser, dentist, shops and bank. This was reflected in service user records seen. A group from the local day centre came to the home to assist with a gardening project. Service users individual files detail family and friends contact. Each service users file has a recording sheet and all contact is detailed. Daily routines are detailed in each service users support plans. Preferences in respect of how personal care is delivered are noted on support plans and supporting risk assessments produced. Service users were seen spending time alone or interacting with other for a small group activity out. Menus were supplied and food detailed was varied, the menus have improved but the Manager discussed the need to improve menus further to assist service users to make more choices and ensure a balanced diet. The Manager has accessed a pictorial colour coded menu planning system, this was shown to the Inspector and the plan is to be introduce this to staff and service users in the next few weeks. It will be a recommendation of this report that this new system is implemented. Service users were observed making choices at breakfast, varied foods are set out and service users are supported (if required to make a choice). The fridge and freezer were well stocked and there was fresh fruit available in the home. Dietary needs are detailed on each individual service users support plan. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 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 the following standard(s): 18.19 and 20 Quality outcome in this area is adequate. EVIDENCE: Since the previous inspection support plans and health care records have been reviewed and improved Service users personal support preferences are detailed in service users “support plans”. Health care records have been reorganised and improved. Evidence was seen of some recent healthcare appointments being undertaken, there is still some improvement to make in this area to ensure necessary healthcare checks are up to date and this will be a requirement of this report. Detail was seen of referrals to healthcare professionals for specific issues e.g. behavioural assessments. Medication is stored securely in locked cabinets in the homes office. There is a detailed medication policy. The home operates a blister pack system and all staff must be trained prior to administering medication. The Inspector examined a sample of completed medication assessments, which are renewed every 6 months. The Inspector was informed that the medication file is checked at every handover. A selection of MAR sheets and medication stock checked were satisfactory. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 Quality outcome in this area is good. EVIDENCE: The home has a detailed complaints policy and log in place. The log has no recent complaints recorded. The home has not developed a complaints log in different formats for service users, The Manager explained due to the complex needs behavioural and communication issues with service users, staff plan to address this issues via keywork sessions and house meetings, this work will need to be recorded.” Communication passports” have been developed for individuals, which detail service users communication methods including ways of communicating if they are unhappy or distressed. One service user completed a survey with assistance and indicated that they would know who to speak to if unhappy. The home has a detailed vulnerable adults procedure and a whistle blowing procedure, this was requirement of the previous report, which has been met. Training records seen indicate that staff have or are due to attend vulnerable adults training, which includes whistle blowing. Records of incident report were seen, discussion to confirm the requirement to send relevant copies to the CSCI took place, this meets the previous requirement. Milbury is appointee for all the service users. The Manager informed the Inspector all service users now have individual bank accounts, they are unable to sign so some senior staff assist with this. The area manager audits all service users finances on a monthly basis. Money is kept securely with restricted access. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 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 the following standard(s): 24, 26 and 30 Quality outcome in this area is adequate. EVIDENCE: The Inspector toured the property and noted that since the previous inspection there has been some extensive improvement to the inside of the property. This was requirement of the previous inspection, which has been met .The lounge; hall office and kitchen have been decorated. There is new carpet in most areas of the property. New blinds have been fitted in the conservatory and lounge. There is also new furniture in the lounge. The premises were clean throughout including kitchen and bathrooms. The garden to the rear of the property is secluded and utilised by service users. The local day centre is assisting the home to try to improve the rear garden and were working in the garden during the inspection. Some flooring in the bathrooms needs to be fixed to the floor and bare floor (where sanitary ware has been replaced) needs to covered. The utility room is of some concern, there are numerous large holes in the walls and the flooring no longer fits where machines have been replaced, this means it is not possible to clean this room effectively. There needs to a review of the suitability of this room for service users to use. This will be a requirement of this report. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 16 Service users rooms seen were suitable decorated and furnished and all had been personalised. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,34 and 35 Quality outcome in this area is good EVIDENCE: Since the previous inspection the home has continued to recruit staff and now has only 1 vacancy. Service users clearly benefit from the consistent continuity of staffing and this was supported by comments from the outreach team. Samples of staff files were examined, recruitment checks were all in place and copies of relevant supporting documentation had been obtained. Copies of contacts and job roles were also on file. Staff were observed working well together on the visit to the home and were clear about their roles. Staff share responsibility for various tasks and these are detailed on the notice board in the office. Samples of staff training records were seen. Copies of training certificates are retained and demonstrate training is regular and ongoing. The Manager produced the up to date training plan for the home, this details training required, when completed. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality outcome in this area is good EVIDENCE: The current Manager has been in post since July 2005 and has extensive experience in residential care including management. The Manager has completed NVQ level 4 in care and the Registered Managers award. The Manager has made good progress in improving the practice and records in the Home. The home Manager needs to complete the registration process and the relevant applications are to be sent. The home undertakes to send out Quality assurance questionnaires, a blank format was seen. The Manager informed the Inspector the current questionnaires had been sent to the head office to assist the annual development report. This was confirmed by the area manager who explained there had been a problem with the Q/A software and the report had still not been completed. The completion of this report will be a recommendation. The Manager also stated that the key worker meetings and residents meetings were also ways of gaining service user views, this will also be a recommendation of this report. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 19 The home has detailed health and safety files, which contain policies and audit records. Checks seen were well organised and up to date. The surveyor was at the home on the 8th June to check the work completed in respect of the Legionella survey. This was a requirement of the previous report, which has been met. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 20 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 X 29 X 30 1 STAFFING Standard No Score 31 3 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 21 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 YA19 Regulation 12 Requirement Healthcare records need to continue to be developed, ensuring necessary healthcare checks are up to date. Timescale for action 31/12/06 2. YA30 23 (2b) The safety of the laundry room is 30/09/06 reviewed and the poor sate of the flooring and walls are addressed. 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. 4. Refer to Standard YA9 YA12 YA17 YA39 Good Practice Recommendations Continue to develop and expand risk assessments Continue to offer more activities for service users, including the introduction of new activities. Implement the new menu system Complete the annual development plan and records service users views as discussed. 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 30 Broad Lane DS0000011147.V292374.R01.S.doc Version 5.1 Page 23 - 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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