Inspection on 12/01/06 for 43 Station Road

This inspection was carried out on 12th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

43 Station Road 02/12/08

43 Station Road 04/12/06

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Dalewood Respite Care

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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 Station Road 43 Station Road Wraysbury Middlesex TW19 5ND Lead Inspector Katy Brown Unannounced Inspection 12th January 2006 12:30 DS0000064796.V275411.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 DS0000064796.V275411.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. DS0000064796.V275411.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 43 Station Road Address 43 Station Road Wraysbury Middlesex TW19 5ND 01543 416106 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 Miss Julie Skelly Care Home 8 Category(ies) of Learning disability (8) registration, with number of places DS0000064796.V275411.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection N/A Brief Description of the Service: Station Road is a purpose built residential home that provides a service to people with learning and associated physical disabilities. The service users are between the ages of 18 and 65 of both sexes. Each service user has a large individual bedroom and shares the communal space. The building is two storeys; there is no internal lift for access to the first floor. The home has its own vehicle to easily access Wrasbury and Langley village and Slough town centre. The home is within walking distance of local shops and facilities. DS0000064796.V275411.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during the afternoon. This is the homes first inspection against the National Minimum Standards. It is expected that the number of requirements and recommendations that have been made will reduce when the next inspection is completed. A tour of the premises took place and residents’ care records and some of the homes’ records were inspected. Three residents, three members of staff and the manager were spoken to during the visit. What the service does well: What has improved since the last inspection? What they could do better: Some of the residents have restricted access to parts of the home and the reasons why these decisions were made or how they were reached has not been recorded. One resident does not eat beef due to religious and cultural beliefs and this has not been recorded within the plan of care. DS0000064796.V275411.R01.S.doc Version 5.1 Page 6 Some residents have listening devices in their rooms due to their health needs although, not all of them have a record of this device being used or why it is in use. Not all staff that were spoken to, were aware of the reasons why the device was in use and risk assessments had not been completed. These are things that are required by the Care Homes Regulations 2001. Currently there is not much storage space at the home and the sensory room is being used to store equipment and empty boxes and is also being used as a staff cloakroom. Staff do support and encourage relationships between friends, relatives and the residents; although the residents preferred contact arrangements have not been recorded within the plan of care. These are recommendations that have been made. 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. DS0000064796.V275411.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 DS0000064796.V275411.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. All residents receive satisfactory care needs assessments prior to moving into the home. EVIDENCE: Most of the residents transferred to Station Road from a home in Langley and received care needs assessments prior to their admission at that home. The residents that were most recently admitted to the home received care needs assessment prior to their admission. The assessment documents that were seen were detailed and informative and contained information that was specific to the residents need. Likes, dislikes and hobbies and interests had all been addressed. DS0000064796.V275411.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 & 9. Residents are provided with a good standard of care and support that is consistent with the information within the plans of care and risk management plans. The manager and staff encourage residents to take part in the care planning process and provide them with additional support from other agencies when required, although risk assessments must be completed when a decision is made that restricts access or intrudes on the residents privacy. EVIDENCE: Individual plans of care are available for all residents and they contain information about their personal care and social care needs. The records indicated that the residents’ needs are being met and that clear plans and guidance is in place. The plans of care however, did not include the cultural and religious needs for one resident who does not eat beef and another resident that enjoys riding an exercise bike in the sensory room as this is a favourite hobby. Risk management plans have been completed and residents confirmed that they are supported to take sensible risks. Listening devices are used for some residents and others had their en-suite bathroom doors locked to restrict access. Not all residents however, had DS0000064796.V275411.R01.S.doc Version 5.1 Page 10 completed risk assessments in place that identified why or how these decisions had been reached. Residents that were spoken to said that they attend care review meetings and that they are involved in decisions that are made about their care. Information about advocates is available to everybody and residents are provided with advocacy support when required. DS0000064796.V275411.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 & 17. The residents take part in a variety of activities and are provided with opportunities to take part in and explore local community events. Relationships with families and friends are encouraged, supported and maintained and residents are provided with opportunities to discuss the way the home is run. Residents are provided with balanced and nutritious meals. EVIDENCE: One resident spoke about attending college where she learnt daily living skills and residents said that they attended a village firework display in November and would be attending a Cinderella show that was being performed by the local amateur drama society. Staff encourage the residents to take part in a variety of community activities including, trips out for meals, the leisure centre and bowling. The residents are planning to join the local library to enable them to access the numerous resources available. The residents say that the staff support them to maintain relationships with their families and encourage friendships that have been made outside of the home. Relatives are encouraged to visit and staff provide transport for the residents to enable them to visit their relatives homes and spend weekends DS0000064796.V275411.R01.S.doc Version 5.1 Page 12 and holiday breaks with them. The plans of care however, did not always make it clear whether relatives were involved in the residents’ lives and if so, what the contact arrangements were. The residents say that they do not yet attend meetings to discuss topics that affect the way in, which the home is run, although staff do listen to their views and concerns. The manager confirmed that meetings are being planned for the residents to attend. The residents have keys to their own rooms and have free access throughout the home apart from two residents that have restricted access to their en-suite facilities. Milbury Care has recently developed some policies that are in a language that is accessible for the residents. The meals that are provided at the home are varied, balanced and nutritious and reflect the individual preferences of the residents. The staff are aware of the residents dietary requirements and provide the individual level of support that is required for each individual. Residents said that the meals are tasty and that they always have enough to eat. DS0000064796.V275411.