Inspection on 30/01/06 for 46a Eastern Avenue

This inspection was carried out on 30th 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 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

46a Eastern Avenue 03/03/09

46a Eastern Avenue 05/03/07

46a Eastern Avenue 23/08/05

46a Eastern Avenue 17/01/05

46a Eastern Avenue 08/06/04

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

CARE HOME ADULTS 18-65 46a Eastern Avenue Reading Berkshire RG1 5RY Lead Inspector Julie Willis Unannounced Inspection 30th January 2006 09:00 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 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 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 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. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 46a Eastern Avenue Address Reading Berkshire RG1 5RY 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) 0118 926 3510 0118 926 3510 londonroad@tiscali.co.uk Milbury Care Services Limited Mrs Katharine Anne Doyle Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: 46a Eastern Avenue provides care and accommodation for 6 adults between the ages of 18 and 65 who have learning disabilities. The house is owned and the service provided by Milbury. The home has a lounge/dining area and separate kitchen. There is a laundry area located in a small cupboard on the landing. There is a private enclosed garden and patio to the rear of the property and parking for several cars to the front of the property. All service users have their own single bedroom, which is decorated to their personal choice. Two bedrooms are located on the ground floor. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of four hours on a weekday morning and early afternoon. The inspector looked at all areas of the home including a number of bedrooms and communal areas. The inspector examined a number of care and staff records, spoke to the staff on duty and met all of the service users. The focus of this inspection was to gauge the users opinion on the quality of services offered at the home and this was achieved by spending the majority of time talking with service users and observing and listening to the interactions between staff and users. Brief feedback was provided to Registered Manager at the end of inspection about the inspector’s findings. There were no requirements outstanding from the previous inspection, which took place on the 23rd August 2005 and no new requirements were made as a result of this inspection. What the service does well: This is a well run home where staff are highly trained and skilled in their job roles. Staff are keen to gain extra professional qualifications that can help them to provide better care to users of the service. The home appears well staffed to enable users to take advantage of activities outside of the home. Service users are supported to participate in a wide range of community activities. Staff and management work well together to provide a happy and cheerful home for the residents. The service users were happy and relaxed in the staffs care. The records in the home are well written, easy to understand and help staff to provide users with the right type of care. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 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. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 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 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 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): None of the above standards were fully assessed on this occasion EVIDENCE: None of the above standards were fully assessed on this occasion. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 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): Service user plans were well-documented and provided sufficient information for staff to provide the appropriate care. EVIDENCE: Examination of care documentation evidenced that service user plans encompassed users personal and health care, social activities, specialist needs and behaviour management guidelines in an effective way. The care plan process afforded users meaningful involvement in the way their care was delivered. A key worker system is in place and service users benefit as a result of the continuity of care that this system provides. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Service users are provided with a menu that is varied and meets their individual need. EVIDENCE: Examination of the menus indicated that users were able to express their personal choice in relation to meal times. All service users have the opportunity to pick the meals for a particular day of the week and their choice is discussed and agreed at the regular house meetings. There is a need for management to ensure that menus are varied and contain nutritious and well-balanced meals, as there is a tendency for users to choose highly processed foods, which are high in salt, fat and other additives. The users do not appear to choose many meals that include fresh fruit and vegetables. It may be helpful to involve a dietician in the planning of a four week rotated menu that can be adopted by the home. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 11 At the time of inspection one user was being supported by day services to produce a meal for Chinese New Year. The meal was being prepared for all users to eat at teatime. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were fully inspected on this occasion EVIDENCE: None of the above standards were fully inspected on this occasion 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 13 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 The home has a clear accessible complaints policy and procedure where users concerns will be listened to and acted upon. EVIDENCE: There have been no complaints recorded by the home or reported to the CSCI in the past year. Service users have access to the complaint procedure, which is explicit in the Service User Guide. It has been produced in a user-friendly format. Discussion with the Manager and staff indicated that feedback is actively sought from service users and their families on a regular basis. Service users said that they were provided with appropriate life chances and that staff and management took their views into account before making decisions that may affect them. