Inspection on 05/03/07 for 46a Eastern Avenue

This inspection was carried out on 5th March 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

46a Eastern Avenue 03/03/09

46a Eastern Avenue 30/01/06

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 Kate Harrison Unannounced Inspection 5th March 2007 10:30 46a Eastern Avenue DS0000011050.V327252.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 46a Eastern Avenue DS0000011050.V327252.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. 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 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.V327252.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 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 Care Services. 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. The manager and a team of carers provide care over the 24 hours. The fees start from £792 per week. 46a Eastern Avenue DS0000011050.V327252.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 10.30 and was in the service for 5 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service, and any information that CSCI has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The recently appointed manager was available on the day and was able to help the inspector gain a full understanding of the service provided. The inspector asked the views of the people who use the services or who responded to questionnaires (comment cards) that the Commission had sent out. Four relatives and two health care professionals replied to the Commission’s comment cards and all the residents replied to the questionaires. The inspector spoke to several residents at the home during the day, but no visitors were available at the time. All the comments about the care at the home were very positive. From the evidence seen and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of differing religious, racial, physical or cultural needs. This is because the home has a strong focus on the needs of the individual, and the manager knows how to access training and advice for staff members as needed. What the service does well: What has improved since the last inspection? The new manager is experienced and qualified to lead the staff team at the home. Some systems have been improved and staff training has continued. 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 6 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. 46a Eastern Avenue DS0000011050.V327252.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 46a Eastern Avenue DS0000011050.V327252.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. Prospective residents’ needs and aspirations are assessed over a period of time before admission to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All of the residents present in the home at the time of the inspection visit had lived at the home for several years, and some remembered that they were involved in the admission process. The inspector discussed the admission process with the manager. When a request for a place at the home is received by the organisation a decision is made about who is the most suitable person to carry out the assessment of need. The designated person, sometimes a behaviour psychologist, gathers information from professionals involved in the care of the individual before visiting the prospective resident and his/her representative, and completes the pre-admission assessment form. Discussions are started with the manager of the service deemed most suitable to meet the needs of the individual, and arrangements are made for the individual to pay short visits to the home. If the individual and representatives are satisfied with the home’s service then a week’s stay is arranged, so that the individual can form an opinion about moving into the home on a permanent basis. The week’s stay also gives the other residents and staff an opportunity to assess the individual’s suitability 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 9 within the group, and their views are taken into account before a three-month trial stay is offered. At the end of the trial period a review meeting is held to hear the views of all concerned. If the home is satisfied that the individual’s needs could be met at the home then a permanent place is offered at the home. Risk assessments are carried out and care plans developed to make sure that the needs of the individual are understood and met. 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 10 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 good. The residents are supported to make choices and take risks in their daily lives through good planning and support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents gave the inspector permission to look at their care plans. The care plans were written from the resident’s perspective, and contained risk assessments and details for staff on how best to care for the individuals. The residents are supported by the key-worker to consider information relevant to making a choice, and the residents told the inspector why they had made particular choices. Risks affecting the health and welfare of the residents were identified, such as smoking and travelling, and strategies are in place arranged to support the activity. 46a Eastern Avenue DS0000011050.V327252.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. Residents enjoy choice and control over their daily lives, including the quality of their relationships with the local community and their families. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Some of the residents told the inspector about the activities they take part in, and about how they enjoyed certain aspects of the activities. A chart in the home shows the daily activity plans for the residents, and a mixture of group and individual activities is provided. Some activities are provided at a local facility, while in one instance, an activity worker comes to the home to support one resident’s preference. Some of the residents like to help with the household shopping, and others like to go to the cinema and to the local pubs. All the residents stated in the Commission’s questionnaire that they could choose what to do throughout the day, and the inspector observed that the residents were consulted about their views and preferences during the inspection visit. 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 12 Residents are supported to maintain links with their families, and one resident told the inspector about the regular times he/she telephones relatives every week. Residents are encouraged to decide what to eat and to plan the menu for the week. The home has tried to follow a recommendation from the last inspection report to encourage residents to try more nutritious food by supplying more fresh fruit. The manager explained the difficulties encountered in trying to make more progress, as the majority of the residents have some food preferences that are less healthy, such as canned foods and white bread. The inspector recommends that advice from the community dietician should be sought to help change the attitude of the majority of the residents towards food, so that more healthy food is provided on a daily basis. 