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 & 20. The residents’ are provided with a good and flexible standard of care that reflects their wishes and meets their health and social needs. The residents that take medication are protected by the homes policies and procedures. EVIDENCE: Staff that were spoken to demonstrated a good understanding and awareness of individual residents’ likes and dislikes and were seen treating them with respect and dignity, and in a way that made them happy. Residents said that they visit the GP and dentist and records identified that that a referral has been made to the dietician to supervise weight gain and weight loss for some residents. The residents say that they are happy at the home and that the staff treat them well. The staff are approachable and the residents are comfortable and relaxed with them. Individual records are kept for medication requirements and health related visits. Care and health needs that have been identified during various appointments are followed through carefully by staff. DS0000064796.V275411.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 & 23. Policies and procedures are in place to protect the residents from abuse and residents are supported to make complaints. All complaints are treated seriously. EVIDENCE: The home has a policy/procedure for the management of complaints that is compliant with current legislation. The manager and staff keep a satisfactory record of complaints that are made and the record indicates that the complaints that had been received were investigated and managed satisfactorily. The residents that were spoken to say that they are comfortable making a complaint as their complaints are taken seriously and that staff always resolved any issues or concerns that they had raised or identified. The CSCI has not received any complaints in respect of this service. The residents that were spoken to said that they felt safe at the home and that staff cared for them well. The home has a satisfactory policy for abuse and has adopted the Berkshire Inter-Agency Procedures. Records confirmed that the staff have received training in the protection of vulnerable adults. Evidence was seen that identified that allegations of abuse are taken seriously and that local procedures are adhered to. DS0000064796.V275411.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 & 30. The residents live in a safe environment that is able to meet their needs and the home is clean and hygienic. EVIDENCE: A tour of the premises identified that the home is well decorated and the furniture looks nice, warm and homely. All residents have their own bedroom and there are separate facilities for the lounge and dining room areas. There are a number of aids and adaptations in place to enable the residents to be more independent and there is also a spacious garden available. There is a sensory room at the home, which the residents enjoy and enables them to have quiet time alone. One resident also uses this room to complete his daily exercise regime on his exercise bike. Due to the current lack of storage space, the sensory room is used to store a wheelchair, empty boxes and is also utilised as a staff cloakroom. The staff have also been storing a number of dining chairs in this room, which makes it cumbersome and not always able to provide the tranquil effect that was initially intended. The home has satisfactory policies in place for the control of infection and staff have received the appropriate training. There are separate laundry facilities DS0000064796.V275411.R01.S.doc Version 5.1 Page 16 within the home and soiled articles are transported and cleaned within relevant guidelines. The home is clean and hygienic. DS0000064796.V275411.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): 32, 34 & 35. Competent staff that have been recruited in accordance with satisfactory procedures support the residents. Staff receive an induction to the home and a variety of training that enables them to provide a good service to the residents that live there. EVIDENCE: The residents say that the staff at the home are able to meet their needs and they are always willing to help and offer support when required. The home has a staff compliment that is a rich mixture of experience and skills and knowledge. Currently there is one member of staff that has achieved NVQ level 2 or above. Other members of the team have either already commenced the qualification or are scheduled to commence the course at a later date. The home has a satisfactory recruitment policy in place. The recruitment records were sampled for the two members of staff that have been most recently employed. The sample confirmed that the checks required by regulation had been completed. Staff that were spoken to, confirmed that they receive training that helps them meet the needs of the residents. A training record is kept and maintained by the manager. Staff receive an induction when starting work at the home; to enable them to become familiar with residents and their needs and also the DS0000064796.V275411.R01.S.doc Version 5.1 Page 18 homes policies and procedures. The home is currently dependent on agency staff and a satisfactory induction is in place for them. DS0000064796.V275411.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. The manager and staff at the home seek the residents views and opinions and ensure that they are reflected in the way that the home is run. The welfare of the residents is met through the policies and care practices at the home. EVIDENCE: Residents and staff say that the home is well run and the manager is liked and trusted. The manager of the home has 12 years experience working within social care and five years experience working with people with learning disabilities. She has completed her NVQ level 4 in management and the Registered Managers Award. The manager has sent questionnaires to relatives, representatives and other people involved in residents lives, to seek their views and opinions about the services provided at the home. The home has satisfactory health and safety policies and procedures in place and staff records confirmed that they complete training in health and safety. Regular maintenance checks are completed for equipment used at the home DS0000064796.V275411.R01.S.doc Version 5.1 Page 20 and a visit by the fire officer prior to the homes registration, raised no concerns. Regular fire checks and drills are carried out at the home. DS0000064796.V275411.R01.S.doc Version 5.1 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 2 2 X 2 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 DS0000064796.V275411.R01.S.doc Version 5.1 Page 22 N/A 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 YA6 Regulation 15 Requirement Timescale for action 12/02/06 2 YA7 Schedule 3 3 YA9 13 The registered person ensures that the plans of care contain the individual needs of each resident; this must include their cultural and religious needs. The registered person ensures 12/02/06 that a record is kept of decisions that have been made for residents and the reasons why these decisions have been made. The registered person ensures 12/02/06 that all identified risks have completed assessments in place. 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 Refer to Standard YA15 YA24 Good Practice Recommendations The registered person ensures that the residents preferred contact arrangements with relatives and friends are recorded within the plan of care. The registered person ensures that the items that are currently stored in the sensory room are removed to an alternative storage area. DS0000064796.V275411.R01.S.doc Version 5.1 Page 23 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 DS0000064796.V275411.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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