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 14 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): None of the above standards were fully inspected on this occasion. EVIDENCE: None of the above standards were fully inspected on this occasion. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 15 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): 31, 32, 33, 34, 35, 36 Service users at this home benefit from having a highly motivated, well trained and skilled staff team to meet their needs. Staff receive the support and supervision they need to effectively meet the needs of users. EVIDENCE: Discussions with staff on duty confirmed that they knew, understood and supported the aims, values and ethos of the home and fully complied with organisational policies and procedures. Staff were able to demonstrate an in-depth knowledge of service users needs. They appeared highly motivated, kind and caring and had clearly developed valued relationships with users, based on mutual trust and understanding. The relationship between service users and staff was observed to be relaxed, informal and positive. The current staffing levels are effectively meeting the needs of users. The home employs four care staff in the morning, three in the afternoon and two waking night workers. This level of staffing enables users to participate in a wide range of activities outside the home. Transport to activities is either using public transport or the house vehicle. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 16 The home has recently recruited new permanent staff to its 3 FTE (full time equivalent) vacancies. The inspector was informed of plans to involve users in future recruitment drives by enabling users to ask questions of each candidate and to express their opinions about those people interviewed. Examination of the staff files indicated that the selection and recruitment procedures at this home are robust. All necessary checks are carried out on staff to ensure that staff possess the necessary attributes to care effectively and protect users from abuse and exploitation. The staff have been properly inducted and have received training in core skills such as fire safety, first aid, manual handling, food hygiene, health & safety And infection control. The majority of staff have received refresher training in POVA (protection of vulnerable adults) in the past year. All staff receive adult protection training as part of their induction and as a core module in NVQ training. All staff at this home are highly motivated and have either achieved or are working towards a National Vocational Qualification at level 2 or 3. A formal structured supervision arrangement was operating in the home for all staff in accordance with recognised good practice. There was a shortfall in the frequency of one-to-one meetings in the last few months due to staff and management shortages, which are currently being addressed by management. Staff confirm that they feel well supported by management and have the opportunity to express their views in the regular team meetings and in formal supervision sessions. Service users were very complimentary about the staff and said they felt staff and management were approachable and caring. Users said that they each had a key worker and a number of co-key workers that knew their particular needs well and took a special interest in their welfare. The users felt confident that they would be listened to and felt their opinions were valued. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 17 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 Service users benefit from living in a well managed home where management are qualified and competent and demonstrate effective leadership skills EVIDENCE: The Registered Manager has recently returned to work at the home following a period of maternity leave. In her absence the Deputy Manager has been acting up supported by a team of skilled and competent staff. The Manager is widely experienced and has completed the NVQ 4 Registered Managers Award to further enhance her knowledge and skills. The Deputy Manager has achieved an NVQ 2 & 3 and LDAF level 3 in care and is currently undertaking a Foundation Degree in Learning Disabilities. Several of the staff also holds NVQ level 2 & 3. Staff and management are highly skilled practitioners who strive to improve the life chances and quality of care to users of the service. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 18 Staff were able to confirm that this is a happy home where management are supportive and staff feel included in the way the service is delivered. Service users say that the management and staff are approachable and caring. They say that they feel safe and like living at the home. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 46a Eastern Avenue Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x DS0000011050.V270783.R01.S.doc Version 5.0 Page 20 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. 1 Refer to Standard YA17 Good Practice Recommendations Service users should be encouraged to try more nutritious foodstuffs and to eat more fresh fruit and vegetables in their daily diet. Ready prepared meals and foods high in salt and fat should be kept to a minimum. 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 21 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 46a Eastern Avenue DS0000011050.V270783.R01.S.doc Version 5.0 Page 22 - 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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