Inspection on 13/04/05 for 30 Richmond Road

This inspection was carried out on 13th April 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

30 Richmond Road 02/04/07

30 Richmond Road 24/10/05

30 Richmond Road 26/07/04

30 Richmond Road 20/04/04

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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 30 RICHMOND ROAD Caversham Reading Berks RG4 7PR Lead Inspector Robert Dawes Unannounced 13 April 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. 30 RICHMOND ROAD Version 1.10 Page 3 SERVICE INFORMATION Name of service 30 Richmond Road Address 30 Richmond Road, Caversham, Reading, Berks, RG4 7PR 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) 0118 946 3282 Milbury Care Services Limited Ms Helen Randall Care Home 5 Category(ies) of Learning Disability (5) registration, with number of places 30 RICHMOND ROAD Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: No Date of last inspection 26/07/04 Brief Description of the Service: 30, Richmond Road is a care home registered to provide personal care and accommodation for 5 younger adults with learning disabilities. The home currently accommodates 5 service users with learning disabilities, two of whom have profound physical disabilities. It is owned by Milbury Care Services Ltd. The home is located in a suburb of Reading and is a two-storey building. All the home’s bedrooms are single and two have en-suite facilities. The aims and objectives of the home is to provide a secure and comfortable home; encourage and support residents to make decisions and choices in their lives; support and assist service users to make and maintain satisfying relationships; assist service users to develop their skills; and enable service users to engage in valued day time occupation and use the community facilities. 30 RICHMOND ROAD Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection, which was carried out from 11.30am-4.0pm on Wednesday 13th April 2005. The manager, two staff, two relatives and a visiting professional were spoken to in private. The Inspector was unable to speak in depth with the service users because of their very limited communication skills. The Inspector also saw records and toured the premises. What the service does well: What has improved since the last inspection? What they could do better: The manager wants to improve the communication between staff and service users in order for service users to be more involved in the day to day running of the home; develop the complaints procedure into a more ‘user-friendly’ document so service users can make a complaint; and build a sensory area in the garden for service users to enjoy. 30 RICHMOND ROAD Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 30 RICHMOND ROAD Version 1.10 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 30 RICHMOND ROAD Version 1.10 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. New service users are admitted only on the basis of a full assessment being undertaken. EVIDENCE: A new service user was admitted to the home in August 2004. The Inspector saw a detailed assessment completed prior to admission. 30 RICHMOND ROAD Version 1.10 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) None of these standards were assessed on this occassion . EVIDENCE: 30 RICHMOND ROAD Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 and 17. The manager and her staff work hard to enable and encourage service users engage in appropriate activities in and out of the home. Service users use community facilities. Staff support service users to maintain family links and friendships inside and outside the home. Service users are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: Since the local authority’s grant to Milbury’s day services was reduced two years ago, resulting in less access for service users to day care activities, the manager and her staff have continued to work very hard to ensure service users engage in as many stimulating and enjoyable activities, in and out of the home, as possible. They also ensure the service users feel part of, and participate in, the local community. Examples of activities service users engage in are: gardening, trampolining, music sessions, ice-skating, donkey cart riding, shopping, eating out, visits to the pub, outings, aroma therapy, reflexology, and health and beauty sessions. Parents of a service user informed the Inspector of how pleased they were with the number and range of 30 RICHMOND ROAD Version 1.10 Page 11 activities their profoundly disabled son is taken to. They said, ‘he is always out’. All the service users are going on a holiday to a Centre Parc in June 2005. The home has close links with a local church and all the service users attend a service once a week. On the day of the inspection a service user’s birthday was being celebrated by the home. The service user communicated to the Inspector that she was very happy with her cards, presents and attention. The parents of a service user informed the Inspector that they are always made to feel welcome when they visit and are invited to participate in the activities. One service user is taken to her sister every month to ensure contact is maintained. The Inspector observed staff talk to and interact with service users rather than with each other; relate to service users respectfully; and encouraged and enabled them to be involved in the preparation of the meals. Speech therapists and dieticians are employed to advice on service users’ diets, and the best techniques to assist service users with their eating. Likes and dislikes are catered for and the menu indicated meals are wholesome and varied. The manager plans to introduce picture cards to enable service users more opportunity to decide what they eat. Meals were observed to be relaxed, unrushed, enjoyable and flexible. 30 RICHMOND ROAD Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 21. Staff provide service users with sensitive and flexible personal support and care. Service users’ healthcare needs are assessed and addressed in a competent manner. Staff deal with illness and death in a sensitive and respectful manner. EVIDENCE: Discussion with staff and reading care plans confirmed service users choose their own clothes, hairstyle, make-up and times for getting up/going to bed. Service users have the technical aids and equipment they need. Service users receive additional, specialist support and advice as needed from such professionals as, a speech and language therapist, dietician, behavioural therapist, and a continence advisor. Until a new physiotherapist is appointed staff are using ‘passive exercises’ with service users, taught to them by the previous physiotherapist. Staff were observed to be attentive to the service users’ personal needs and responded in a caring manner. Service users appeared happy and relaxed. A service user asked for a particular member of 30 RICHMOND ROAD Version 1.10 Page 13 staff to feed her and this was actioned. Staff were observed to engage with service users during meal times rather than talk to each other. Service users’ health is monitored and potential complications and problems are identified and dealt with at an early stage. Service users have regular checks with dentists, opticians, chiropodists, GPs and community nurses. A dietician informed the inspector that the staff respond to her advice well and attend to the health needs of the service users in a competent manner. Parents of a service user whose health is very poor informed the inspector that, ‘they considered the care offered to their son was excellent. Staff were attentive, observant and everything is being done to make the quality of his life as good as possible’. Care plans show that the unexplained behaviour of as service user has been thoroughly assessed. The last death of a service user was handled very sensitively. The serious deterioration in a service users physical condition has been handled in a similar manner and his parents informed the inspector that they have been fully involved in the decision making process. 