Inspection on 04/12/06 for 43 Station Road

This inspection was carried out on 4th December 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 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

43 Station Road 02/12/08

43 Station Road 12/01/06

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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 Catherine Kane Unannounced Inspection 4th and 6th December 2006 15:30 43 Station Road DS0000064796.V322251.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 43 Station Road DS0000064796.V322251.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. 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 43 Station Road Address 43 Station Road Wraysbury Middlesex TW19 5ND 01784 48154 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) http/www.milburycare.com/home.html Milbury Care Services Limited Miss Julie Skelly Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 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 17 and 65 and of both sexes. Each service user has a large individual bedroom and shares the communal space. The building is two storeyed and there is no internal lift for access to the first floor. The home has its own vehicle to easily access Wraysbury and Langley village and Slough town centre. The home is within walking distance of local shops and facilities. The fees for this service are £1,400 per week. 43 Station Road DS0000064796.V322251.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 3.30pm on Monday, 4 December 2006. She returned on Wednesday, 6 December 2006. The inspector was in the service for a total of four and a half hours. The inspection 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 the 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 or who responded to questionnaires that the Commission had sent out. 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 first day of the inspection but was present on the second day. She met with a total of six members of staff on duty. The inpsector saw staff and residents who were preparing 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 part of premises. The inspector spoke by telephone with the relative of two residents. The inspector would like to thank the manager and her staff team for their assistance with the inspection. She also thanks residents and all others who shared their experience of this home. What the service does well: The home continues 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. One relative commented, “The home has a strong manager and the staff are very caring”. 43 Station Road DS0000064796.V322251.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. 43 Station Road DS0000064796.V322251.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 43 Station Road DS0000064796.V322251.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure is good. EVIDENCE: The home has been able to provide care for a young person who is 17 years old who has moved into the home since the last inspection. The pre-admission assessment records were seen and these included a full care needs assessments and detailed how the home would specifically meet their needs during transition to adulthood. Generally, admissions are not made to the home until a full needs assessment has been undertaken. The home is then able to confirm that it can meet the needs of the individual through the service it delivers, as detailed in the statement of purpose. Evidence confirms that the assessment is conducted professionally and sensitively and has involved the family or representative of the person who wishes to move into the home. Prospective new residents are given the opportunity to spend time in the home. 43 Station Road DS0000064796.V322251.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): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed four residents’ care plans. These were easy to understand, written in plain language and 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. The inspector observed that the home was using listening monitors to alert staff should one resident require assistance. Clear guidelines and risk assessments were included in the resident’s care plan. However, the decision to start using this equipment, which could compromise their privacy, dignity and restrict their freedom, had been made by the home. Whilst the inspector understands that the decision taken to put limitations may be in the best interest of the resident, this must be done only through a full care planning process if the resident is not able to give their consent. This would involve the individuals who would be able to act on the resident’s behalf, for example, their relatives or advocate and other social care or healthcare professionals. 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 10 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 backgrounds. 43 Station Road DS0000064796.V322251.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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for people who use this service to take part in a variety of interesting activities are good. EVIDENCE: On the first day of the inspection the inspector was in the home during the early evening. She spent this time with five residents and the staff on duty. Two residents had very good communication skills, were confident and able to tell the inspector about their experiences of the home. The other three residents had limited communication but, with the help of staff and notes seen during the inspection, the inspector got an idea about things they like to do. One resident told the inspector, “Staff are nice, they help me to get ready for college”. 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 12 Many activities provided in-house were based on what residents prefer to do in their leisure time; these included relaxing in their bedroom, sensory activities, watching TV, art and craft, foot-spa and cooking. Each resident has a full programme of regular activities outside the home including school, college, day services, swimming, horse riding and going to the pub. One resident showed the inspector how they help staff in the office. Four residents, helped by their relatives, returned questionnaires where they confirmed that staff always treat them well. The inspector spoke with the relative of two residents by telephone. They indicated that they are very satisfied with the care provided in the home. They praised the manager and her staff team for making them welcome in the home and keeping them fully involved. The home supports residents to maintain their relationships with family and friends. The inspector was in the home when the evening meal was being prepared and served. Residents and staff have their meal together in the dining room. The meal was freshly cooked roast pork in gravy, roast potatoes and fresh vegetables followed by pudding. One resident said, “I don’t eat beef, I like fish and chips”. Regular drinks and snacks are available. A varied menu is provided and residents’ special dietary needs are catered for. 43 Station Road DS0000064796.V322251.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): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of residents are generally well met. 