Inspection on 22/01/09 for 6 Sadlers Lane

This inspection was carried out on 22nd January 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.

Other inspections for this house

6 Sadlers Lane 31/01/07

6 Sadlers Lane 31/01/06

6 Sadlers Lane 16/08/05

6 Sadlers Lane 04/11/04

6 Sadlers Lane 27/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 6 Sadlers Lane Winnersh Wokingham Berkshire RG41 5AJ     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: Julie Willis     Date: 2 2 0 1 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 25 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 25 Information about the care home Name of care home: Address: 6 Sadlers Lane Winnersh Wokingham Berkshire RG41 5AJ 01189893210 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): matt.hull@dimensions-uk.org Dimension (NSO) Ltd The registered provider is responsible for running the service Name of registered manager (if applicable): Name of registered manager (if applicable) Mrs Carole Anne Jeffery Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category 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 category: Learning disability - LD Date of last inspection Brief description of the care home 6 Sadlers Lane is a care home providing 24 hour personal care to four adults who have learning disability. The current service users are all male and have some additional challenging behaviour. The house is owned and maintained by Windsor Housing association and Dimensions provide the management and care staff. The home is a domestic sized, bungalow situated in a residential part of Wokingham. Each service user has an individual bedroom, one service user has an ensuite bathroom. The garden Care Homes for Adults (18-65 years) Page 4 of 25 4 Over 65 0 care home 4 Brief description of the care home is easy to access. Shops and local facilities are found in the centre of town, the home has its own transport and access to public transport. The current weekly fees are 1237 to 1450 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 25 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 unannounced inspection took place on the Friday 23rd January over the course of five and a half hours. The inspection took into account detailed information provided by the homes Manager and any information that CSCI has received about the service since the last inspection which took place on 31st January 2008. Prior to the visit a questionnaire was sent to the Manager along with survey and comment cards for residents, staff and visiting professionals. Replies were used to help form judgments about the service. The inspector looked at how well the service was meeting the standards set by by the Government and has in this report made judgments about the quality of the service. Care Homes for Adults (18-65 years) Page 6 of 25 The inspector toured the building, examined records and met all of the residents before they left for their day services and various activities. The inspector also spent time talking informally to staff and observing how care was being delivered to residents. From the evidence seen and comments received it is evident that this service has a good awareness and understanding of equality and diversity issues and would be able to provide positive outcomes for residents in the areas of race, ethnicity, age, gender, sexuality, disability and belief. Feedback was provided to the Manager at the end of inspection. There were no legal requirements and only one recommendation made as a result of this inspection. The Commission has received no information about complaints about this service since the last inspection. 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 8 of 25 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 9 of 25 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. All residents are fully assessed by a multi-disciplinary team of professionals before being admitted to the home to ensure that the home will be able to effectively meet their need. Evidence: There have been no new admissions to the home since 2007. It is evident however, that the admission process is handled well. The most recent admissions transition was handled with care and sensitivity. From the files it is clear that there was a full needs assessment carried out by the home which involved gaining information from a multidisciplinary team of professionals. There was a gradual introduction to the staff initially followed by short visits to the home. The whole transition process was safe and effective. Information gathered formed the basis of the care plan which was reviewed at frequent intervals following admission to ensure the resident had settled. Care Homes for Adults (18-65 years) Page 10 of 25 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. Care is provided flexibly and residents are supported to make choices and decisions in relation to everyday life. Evidence: Examination of two residents files evidenced that they were up-to-date and well documented. The care plans were comprehensive and holistic in detail and provided sufficient information for staff to provide the right care. Every one at the home has a PCP (person centred plan) which is entirely focused on the needs wishes and aspirations of the resident. Residents are involved with their production and review. The residents also have a personal file which contains relevant information including a life history, communication profile, support plans, guidelines and action plans, risk assessments and a vulnerability analysis, review notes and review summarys. The file also contains a community care assessment, activity time tables, My health booklet, medication, weight charts and financial details. All of the documentation was up-todate and accurately documented however, there is a need to ensure that some of the Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: information is tidied and typed rather than being hand written and crossed out. The Manager agreed to do this following the inspection. There was evidence during inspection that residents are supported to participate in the activities of daily living within the limits of their capabilities. Examination of care records and risk assessments evidenced that adequate support is provided whilst involving residents in tasks that could pose a risk to their safety. Care Homes for Adults (18-65 years) Page 12 of 25 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 take part in wide range of activities and leisure pursuits that provide opportunities for personal development and growth. Residents are encouraged to maintain and develop social contacts with family and friends as part of everyday community living. Evidence: Examination of the care files and activity schedules for residents evidenced that residents are provided with a range of stimulating activities which encourage independence and the acquisition of life skills. Residents are involved with the shopping, cooking, cleaning and laundry activities in the home and this is a well documented part of the individual care plan. All residents are provided with day services as part of their activity programme. One of the residents that was being case Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: tracked went to work at growing places each Monday as they were keen on horticulture and to Conservation group on Wednesdays. Another resident attended college where he participated in communication skills training and was about to embark on a full time course at Newbury College. Community use is promoted and residents are frequent visitors to the local shops, sports facilities, cinemas, pubs and restaurants. Transportation