46a Eastern Avenue DS0000011050.V327252.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. The residents’ health care needs are met in a way decided by the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans of the individuals checked by the inspector showed that new health needs are identified quickly and that known health needs are addressed in a systematic way. Residents are supported to keep appointments with health care professionals, and the key-workers accompany the resident, with the resident’s permission. The staff members have good relationships with the residents, and the inspector saw how the residents speak freely to the staff about issues affecting them. The residents decide how they want staff members to behave towards them while giving the support they need. None of the residents manage their own medication, and the home has a policy and procedure to manage all the medication at the home. Medication is supplied by a local pharmacy and kept securely. The medication records show that at times medication was not given at the correct time. The reasons why this happened were explained to the inspector, and were appropriate, and the inspector recommends that the appropriate code on the medication record be 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 14 used so that the team can understand why the medication was not given as prescribed. 46a Eastern Avenue DS0000011050.V327252.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. Residents know that their views are listened to and acted on, and that they are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure in pictorial form, although a copy was not easily found on the day of the inspection visit. All the residents who spoke to the inspector were very clear about how to complain and to whom to address complaints. The complaints record showed that residents made complaints and that they were addressed seriously within the timescales of the procedure. One relative contacted the Commission with information about the home, and the inspector discussed the issues with the manager and was satisfied that there were no issues outstanding. The home has a policy on protecting vulnerable adults that includes clear details for staff members on how to manage issues arising. All new staff members have training about safeguarding vulnerable adults during the company’s week of induction training, and update training is provided regularly. 46a Eastern Avenue DS0000011050.V327252.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 adequate. The home is comfortable and safe, but maintenance issues should be addressed in a timely way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home environment is comfortable, safe and homely. Maintenance issues are recorded and a request is sent to head office to manage the issue. Professional help is sought if the company’s maintenance person is not able to address the problem. Some maintenance issues have not been addressed, including the redecoration of the downstairs bathroom and a new mattress for two residents’ beds. Maintenance issues should be addressed in a timely way. All of the residents who replied to the Commission’s questionnaire said that the home was always fresh and clean. The staff members manage the home’s laundry. The laundry room is compact and has no hand-washing facilities. Staff members need to be particularly careful in managing infection control and use the nearby bathroom for hand washing while doing the laundry. The laundry floor should be finished in an easily cleaned impermeable surface. 46a Eastern Avenue DS0000011050.V327252.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 adequate. Staff are skilled and caring, though the home does not meet the standard for NVQ training, and the recruitment process needs to be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does not yet meet the 50 National Vocational Qualification (NVQ) trained staff members. The manager is doing the assessor’s course and when she has completed she will be able to help staff progress through the NVQ training. The staff members have a good understanding of the residents’ needs and maintain good relationships with the residents. All of the residents who replied to the Commission’s questionnaire said that staff members ‘always’ treat them well. The company provides a three-day induction for all new employees, and training on mandatory subjects such as moving and handling, fire safety and food hygiene. Training is also provided on subjects such as first aid, infection control and topics on how best to manage residents’ behaviour. The home’s induction processes meet the Skills for Care standard. 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 18 The inspector saw two individual staff files to check the recruitment procedure. A reference for one of the individuals was of a ‘To Whom It may Concern’ type reference, and it is not clear that the company was satisfied as to the authenticity of the reference. The inspector recommends that the company should make sure that all the references about prospective carers are sought by the company and are authentic. 46a Eastern Avenue DS0000011050.V327252.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. The residents benefit from a safe well run home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The recently appointed home’s manager intends to apply to the Commission to be the registered manager in the near future, so the inspector could not fully assess this key standard. The home carried out a quality review of the service last year, including the views of residents and health care professionals, and overall the service was viewed as ‘good’. Residents are helped, on a monthly basis, to review the quality of their lifestyle during the previous month, and to identify how it could be improved in the future. The company has a health and safety policy statement and provides training for staff members on safety topics. The home has carried out a fire risk assessment and has an evacuation plan in case of emergency. 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 20 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 2 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X X X 3 X X 3 X 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 21 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 2 3 4 Refer to Standard YA20 YA24 YA30 YA34 Good Practice Recommendations The appropriate code on the medication record should be used to record why medication was not given as prescribed. Outstanding maintenance issues should be addressed in a timely way. The laundry floor should be finished in an easily cleaned impermeable surface. The company should make sure that all the references about prospective carers are sought by the company and are authentic. 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 22 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 46a Eastern Avenue DS0000011050.V327252.R01.S.doc Version 5.2 Page 23 - 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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