Inspection on 14/02/07 for 43 Clayhill Road

This inspection was carried out on 14th February 2007.

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

43 Clayhill Road 10/02/09

43 Clayhill Road 22/02/06

43 Clayhill Road 02/09/05

43 Clayhill Road 29/11/04

43 Clayhill Road 07/09/04

43 Clayhill Road 04/03/04

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Fairways

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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 43 Clayhill Road Burghfield Common Nr. Reading Berkshire RG7 3HF Lead Inspector Robert Dawes Unannounced Inspection 14th February 2007 10:25 DS0000011195.V328562.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 DS0000011195.V328562.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. DS0000011195.V328562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 43 Clayhill Road Address Burghfield Common Nr. Reading Berkshire RG7 3HF 0118 983 5047 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) www.new-support.org.uk New Support Options Limited Mrs Mandy Patrina Williams-Feast Care Home 6 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (2), of places Physical disability (2), Sensory impairment (1) DS0000011195.V328562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: 43 Clayhill Road is a six bedroom detached house in a residential area of a large village. There are some local amenities close by and a bus service is available. The home provides care for 6 people with learning disabilities. Some of the present residents also have physical, mental and sensory disabilities. The home caters for both genders and provides 24-hour care with waking night staff. The home has an assisted bathroom and shower room and can accommodate people who use wheelchairs. Three of the bedrooms are downstairs. The home has its own assisted transport that enables all the residents to lead full and active social lives. Fees range from £828-£1193 per week. DS0000011195.V328562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced site visit, which took place during the day on the 14th February 2007. The pre-inspection questionnaire, six service users’ questionnaires and two comment cards from visiting professionals were returned to the inspector before the site visit. These, together with the site visit, were the main sources of information for the key inspection. During the site visit the inspector spoke with four service users; interviewed the manager and two members of staff; toured the premises; looked at records; case tracked; and observed the interaction between service users and staff. Twenty-two standards were assessed during the site visit of which all were met. No requirements or recommendations were made. What the service does well: What has improved since the last inspection? What they could do better: Aim to make it an excellent home. DS0000011195.V328562.R01.S.doc Version 5.2 Page 6 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. DS0000011195.V328562.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 DS0000011195.V328562.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): Number 2. Quality in this outcome area is good. There is a clear criteria and procedure regarding the admission of new residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no admissions to this home since July 2003 therefore it is not possible to case track whether any new service users have only been admitted following a full assessment. However, the home does have policies and procedures to ensure that this process is completed prior to anyone moving into the home. DS0000011195.V328562.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): Numbers 6, 7 and 9. Quality in this outcome area is good. All service users have individual plans, which are reviewed, at regular intervals. Service users make decisions about their lives with assistance as needed. Service users are supported to take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the service users’ files looked at had detailed individual care plans, which had been reviewed every month by the key worker and annually with the service user, care manager and home’s staff. The files also contained daily notes, behavioural guidelines, risk assessments and a photograph of the service user. DS0000011195.V328562.R01.S.doc Version 5.2 Page 10 Records of service users’ meetings showed service users were consulted about meals, activities, outings, holidays and the colour schemes for their rooms. Two service users with little contact from their families have advocates to assist them make decisions about their lives. One service user declined the services of an advocate and signed to that effect. In response to the question in the service user questionnaire, ‘do you make decisions about what you do each day?’ four replied ‘always’ and two replied ‘usually’. No service user manages his/her own finances. Service users are encouraged to be as independent as possible. The inspector was informed that several service users go to the local shop on their own and a service user who is blind moves around the home on her own with the assistance of hand rails and makes hot drinks. Other service users were observed to make a hot drink for themselves. Appropriate risk assessments were seen on service users’ files, which had been regularly reviewed. DS0000011195.V328562.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 12, 13, 15, 16 and 17. Quality in this outcome area is good. Service users are able to take part in appropriate activities, which reflect their diverse needs; they participate in the local community and are enabled to keep in touch with their families and friends. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As the service users have become older so the number of activities they want to engage in has declined. They go to day centres, are taken out by staff and occupy themselves in the home by helping with household tasks or listening to music and watching television. One service user has been provided with a special trolley to enable her to help lay and clear the tables without injuring DS0000011195.V328562.R01.S.doc Version 5.2 Page 12 herself. A service user who is blind has one to one support from a community support worker for seven hours a week to engage in activities of her choice. Service users are enabled to take full advantage of the community by going on outings; shopping trips to town; visiting pubs and restaurants; and going to the cinema and theatre. The home has it’s own adapted transport. Service users are offered the opportunity to vote at elections. One service user attends a local church every Sunday. The majority of service users maintain contact with members of their family. Staff will transport service users to their relatives to ensure contact is maintained. Two service users without regular contact with their families have advocates who visit regularly on a social basis as well as providing an advocacy service. Service users were observed to have unrestricted movement around the home. Service users are offered keys to their rooms. Service users can choose to be alone, i.e. one service user prefers to have all her meals on her own and another service user watches the television in the lounge when all the other service users have gone to bed. Records and observation showed staff consult service users as much as possible about the daily routines to encourage them to feel respected and responsible. In response to the question in the service user questionnaire, ‘can you do what you want to do during the day, evening and week ends?’ all six replied ‘yes’. The menu seen showed varied, nutritious and balanced meals were offered to the service users. Service users spoken with said they enjoyed the meals. Service users with dietary needs and who like softer food are catered for. Guidelines for a service user with diabetes were on display in the kitchen. Service users help with the shopping, and assist in the preparation and cooking of the meals. Service users contribute to the menu. DS0000011195.V328562.