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Inspection on 03/03/09 for 46a Eastern Avenue

Also see our care home review for 46a Eastern Avenue for more information

This inspection was carried out on 3rd March 2009.

CSCI found this care home to be providing an Good service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 46a Eastern Avenue 46a Eastern Avenue Reading Berkshire RG1 5RY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Gary Bartlett     Date: 0 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 46a Eastern Avenue 46a Eastern Avenue Reading Berkshire RG1 5RY 01189263510 01189263510 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Milbury Care Services Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home 46a Eastern Avenue provides 24 hour care and accommodation for 6 adults between the ages of 18 and 65 who have learning disabilities. The home has a lounge/dining area and separate kitchen and all bedrooms are for single occupancy. There is a private enclosed garden and patio to the rear of the property and car parking to the front of the property. The fees start from £988 per week. Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in 46a Eastern Avenue from 10.00 a.m. until 2.00 pm. Judgements about quality of life and choices were taken from direct observation and by discussion with the Manager, residents and staff. Some records and parts of the building and grounds were inspected. The Manager had completed an Annual Quality Assurance Assessment, from which information was used to inform the inspection process. The Inspector would like to thank everyone involved for their contribution to the inspection. Care Homes for Adults (18-65 years) Page 5 of 26 Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident they will have an assessment of their needs before they move in. This tells the home all about them, what they hope for and want to achieve, and the support they need. Evidence: The organisation has a comprehensive assessment and admission policy and procedure for Registered Managers to follow to ensure each admission is undertaken in a planned way. The Manager described how prospective residents are only admitted to the home after a full assessment of needs. These are inclusive of relatives and health care professionals and are the starting point for service users individual care plans. Further assessments are undertaken after the resident had been admitted to the home. The records sampled included assessments of personal support, health care needs, religious and cultural needs, disability, sexual orientation and social interests. If prospective residents are assessed to be suitable for the service, arrangements are made for them to visit the home, where they can have a meal and get to know the Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: staff and those who already live at 46a Eastern Avenue. Discussion with care staff indicated they are sensitive to helping people settle in, learning their care needs and preferences. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents individual needs are clearly recorded and reviewed through the care plan system. Residents are supported in making choices and decisions about their lifestyles and in taking appropriate risks. Evidence: Each resident has an individual care plan. Three were inspected in detail. Staff have been busy in introducing a new care plan format. They are comprehensive and contain the information staff need to know to help residents with their care needs in an appropriate manner. The care plans also include assessments on potential risks for each individual and these are not limited by assumptions and beliefs about peoples diversity. The care plans and risk assessments are regularly reviewed. The Manager gave assurance that information held about each resident is stored securely when not in use. 46a Eastern Avenue has policies and procedures in place in Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: respect of data protection and confidentiality of information. The office is very small and it is difficult for staff to use this at shift handover times to exchange confidential information in privacy. Staff say they are mindful of this. Residents have regular opportunities to contribute their views and ideas with regard to the running of the home and are supported in doing so. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy individual lifestyles and are supported to develop their life skills. They have the opportunity to experience a variety of social, educational and recreational activities. Evidence: From observation, discussion and records it is clear that residents benefit from opportunities for personal, educational and social development and are supported towards independent living skills, tailored to their abilities. Residents are treated as individuals and are consulted about their different interests and aspirations, which are recorded in their personal care plans. Activities are provided accordingly. Personal development is enabled through attendance at college, day centres, leisure activities and relationships with friends and family. Residents spoken Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: with clearly enjoy the activities they participate in. The home is in the centre of the town where there are shops, pubs and restaurants and records show that residents are encouraged and supported to use these local community facilities. Residents are registered to vote and are given the opportunity to undertake this right should they wish. Three residents choose to regularly attend church. Residents are able to see their family and friends as often as they wish. Individuals can visit the home at any reasonable time. There is not a designated room in which service users can meet with visitors in private should they choose to not use their bedroom. At current occupancy levels, the home would find it very difficult to provide this facility. Residents say they are content with current arrangements and the Manager explained the office can be made available. Whilst the staff do the bulk of the cleaning, the residents share in helping with this, particularly in regard to their own bedrooms. Residents participate in planning the menus and they enjoy a variety and choice of meals. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from personal support which meets their individual needs and preferences. Their privacy and dignity is respected. Evidence: Records show that staff are clearly made aware as to the type and nature of the support required for individuals personal and intimate care needs. Staff have an understanding of the preferred routines and varying requirements of each individual. They provide flexible support to residents based on individual choice and personal care is provided in private to promote the dignity of residents. Through discussion with the staff and assessing three care plans, it is evident that residents have ready access to health and social care professionals. Residents are supported with any routine and specialist appointments. Staff say they receive Moving and Handling training as part of their induction training and it is updated as necessary to ensure they know how to assist residents safely. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: A procedure is in place for the storage and administration of medication by the home, which aims to protect residents. No one at the home is currently self medicating. The Manager described how they are working towards this for one resident with risk assessments being made. Records show that all staff administering medications have been trained and signed off as being competent to do so. The administration records seen are completed appropriately. The Manager undertook to monitor the temperature of the medicines storage area with immediate effect, to help ensure medicines are stored in accordance with their guidelines. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives know their complaints are listened to and acted on. There are systems to protect residents from abuse. Evidence: The complaints procedure is readily available to residents and their relatives. They say they feel confident they are listened to and any necessary action is taken. The Home keeps a record is of all complaints received by them, the result of the investigation and how the complaint has been resolved. The Commission has not directly received any information regarding complaints about the home since the last inspection. There are procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of residents. The staff spoken with have a sound understanding of safeguarding vulnerable adults procedures and of the need to be mindful of individuals needs. The Manager stated any allegation of abuse would be referred to the concerned agencies without delay. There have not been any safeguarding alerts since the last inspection. Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean and generally comfortable home. Evidence: Each person living at the home has a single bedroom that they are able to decorate and furnish to their own taste. Bedrooms are considered to be private spaces and residents have a key to their bedroom if they wish. Staff and residents say the bathroom and toilet facilities are adequate for their purposes. Those parts of the home seen are clean and free from offensive odours. Infection control in the main laundry is better maintained now that an appropriate floor covering is in place. There are not hand washing facilities in the laundry, which is very compact, and staff and residents have to use the nearby bathroom for hand washing. As mentioned previously in this report, there is not a designated room in which service users can meet with visitors in private should they choose to not use their bedroom. At current occupancy levels, the home would find it very difficult to provide this facility. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: Since the last inspection, the kitchen has been refurbished, new lounge and dining room furniture purchased and parts of the home have been redecorated. There is a large, well maintained garden that residents like to use in more clement weather. Part of the garden is used as a vegetable patch. When there is produce from this, residents enjoy the results in their meals. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment processes are followed to ensure only properly vetted people work at the home. People living in the home benefit from the support of staff who demonstrate a good understanding of residents needs. Evidence: Robust recruitment processes are followed to ensure only properly vetted people work at the home. Residents are actively involved in the recruitment of staff and their comments are invited on the suitability of any candidate. Residents say they like the staff and find them approachable, polite and kind. Throughout the site visit there was evidence of good relationships between staff and residents. Staff obviously know the residents well and how best to put them at ease. People applying to work at the home have to complete an application form, provide two references and have a POVA and Criminal Records Bureau (CRB) check and attend an interview. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: There is an induction programme in place for new staff and staff say there is regular training. This was confirmed by records seen. Staff spoke of regular supervision and appraisals. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and run in the best interests of residents. There is an open and friendly atmosphere. Evidence: The Manager is an NVQ Assessor, holds an NVQ level 4 in care and the Registered Managers Award. She has been the registered Manager of two other homes and has many years experience of working in care environments. The Manager stated she is in the process of submitting an application to be registered. Residents and staff say they find the Manager approachable and supporting. A quality assurance process is in place, which elicits views from residents, their families and other professionals involved with the home and outcomes are collated and published. There are records of fire systems checks and fire drills and training. Staff spoken with have a good understanding of emergency procedures. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The Manager stated that records of maintenance and safety checks are in order. These were not inspected on this occasion. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 15 It is recommended the home should explore the possibility of providing residents with an appropriate area in which they can entertain their visitors in private should they choose to not use their bedrooms. It is recommended the home should explore the possibility of providing residents with an appropriate area in which they can entertain their visitors in private should they choose to not use their bedrooms. 2 28 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!