Inspection on 18/01/07 for 51a Circuit Lane

This inspection was carried out on 18th January 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

51a Circuit Lane 12/02/09

51a Circuit Lane 19/01/06

51a Circuit Lane 28/07/05

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 51a Circuit Lane Southcote Reading Berks RG30 3HB Lead Inspector Kerry Kingston Unannounced Inspection 18th January 2007 3.30 DS0000061336.V325359.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 DS0000061336.V325359.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. DS0000061336.V325359.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 51a Circuit Lane Address Southcote Reading Berks RG30 3HB 0118 957 4644 0118 957 4644 qualitycareproviders@yahoo.co.uk www.qualitycareproviders.co.uk Quality Care Providers Limited 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) Mrs Osarumen Desiree Ann Odiase Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000061336.V325359.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: Quality Care Providers is based at 51A Circuit Lane, which is approximately two miles from Reading Town Centre. It is a six bedded home, offering care to six service users with learning and associated disabilities. The house is domestic in appearance, has two ground floor and four first floor bedrooms. The home is located on a public transport route and has access to local facilities. The fees are £850 per week, to £1100 (the fees include residential and day services.) DS0000061336.V325359.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place on the 18th January 2007, between the hours of 3.30pm and 7.30pm. The purpose of the visit was to collect information to inform the key inspection report. Information for this inspection was collected on the day of the visit. There were four service users resident in the home on the day of the visit, three were permanent residents and one was visiting the home for respite care. The inspector toured the building, observed care practice, spoke with two staff members, the manager/proprietor and met all four service users. Three Service users offered only minimal verbal communication, one service user was able to speak very clearly and discuss his views and feelings. An annual report completed by a Local Authority accreditation officer and comments made by families and care managers at reviews were seen, as were Service user care plans and other records. Overall the home offers good care to the service users. What the service does well: What has improved since the last inspection? The staff make sure that they give medicines safely and show this by writing it down correctly. The home has rented a building that residents can go to for their daytime activities. This has helped residents to be more interested in going out during the day and doing more things. DS0000061336.V325359.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. DS0000061336.V325359.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 DS0000061336.V325359.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): 2,4 and 5. Quality in this outcome area is adequate. The home carefully assesses prospective service users and ensures it can meet their needs but they do not provide a contract/statement of terms and conditions for the individuals who are admitted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been two new service users admitted since the last inspection, one has been discharged and went back to live with their family. There are, currentl, one female and two males, permanently resident in the home. Service users have very diverse needs. Both the newly admitted service users have care management assessments,care plan assessments and admission forms completed by residential staff. A letter from the manager/provider to the care manager sets out that the home can meet the needs of the individual and how it will do so. The parents of one of the service users visited the home,prior to their admission. The home worked closely with previous placements to ensure as much continuity of care as possible. A review of the placement was completed one month after admission and again six months later. One service user has no family input but communicates well and is able to articulate his wishes, needs and choices very clearly. He said that he had ‘chosen to live here’ and ‘I am happy’. It is not clear how the home gains the views of existing service users with regard to new admissions but there is evidence of work completed for both DS0000061336.V325359.R01.S.doc Version 5.2 Page 9 service users to help them with the settling in’ process. Work has been done with the existing service user to help with the adjustments necessary, when new people move into your home. The senior staff member was unable to locate contracts/statements of terms and conditions which were not on service user files, she had not seen these documents. DS0000061336.V325359.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 home assess the changing needs of service users and try to ensure their involvement, as far as possible. Service usersmake as many choices for themselves as they are able and risk assessments ensure they can be as independent as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Only one service user has been resident in the home since the last inspection, regular reviews are held and the review report notes short and long term goals. Care plans describe how these will be met and goals are reflected in activity and daily care plans. It was identified at review that a service user needed a bath chair to make their personal care routines more comfortable and safer and this was acted upon quickly. Another goal was to assist a service user to gain independance skills(domestic), the service user was observed being encouraged to help with meal preparation, as described on the care plan. DS0000061336.V325359.R01.S.doc Version 5.2 Page 11 The service user who is able to communicare verbally said that they always has a choice of what to do and a discussion between a staff member and a service user about a change of plans that had occued during the day (at the service users request) evidenced this. One service user was observed choosing to spend time in his room and what to eat at tea time. The manager advised that service user meetings are held but notes of the meetings were not seen, service users are able to attend parts of the staff meetings and one does on occasion. The manager also advised that service