Inspection on 15/03/07 for 353 Old Whitley Wood Lane

This inspection was carried out on 15th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

353 Old Whitley Wood Lane 29/07/08

353 Old Whitley Wood Lane 07/02/08

353 Old Whitley Wood Lane 24/01/06

353 Old Whitley Wood Lane 28/06/05

353 Old Whitley Wood Lane 01/02/05

353 Old Whitley Wood Lane 15/12/04

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

CARE HOME ADULTS 18-65 353 Old Whitley Wood Lane Reading Berkshire RG2 8PY Lead Inspector Catherine Kane Unannounced Inspection 15th March 2007 3:15 353 Old Whitley Wood Lane DS0000011348.V331257.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 353 Old Whitley Wood Lane DS0000011348.V331257.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. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 353 Old Whitley Wood Lane Address Reading Berkshire RG2 8PY 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) 01189 672 369 g7bxu1@hotmail.com Multi Care Limited Mr Joseph Kingsley Gyamfi Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: This residential home has been registered for two service Users aged between 18 and 65, with learning disabilities. The house is situated on the perimeter of a residential area within a short distance from a main link road and the M4 in Whitley Wood, Reading. The house was refurbished to include the provision of a new bathroom and is well presented in good decorative order. There are 2 single bedrooms for Service Users, a lounge/ diner, kitchen, 2 bath/shower rooms with toilets, a kitchen, staff sleeping in room/office and a large garden to the rear. The home is owned by an individual proprietor and was registered on 7/01/02. The home has been providing short-term respite care since July 2004 and now has one long-term placement also. The manager declared that the fees for this service are £180.46 per day. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 3.15pm on Thursday, 15 March 2007. The inspector was in the service for a total of two and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The registered manager was not on duty on the day of the inspection visit. One member of staff was on duty who was joined by another staff mamber, the proprietor’s spouse, who assisted with the inspection process. The inspector spoke with one resident. The inpsector saw staff and residents prepare for their evening meal and saw how staff help residents look after and take their medicines. She also looked at residents care plans and other records kept in the home and made a tour of the part of premises. The inspector spoke with the proprietor of the home by telephone the following day. The inspector would like to thank the staff team for their assistance with the inspection. She also thanks people who live in or who visit this home who shared their experiences of the care provided. What the service does well: The home continued to have a friendly, relaxed atmosphere with positive relationships between residents and staff. Staff had a good understanding of residents’ support needs. Meals provided are good. Personal care and healthcare support provided in this home is good. The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. Residents say they like living in their home. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2. Quality in this outcome area is good. The homes statement of purpose needs to be updated. The admission procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose document made available at the time of the inspectors visit did not reflect the accommodation provided in this home. There has been one new admission to this home since the last inspection for a respite short break service. The inspector viewed the pre-admission assessments; these were comprehensive documents, they clearly indicated that the home could meet the individual’s needs at the time of admission and a review process was in place. Generally, admissions would not made to the home until a full needs assessment has been undertaken. The home would then be able to confirm that they can meet the needs of the individual through the service they deliver. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is good. The care planning system in place to provide staff with the information they need and for assessing risk is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed one resident’s care plan. This was easy to understand, written in plain language, considered all areas of the individual’s life including health, personal and social care needs. The plan is regularly reviewed and includes comprehensive risk assessments. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. 353 Old Whitley Wood Lane DS0000011348.V331257.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): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. Opportunities for people who use this service to take part in a variety of interesting activities are excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the inspector was in the home during the afternoon and early evening. She spent this time with one resident and the staff on duty. This resident had very good communication skills, were confident and able to tell the inspector about their experiences of the home. They told the inspector “It’s good. I like to do music and watch videos. I go to the club with Joe (the manager).” 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 11 Many activities provided in house were based on what residents prefer to do in their leisure time; these included watching TV, videos, art and craft, and helping in the kitchen. This resident has a full programme of regular activities outside the home that include frequent outings for walks, drives out, going to the pub, bowling, music sessions at the local college and attending sessions at the local day service. The parents of another resident, who has regular respite stays in this home, wrote to the inspector. They were complimentary about the care provided in the home and that the home supports them to attend their clubs and other social events during their stay. A resident told the inspector about how the manager and staff support them to maintain their relationships with their family. This was very important for them. The inspector was in the home when the evening meal was being prepared and served. The meal was freshly cooked toad in the hole, a particular favourite, followed by fruit salad and cream. Regular drinks and snacks are available. A varied menu is provided and residents special dietary needs are catered for. 353 Old Whitley Wood Lane DS0000011348.V331257.