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 18, 19 and 20. Quality in this outcome area is good. Service users receive personal support in the way they prefer and require and their physical and emotional health needs are met. Staff adhere to the medication policy and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users looked clean and presentable. Staff were observed to respond and care for the service users in a sensitive and professional manner. Staff said they consider the level of personal care in the home to be very good. Service users said ‘they can go to bed and get up when they like’, and ‘they like the home’. After seeking advice from an Occupational Therapist, aids and adaptations were installed to assist the two service users who have significant disabilities, i.e. a hoist for a service user who is now unable to stand on his own; and DS0000011195.V328562.R01.S.doc Version 5.2 Page 14 hand/guide rails around the home and a talking clock for a service user who is blind. In response to the questions in the service users’ questionnaire, ‘do the staff treat you well?’ and do the carers listen and act on what you say?’ all six replied ‘yes’ to both questions. In response to the question in the visiting professionals’ comment card, ‘ are you able to see the service users in private?’ and ‘if you give any specialist advice is this incorporated into the service user plan?’ both replied ‘yes’. Records showed service users’ physical and emotional health is monitored, i.e. behavioural changes, weight, seizure and blood sugar level charts were evident. Any potential problems are identified and dealt with promptly. Service users are supported to maintain good health, i.e. staff ensure a service user has frequent drinks to prevent urinary tract infections. All the service users have regular sight and dental checks. Service users have support from specialists such as district nurses, psychiatrists, psychologists, dieticians and speech therapists. No service user self medicates. No controlled drugs are on the premises. The medication administration records were in order. Sufficient staff have received medication training to cover all shifts. Appropriate medication policies and procedures are in place. A pharmacist visits the home at regular intervals to inspect the storage, administration, recording and disposal of the medication. In response to the question in the visiting professionals’ questionnaire, ‘ is the medication appropriately managed in the home?’ one replied ‘yes’. The other professional did not answer the question. DS0000011195.V328562.R01.S.doc Version 5.2 Page 15 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): Numbers 22 and 23. Quality in this outcome area is good. Service users feel their views are listened to and acted on. Service users are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: No complaints to the home or the Commission have been made since the last inspection. The home has clear complaints procedures in place. In response to the questions in the service users’ questionnaire, ‘do you know who to speak to if you are not happy?’ and ‘do you know how to make a complaint?’ all the service users replied, ‘yes’. No allegations of abuse have been made to the Commission since the last inspection. A vulnerable adults procedure is in place. None of the service users are physically challenging. Service users’ personal money is kept in locked tins in the manager’s office. Records and receipts are kept of all transactions. The records are checked daily by a senior member of staff and regularly audited by a person from Head Office. DS0000011195.V328562.R01.S.doc Version 5.2 Page 16 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): Numbers 24 and 30. Quality in this outcome area is good. Service users live in a homely, comfortable and safe environment. The home is kept clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is generally well decorated and maintained and benefits from a pleasant and accessible garden. The home has recently had a new carpet in the lounge and several areas have been decorated. The manager has ordered a new carpet for a service user’s room. On the day of the site visit the home was clean and hygienic. In response to the question in the service users’ questionnaire, ‘is the home fresh and clean?’ all six service users replied, ‘yes’. DS0000011195.V328562.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 32, 34 and 35. Quality in this outcome area is good. An effective, competent and qualified staff team who are appropriately trained support the service users in a caring, respectful and equitable manner. The home operates a thorough recruitment procedure. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff interviewed demonstrated a good understanding of the conditions and needs of the service users. 20 of care staff have a NVQ 2 or above in care. Four staff are currently studying for a NVQ. Staff were observed to be patient and relaxed with service users. Service users said ‘staff were ok’. In response to the questions in the visiting professionals’ questionnaire, ‘are you satisfied with the overall care provided to service users within the home?’ DS0000011195.V328562.R01.S.doc Version 5.2 Page 18 and ‘do staff demonstrate a clear understanding of the care needs of the service users?’ both replied ‘yes’. Staff recruitment files seen showed the organisation complies with the recruitment procedures. The organisation provides an induction training programme, which incorporates LDAF, for all new staff. The majority of staff have attended the necessary basic and key training courses. Additional courses on topics, such as signing for beginners, advanced signing and supervision, are available to staff. Staff said they considered they were offered a good training programme. Refresher training takes place for key areas of work. DS0000011195.V328562.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Numbers 37, 39 and 42. Quality in this outcome area is good. Service users benefit from a well run home. The home operates an effective quality assurance and quality monitoring system. The health, safety and welfare of service users are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is qualified, competent and experienced to run the home. Staff informed the inspector that the manager is supportive and clear in how she wants the home to run. DS0000011195.V328562.R01.S.doc Version 5.2 Page 20 Every year the home produces a ‘home’s path plan’ which identifies what needs to happen/change to help service users achieve the goals in their individual ‘path’ plans. The home gathers the necessary information to produce the plan from the ‘Are you getting a good service’ work books which the service users complete before their annual reviews; Regulation 26 visits; service users’ meetings which take place every two months; staff meetings which take place every month; ‘traffic light’ meetings where area managers, service users and relatives get together to discuss the needs of the service users; and an annual audit when a member of staff and a service user from another home visits to talk to service users about the care they are receiving and changes they would like to take place. All health and safety checks and inspections are up to date and completed as required. All necessary health and safety policies and procedures are in place. All files seen contained appropriate risk assessments, which are reviewed regularly. The majority of staff have received the necessary health and safety training including first aid. Staff are reminded about health and safety issues at staff meetings. DS0000011195.V328562.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 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 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000011195.V328562.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation 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. Refer to Standard Good Practice Recommendations DS0000011195.V328562.R01.S.doc Version 5.2 Page 23 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. 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