users are involved in the recruitement process, the service user was unable to confirm this and it was suggested further evidence of this practice would be useful. A non-verbal service user nodded,smiled and did a thumbs up sign when asked if he could choose what to do. A service user was observed using alternative communication methods to ask for for sauce for the meal and for extra food, staff answered both requests quickly and positively. Adequate risk assessments are in place for service users, as necessary but they could be more detailed. There is some confusion between risk assessments and behavioural guidelines but using both results in staff knowing how to deal with individuals in certain situations to increase their activities, access to the community and independence, for example being a passenger in the car/ being in the community/ going swimming and horse riding. DS0000061336.V325359.R01.S.doc Version 5.2 Page 12 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): 12,13,14,15,16 and 17. Quality in this outcome area is good. The home ensures that service users are supported to have a positive and rewarding lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Daytime activities has been an area of major development over the past three months. The home has leased a premises in the town within easy reach of the swimming pool/trampoline /tennis courts and other community facilities. This has resulted in service users having a clear understanding of daytime activities and home life (the home provides the day services for individuals). The development of clearly identified daytime activities has resulted in fewer ‘clashes’ between service users at home, service users being more easily motivated and enthusiastic about participating in activities. Service users confirmed that they had ‘lots of things to do’ in the day, one service user said he ‘ gets tired so does not like going out in the evenings especially when cold and dark.’ Day care programmes are held at the day services premises but staff said that they include horse riding/ swimming/ shopping/ community DS0000061336.V325359.R01.S.doc Version 5.2 Page 13 access/ college and cooking, programmes are varied and flexible. One service user smiled and nodded when asked if he had things to do during the day. There are less evening and weekend activities because of the season but service users went on holiday in the summer and staff and service users confirmed that there are more activities when it is warm and light in the evenings. One service user was observed, with one-to-one staff support, listening to and playing music in the sensory room. This room has been designed to ensure that the service user is able to relax and have some entertainment, inspite of some sensory difficulties. Daily diaries noted that service users go shopping/walking and out to meals in the community. Only one service user has no contact with their family, the manager advised that the home is trying to find an advocate or befriender to enhance his quality of life. The staff,currently, act as a surrogate family. The manager recognised the difficulties that this may cause wih regard to the staff teams’ personal and professional boundaries but is concerned for the emotional well being of the service user. Staff assist service users to visit their families and provide transport and escorts as appropriate. One service user clealry expressed how happy he was to be staying at the home (i.e. thumbs up sign reinforced by insisting on touching your thumb with his and smiling very broadly.) Another service user said he ‘really liked living here’. Staff were observed treating service users with respect,sensitivity and dignity and were seen to involve them in the daily routines, encouraging them with humour and patience. Service users appeared to be very relaxed and confident with the staff and the manager. Menus seen were varied and nutritious, the food was fresh and of good quality. Service users were seen being inolved in the shopping, food preparation and choosing alternative meals. All service users said or indicated that they enjoyed the meal. DS0000061336.V325359.R01.S.doc Version 5.2 Page 14 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 home offers good quality personal and health care support to service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans contained all the necessary information to ensure that the staff could offer appropariate care. They included behaviour charts,activities, methods of communication (one service user has communication boards in his bedroom) ,daily routines ( one service user has special equipment to assist her with additional sensory and physical needs) and cultural and religious needs (one has a special diet). The care plan also includes preferences, likes and dislikes and a description of how those who are unable to verbally communicate make choices. Health care needs are recorded as are appointments, if necessary the home keep bowel,menstruation,epilepsy and weight charts. The home get good support from the G.P and referrals to specialists are made as appropriate. Some behavioural guidelines are in place but are not always very detailed, however incidents recorded demonstrate that the number and frequency of incidents has reduced since the day services dvelopment (as described in DS0000061336.V325359.R01.S.doc Version 5.2 Page 15 lifestyle). A staff member advised that physical restraint is not used in the home. One service user has a new communication system with a communication board in his bedroom to help him understand what is going on and when. Staff said that this has had a very positive effect on his behaviour. Medicaion records seen were accurate. Medication is locked in a cupboard in the kitchen this has been reviewed by the staff team and considered to be appropriate storage. The cupboard is kept locked and the key is carried by the senior who is ‘leading’ the shift. The home uses the Boots Home/domestic dispensing system, the pharmacist packs the medication for the home into daily doses. The packs are not dated and it was suggested that these could be dated on the first day of administration to provide further clarity for staff. There are few medicnes in the home a review may be needed if there is an increase in the quantity of medications that the home have deal with. One service user has only liquid medication, which the home administers and one service user has only paracetemol when necessary. Rectal paracetemol is prescribed for one service user and there are no written guidelines for its’ use, only two staff are trained to use it and there is no evidence of their competency,this should be reviewed. All staff have medication administration training and two staff administer, wherever possible. No controlled medications are used. It was noted that guidelines for how non verbal service users express pain may be beneficial. DS0000061336.V325359.R01.S.doc Version 5.2 Page 16 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. The home listens and acts upon service users views and protect them from all types of abuse, except financial where there is not a robust accounting system to ensure the safety of service users finances. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a comprehensive complaints procedure and a complaints book, there have been no entries since last inspection. The Commission for Social Care Inspetion has received no information concerning complaints or safeguarding adults issues since the last inspection. All staff attend Protection of Vulnerable Adults training and staff members are able to describe very clearly how they would handle a vulnerable adults concern. A service user confirmed that he would ‘know who to talk’ to if he was unhappy and said he felt safe in the home. Service users’ cash is accurately recorded and securely kept. One service user has family as appointees and the staff member thought that the manager was the appointee for the other two, however this ws not clear from records kept. Service users bank accounts did not clearly account for large withdrwals and it was not possible to follow an audit trail for monies withdrawn /paid into bank accounts. There are no contracts to show how much contributions service users are making to their care costs and no record of the amount of benefit being recieved . DS0000061336.V325359.R01.S.doc Version 5.2 Page 17 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 excellent. Service users are provided with a homely clean and hygienic environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home in is kept in an excelllent condition, it is very comfortable and one service user said that he ‘really liked his bedroom.’ Special adaptations for one service users’ special needs have been provided. The parts of the home seen were of a very high standard of hygiene and cleanliness. Photographs of service users are framed and hung on the walls of the entrance passage and stairwells, creating a very pleasant and homely atmosphere. DS0000061336.V325359.R01.S.doc Version 5.2 Page 18 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. The home has a competent, well qualified staff team, who are recruited safely and are able to meet the needs of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home operates with a minimum of two staff on duty (if there are three service users in residence), staffing numbers are flexible as the home is not fully operational, as yet. There are seven permanent staff and regular bank staff, this will increase as the home admits more, permanent service users. Five of the seven permanent staff have N.V.Q.2 or above. There is one waking night staff.Staff said that it is a ‘good staff team, very enthusiastic about the standard of care given to the service users. Staff views and ideas are listened to.’ Staff members confirmed that the home offers good training opportunities. Recruitment records contained all the necessary information to ensure that staff are safely recruited. Staff are knowledgable and most have experience in caring for adults with learning disabilities. DS0000061336.V325359.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. That the home is well managed and service users are generally kept safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is managed by the proprietor, who is qualified and has experience in the residential care of service users with learning disabilities. She does care shifts and spends approximately half her time on management tasks. There is one area of record keeping that needs attention (as described in Concerns, complaints and protection) but management systems are generally good. The home has several quality assurance elements such as an external unannounced visitor to write a report and comment on quality, an annual assessment by a local authority Accreditation officer (the home is currently ‘rated’ as a 2 star (good) service),service users are involved in the recruitment process and some service users join staff meetings to express their views. DS0000061336.V325359.R01.S.doc Version 5.2 Page 20 Service users’ input into the Quality Assurance process is not evidenced and the annual ‘action plan’ (business plan) was not available on the day of the visit (the manager advised that it is being completed). However there is evidence of development work (see lifestyle) Health and Safety maintenance records seen were up to date ( the gas safety certificate was not seen). The water is sometimes hot, the manager advised that this is being adressed. Radiators are not covered, risk assessments are in place although they are not very detailed. Staff are trained in Health and Safety. DS0000061336.V325359.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 3 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X DS0000061336.V325359.R01.S.doc Version 5.2 Page 22 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. 1. Standard YA5 Regulation 5(1)(b) Requirement Timescale for action 01/04/07 2. YA23 13(6) 3. YA39 24 To provide service users with a contract /statement of terms and conditions to include the amount and method of payment of fees. To review the procedures and 01/03/07 recording relating to service users finances to ensure they are safe from the risk of financial abuse. To further develop the methods 01/06/07 of reviewing the quality of care in the home, to include consultation with service users and their representatives. 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. YA18 YA19 YA42 Refer to Standard Good Practice Recommendations To develop more detailed behaviour guidelines and risk assessments, as necessary. To review he use of rectal paracetemol for one service user. To review the systems for ensuring hot water DS0000061336.V325359.R01.S.doc Version 5.2 Page 23 temperatures and the surface temperatures of radiators remain safe. DS0000061336.V325359.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. 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