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): Standards 18, 19 and 20. Quality in this outcome area is good. The personal and healthcare needs of residents are generally well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and see they get to see their local GP and other community healthcare services when needed. The inspector saw how the home helped residents to access specialist healthcare support when this was needed. One comment card was returned from residents’ GPs. They indicated that they were satisfied with the overall care provided in this home and that the home has always worked well and in partnership with them. Residents’ medicines are securely kept in a locked medicines cabinet situated in the home’s office/sleep in room. The home uses it’s own hand written medication administration record (MAR). Records seen were neat and well 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 13 maintained. All staff have completed training delivered by an appropriately qualified person with knowledge of medicines. During the inspection the member of staff confidently demonstrated how a residents medicines are looked after and how residents are helped to take their medicines. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. The home has a protection from abuse policy and the complaints procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager declared that home has received no complaints in the last year. The Commission has received no information relating to complaints in the last year. Residents who spoke with the inspector were very clear about whom they needed to speak to if they wished to make a complaint. Staff have attended specific training on protecting vulnerable people from abuse and about local adult protection procedures. Staff who spoke with the inspector were clear about their responsibilities and were aware of the homes ‘whistle blowing’ policy. The Commission has received no information relating to adult protection issues since the last inspection. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 Quality in this outcome area is good. The home was tidy and clean at the time of the inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The furniture and fittings are modern and domestic in style providing a homelike environment. The comfortable lounge/dining room and leads to the kitchen then to a well established the gardens. The home has a programme of repair and renewal. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35 Quality in this outcome area is adequate. This homes recruitment procedures and training for staff to do their jobs well is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the day of inspection visit the inspector spoke with two members of staff on duty. The home has a core of well-established staff that understand residents needs and they relate well to. No staff members have left and one new member of staff has been recruited since the last inspection. Staff commented that morale is high. On the day of the inspector’s visit the manager was not present. A member of staff made available staff files. However, these files were disorganised and some information was missing or kept in other locations. Staff were able to confirm the homes induction programme and other training completed; certificates seen indicated that this training had been mostly completed through the staff members previous employers. One member of staff has 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 17 recently completed a National Vocational Qualification (NVQ) level 3. Another two staff are currently registered on the NVQ programme. The proprietor confirmed that Multicare intends to renew the Criminal Record Bureau (CRB) disclosures made on staff every three years. See also Standard 41. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 41 and 42. Quality in this outcome area is adequate. The proprietor and registered manager have a good understanding of management areas in which the home needs to improve and has plans in place to address this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the manager has successfully completed the registration process with CSCI. The manager is competent to run the home and meet its stated aims and objectives. He has sound knowledge and experience in care of people with a learning disability. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 19 Members of staff who spoke with the inspector stated that the manager was open and fair with good leadership skills and said they felt he manages the service efficiently. The manager is well respected by members of his staff team and is trusted and well liked by the residents of the home. The proprietor is closely involved with the day-to-day running of the home. He confirmed that the home does not have a formal quality assurance process where a survey of the views of residents, their family representatives and any other parties involved with the home is gathered. He stated that this is done on an informal basis and where issues that have been identified are acted upon to ensure residents’ care is not compromised. However, there was no evidence through reports or audits to demonstrate this. While the inspector appreciates this is a small care home registered for up to two people, National Minimum Standards expect that the home would have a quality assurance and quality monitoring system that would measure how the home was achieving its aims and objectives as set in the statement of purpose. This was a requirement set at the previous inspection. The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure the home meets relevant health and safety requirements and legislation. Records seen were good and are routinely completed. 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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 2 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 1 X 2 3 X 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 21 Yes 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 YA41 Regulation 7, 9 and 19 Requirement Staff information required including proof of staff identity, documentary evidence of recruitment checks, relevant qualifications and training completed must be kept in the home and made available for inspection. That a formal system is developed to review the Quality of the service provided. (This requirement from the previous inspection was not met.) Timescale for action 30/06/07 2. YA39 24 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 Page 22 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 353 Old Whitley Wood Lane DS0000011348.V331257.R01.S.doc Version 5.2 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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