30 RICHMOND ROAD Version 1.10 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) 22 and 23. Every effort is made to enable service users’ express their views and these views are acted upon. Adult protection procedures are in place. Staff are trained to ensure service users are protected from abuse, neglect and selfharm. EVIDENCE: The complaints log showed no complaints have been made since the last inspection. The Inspector saw a complaints procedure in a service user-friendly format. The manager plans to make improvements to the format to ensure all service users are clear about how to make a complaint. As the service users ability to communicate is very limited all staff are reminded to be alert to any changes in behaviour and mood that could indicate that a service user is unhappy about something. Service users’ relatives have been given leaflets explaining the complaints procedures and how to contact the CSCI if necessary. The Inspector saw a comprehensive adult protection procedure. Senior staff have recently attended a POVA retraining course. The LDAF induction training for new staff includes a module on the protection of vulnerable adults. Agencies have been requested to ensure staff who work in the home have received vulnerable adults policy and procedures training. 30 RICHMOND ROAD Version 1.10 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, 29 and 30. The home has a comfortable and homely atmosphere. It is well maintained, clean and hygienic. Service users have the necessary aids and equipment to maximise their independence. EVIDENCE: The Inspector toured the home and found it to be suitable for its stated purpose; accessible, safe and well maintained; comfortable and homely; and clean and hygienic. Parents of a service user said it is always clean when they visit their son. The annual development plan identifies the maintenance and refurbishment issues to be addressed. The home has the necessary adaptations and equipment to meet the individually assessed needs of all the service users. The manager and senior staff recently attended a disability aids and equipment exhibition to look for new ideas to improve the quality of life for the service users. 30 RICHMOND ROAD Version 1.10 Page 16 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, 34 and 35 The home has been seriously short of permanent support staff for a long period of time but the service users’ needs have continued to be well supported. The organisation operates a thorough recruitment procedure. The organisation and manager ensure staff are appropriately trained. EVIDENCE: There are currently four full time support worker vacancies (40 of the staffing compliment). The organisation has been very proactive in trying to recruit new staff and it is anticipated that the home will be fully staffed within the next couple of months. Staff working overtime and using bank and agency staff has covered the vacant hours. It has not been an easy period with such a high number of vacancies but a good level of care has been maintained thanks to the experience of staff who have worked at the home for many years and the commitment of the manager and her team. There is always a minimum of three staff on duty including the manager or deputy manager. Staff sickness is very low. The staff files seen by the Inspector showed the organisation operates a thorough recruitment procedure. The Inspector was informed that all references are verbally verified. One file did not have copies of the staff 30 RICHMOND ROAD Version 1.10 Page 17 member’s passport and birth certificate. If not at the Head Office the manager will ensure they are obtained. All new staff first receive induction training, which covers the basic care requirements, and then take part in the LDAF induction programme. Three staff are currently studying for a NVQ in care. Additional training opportunities such as courses on cerebral palsy and ageing, continence management, and spiritual needs for service users are provided for staff. Staff attend refresher training on key aspects of care. 30 RICHMOND ROAD Version 1.10 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 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 and 42. The manager is competent, experienced and will shortly complete her Registered Manager’s Award and NVQ 4 in care. She manages the home in an open and transparent manner; encourages service users and staff to express their views; and is hard working and conscientious. The organisation has an effective quality assurance and quality monitoring system in place. The manager ensures so far as is reasonably practicable the health, safety and welfare of service users. EVIDENCE: The manager has been in post for nearly four years. She will complete the Registered Manager’s Award and NVQ4 in care in the next few months. Records show the manager undertakes periodic training to maintain and update her knowledge, skills and competence. 30 RICHMOND ROAD Version 1.10 Page 19 Parents of a service user informed the Inspector that they consider the manager to be conscientious, competent, approachable and is doing an excellent job. Staff informed the Inspector that the manager is supportive and communicates a clear sense of direction and leadership. The Inspector interviewed the manager and found her to be knowledgeable and focused on ensuring the service users receive the best possible standard of care. The organisation has recently conducted a comprehensive service review (which covered areas such as environment, staffing and service users’ needs). The Inspector saw a detailed report which incorporated the annual development plan. The satisfaction questionnaires have been reviewed and will shortly be sent out to relatives and friends of the service users. All health and safety checks and inspections are up to date. All service users have appropriate risk assessments. Accidents to service users recorded have been responded to appropriately. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 30 RICHMOND ROAD Score x 3 x Standard No 22 23 Score 3 3 Version 1.10 Page 20 4 5 x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 3 3 Standard No 11 12 13 14 15 16 17 x 4 x x 4 3 4 Standard No 31 32 33 34 35 36 Score x x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 x 4 Standard No 37 38 39 40 41 42 43 Score 4 4 3 x x 3 x 30 RICHMOND ROAD Version 1.10 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 Regulation None Requirement Timescale for action 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 None Good Practice Recommendations 30 RICHMOND ROAD Version 1.10 Page 22 Commission for Social Care Inspection 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. 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