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 make sure that 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. A comment card was returned from residents’ GPs where they indicated that they were satisfied with the overall care provided in this home. They commented that the home has always worked well and in partnership with them. One resident is currently in hospital. Staff from the home have been able to provide support to this person and their family. Residents’ medicines are securely kept in a locked medicine cabinet. The home uses a pharmacist-produced medication administration record (MAR). 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 14 Records were kept of staff assessed as competent to administer residents’ medicines. The inspector recommends that a sample of the initials of staff who are assessed as competent to administer medicines be kept. The manager has completed training delivered by an appropriately qualified person with knowledge of medicines. The inspector recommends that all staff who administer medicines also complete this training. During the inspection one staff member confidently demonstrated how a resident’s medicines are looked after and how residents are helped to take their medicines. A resident confirmed that the staff member did it properly. 43 Station Road DS0000064796.V322251.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): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a protection from abuse policy and the complaints procedure is good. EVIDENCE: The manager declared that home has received five complaints in the last year. Details of these were made available to the inspector at the time of the visit. The Commission has received information relating to two complaints in the last year. From information seen during the inspection these issues were dealt with in line with the Milbury complaints policy. Staff have attended specific training on protecting children and vulnerable adults from abuse and were aware about local adult protection procedures. The Commission has received no information relating to adult protection issues in the last year. 43 Station Road DS0000064796.V322251.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): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was tidy and clean at the time of the inspection. EVIDENCE: The furniture and fittings are modern and domestic in style, providing a homelike environment. The comfortable lounge leads to a well maintained garden and patio area. The home has a programme of repair and renewal. At the time of the visit areas of damaged carpet were seen in the lounge, hallway and stairs. This needs to be replaced or repaired without delay. 43 Station Road DS0000064796.V322251.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): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home’s recruitment procedures and training for staff to do their jobs well is good. EVIDENCE: During the inspection the inspector spoke with three members of staff on duty. The home has a core of well-established staff who understand residents’ needs and they relate well to. From the shift rota seen there has been some moderate use of agency staff in this home in recent months but this has improved with the recruitment of new staff. Two staff have left and eight new staff have been recruited or transferred from other services since the last inspection. Staff commented that morale is good. The recruitment process is thorough. The inspector viewed staff files for three staff sampled at random. These were well organised and contained the necessary documentation. The manager confirmed that Milbury intends to renew the Criminal Record Bureau (CRB) disclosures made on staff every three years. 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 18 The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they have undertaken. Five staff members have completed a relevant National Vocational Qualification (NVQ) and three further staff are currently undertaking this qualification. 43 Station Road DS0000064796.V322251.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): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager has a good understanding of management areas in which the home needs to improve and has plans in place to address these. EVIDENCE: The experienced registered manager has completed the Registered Managers’ Award. She is competent to run the home and meet its stated aims and objectives. The manager has sound knowledge and experience in care of people with a learning disability, quality assurance systems, equal opportunity issues, development and implementation of the service’s policies and procedures, good people skills, strong leadership of staff which leads to confident workers, responds to need, provides an excellent role model and manages the service efficiently. She has a strong ethos of being open and transparent in all areas of running of the home and is aware of current developments, both nationally and by the CSCI, and plans the service accordingly. 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 20 The manager completes monthly quality monitoring checklists. The inspector receives copies of the proprietor’s representative’s monthly visit reports. The Commission no longer requires that a copy of this report is sent routinely to the CSCI but a copy must be kept in the home and made available for 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 that the home meets relevant health and safety requirements and legislation. Records kept were good and are routinely completed. Where issues have been identified these have been acted upon successfully to ensure that residents’ care is not compromised. Milbury has undertaken an audit of this home. This report was made available during the inspection and showed that the home had achieved well with positive outcomes. Milbury, who runs this service, has financial and accounting systems subject to internal and external audits. 43 Station Road DS0000064796.V322251.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 2 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 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 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 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes – one requirement partially met 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 YA7 Regulation Schedule 3 Requirement The registered person ensures that a record is kept of decisions that have been made for residents and the reasons why these decisions have been made. (Requirement only partially met from the previous inspection) The registered person must provide the CSCI with details of the renewal, maintenance and repair programme for the home to include details of the replacement or repair to the damaged carpet to be done without delay. Timescale for action 28/02/07 2. YA24 23(2) 28/02/07 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 23 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 YA20 YA20 Good Practice Recommendations The inspector recommends that a sample of the initials of staff who are assessed as competent to administer medicines be kept. The inspector recommends that all staff who administer medicines should also complete training delivered by an appropriately qualified person with knowledge of medicines. 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI 43 Station Road DS0000064796.V322251.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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