to activities is either by the house vehicle or by public transport. All residents are encouraged to take an annual holiday. One resident went to Norfolk where they stayed in a cottage another went to Butlins at Minehead. One of the residents chooses not to have a holiday but is encouraged to participate in a number of day trips out. All residents are encouraged to maintain their relationships with family and friends. There was evidence that one resident regularly stays with their mother at weekends. Several of the current residents have advocates provided by Webcas advocacy group. The menu at the home offers residents choice and variety. Meals are generally healthy and well balanced and meet the cultural needs of the residents. Care Homes for Adults (18-65 years) Page 14 of 25 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 physical and personal support needs are well met and medication is dealt with safely. Evidence: From examination of care records it is evident that residents physical and personal are needs are well met by the home. Care provided is documented in the daily diaries and it is clear that the records appropriately validated the content of care plans. Observation of staff and resident interaction demonstrated that care was provided in a manner which maintained residents right to dignity, privacy, independence and choice. Regular appointments take place with health professionals and there was evidence that appropriate referrals are made to occupational therapists, speech and language therapists, psychiatrists and psychologists as required. The outcome of appointments is recorded in health care charts and daily diaries. All residents have a My health booklet and action plan. The system used at this home for the safe administration of medicines is the Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: monitored dosage system. This reduces the likelihood of medication error and provides accurate records. Two staff administer medication together to ensure that it is correct. All staff are trained and assessed as safe before administering medication to residents. Care Homes for Adults (18-65 years) Page 16 of 25 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. The complaints procedure is robust and accessible to residents. Residents are protected from abuse and exploitation by the homes policies and procedures. Evidence: From examination of the complaints records it is clear that complaints are dealt with swiftly and efficiently. Only one complaint from residents or relatives has been bought to the attention of the Commission in the past year. This was referred back to the home who have taken action to put matters right. There were two complaints recorded in the homes complaint log. Both have been dealt with to the satisfaction of the complainant and were well recorded. All staff receive training in safeguarding adults as part of their induction and again when undertaking National Vocational Qualifications. The management have completed a vulnerability analysis on each resident that identifies the specific risk factors for individuals and puts in place guidelines to prevent abuse and exploitation. Care Homes for Adults (18-65 years) Page 17 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a need to improve the environment for residents by carrying out some maintenance and refurbishment works. Evidence: Since the last inspection there have been several improvements to the environment. The driveway has been resurfaced and is easily accessible and safe for residents and visitors to the home. The home currently has only three residents. The fourth bedroom has been converted into a sleep-in room for staff which provides them with more privacy. There is however, a need to replace double glazed units that have become fogged as this inhibits the view for residents. All of the aluminium windows need to be replaced as they let in cold air and drafts. There are mold marks on the wall in the lounge and mold on the curtains where the damp has penetrated. Care Homes for Adults (18-65 years) Page 18 of 25 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. The residents benefit from being cared for by properly recruited and well trained staff in sufficient numbers to effectively meet their need. Evidence: Staff individually and collectively were able to demonstrate that they have the necessary skills and experience to meet the needs of residents in their care. Observation of care practice concluded that staff on duty had a good understanding of the individual needs of residents. Their approach to managing care needs was consistent and based on establishing good practice. Staff enabled residents to enhance their skills and maximise their independence and quality of life. Staffing levels were adequate and flexibly deployed to meet the needs of residents accommodated. The home has recruited to all of its vacant posts and there is no dependence on agency workers to cover gaps in the roster. Examination of the staff training files for two staff indicated that staff are appropriately inducted and trained. Newly appointed staff undertake Skills for Care common induction standards. They do a four day Approach training which is mandatory for all new Dimensions staff and includes the philosophy and ethos of the Organisation and provides core skill training for the staff. This core skills training is then refreshed and Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: up-dated at frequent intervals. Staff are offered the opportunity to further enhance their skills and knowledge by attaining qualifications in care. Most staff have either achieved or are undertaking National Vocational Qualifications at levels 2 and 3. Care Homes for Adults (18-65 years) Page 20 of 25 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. Resident benefit from living in a well managed home where their health and safety are considered of prime importance. Evidence: The Manager - Matt Hull has completed a Management training course and is commencing an NVQ level 4 in care. Matt is widely experienced and is well liked and respected by the staff. The home is visited monthly by the Service Manager who carries out the Regulation 26 visits on behalf of Dimensions. The Organisation also carries out regular audits of the health and safety policies and procedures for the home. Quality assurance surveys are distributed to relatives and residents at regular intervals. The responses are collated at Head Office and a report is drawn up with an action plan for the Manager. Dimensions also carry out a staff survey which has shown demonstrable improvement in recent months. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: A number of the health and safety records were sampled including fire and hot water records. These checks evidenced that essential servicing and maintenance of equipment is undertaken routinely to safeguard the health, safety and welfare of residents. Servicing and safety certificates were on file. Unnecessary risks to residents are identified using comprehensive risk assessments that are reviewed at regular intervals. So far as possible risks to residents are reduced or eliminated. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 26 Essential maintenance should be carried out to the building to enhance the comfort of residents. Windows should be replaced where fogged. Aluminum windows should be replaced. Mold marks on walls should be removed Curtains should be replaced where they have been affected by damp Care Homes for Adults (18-65 years) Page 24 of 25 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. 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