Inspection on 31/01/07 for 6 Sadlers Lane

This inspection was carried out on 31st 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

6 Sadlers Lane 22/01/09

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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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

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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 6 Sadlers Lane Winnersh Wokingham Berkshire RG41 5AJ Lead Inspector Jill Chapman Unannounced Inspection 31 January 2007 10:00 DS0000051746.V328566.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 DS0000051746.V328566.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. DS0000051746.V328566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 6 Sadlers Lane Address Winnersh Wokingham Berkshire RG41 5AJ 0118 989 3210 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) www.new-support.org.uk New Support Options Limited Mrs Carole Anne Jeffery Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000051746.V328566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: 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 Maidenhead and District Housing association and New Support options 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 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 for the home were not available but service users weekly contributions are £65.35. DS0000051746.V328566.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 10:10am and was in the service for 3 hours and 20 minutes. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector spoke to two staff on duty and to the homes manager, who was off duty, by telephone. Care and health and safety records were sampled and a tour of the building was carried out. The two service users were out during the morning but one returned in time for staff to help him talk to the inspector about life in the home. What the service does well: The home does not admit service users unless they know they can meet their needs. The home would look at whether they could meet special cultural or religious needs. Support Guidelines help staff identify and meet service users needs. Written risk assessments help staff know how to keep service users safe. Staff help service users to access community activities and to lead a fulfilling lifestyle. They help them keep in touch with family and friends. Service users have a choice of nourishing meals to help them keep healthy. Service users receive personal care in the way they prefer. Their health needs are identofied and met. Staff support service users to take their medication safely. Staff in the home know how to help service users make complaints. Staff are trained to protect service users from potential abuse. Service users know that their money is kept safe. Service users benefit from a clean and well cared for home. DS0000051746.V328566.R01.S.doc Version 5.2 Page 6 Service users benefit from enough trained staff on duty to meet their current needs. The home is well managed by a qualified manager. The home seeks service users views to help develop the service. Regular health and safety checks and servicing of equipment helps keep service users safe. 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. The summary of this inspection report can be made available in other formats on request. DS0000051746.V328566.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 DS0000051746.V328566.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. This judgement has been made using available evidence including a visit to this service. The home does not admit service users unless they know they can meet their needs. The home would look at whether they could meet special cultural or religious needs. EVIDENCE: The organisation has an admissions procedure and this includes carrying out a full assessment of need prior to admission. An assessment was seen on a file sampled. Two service users were admitted in an emergency while their home was closed for temporarily. Admissions assessments were not carried out in this instamce because their records and staff to support them came with them for the duration of their stay. Staff spoken with were aware of the admissions procedure. The process includes looking at whether any specific cultural or religious needs. DS0000051746.V328566.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support Guidelines help staff identify and meet service users needs. Written risk assessments help staff know how to keep service users safe. EVIDENCE: There are day to support guidelines in place to cover a variety of needs. Most of these were at home with the manager who is updating them but she sent some over to verify their content. Daily diaries show that care plans are carried out. There are written reviews on file that show that service users, their relatives and other professional are able to contribute to planning their care. There are no special religious or ethnic needs in the current service user group but it was clear from discussion with staff that these could be met if needed. DS0000051746.V328566.R01.S.doc Version 5.2 Page 10 Support Guidelines show that service users preferences are taken into account. Staff said that if choice has to be overridden to keep service users safe and this decision is documented. In discussion with staff it was clear that written risk assessments are in place for both service users. These could not be seen however because they were at home with the manager who confirmed she is updating them. DS0000051746.V328566.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, 14, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff help service users to access community activities and to lead a fulfilling lifestyle. They help them keep in touch with family and friends. Service users have a choice of nourishing meals to help them keep healthy. EVIDENCE: Both service users have formal day services provided by the Community Action Team. Staff helped one service user tell how he enjoys Ten Pin bowling and the Art and Creativity group. Staff have supported service users to join community groups such as Keep Mobile, and a service user talked about the Friday Night Project where he likes dancing. DS0000051746.V328566.R01.S.doc Version 5.2 Page 12 Staff have supported service users to have long weekends away and day trips to the London Eye, China Town, a Thames Cruise and a visit to a Vineyard. One service user showed photos of his Christmas holiday. There is documented evidence of important family and other contacts and staff said they help service users keep in touch by telephone, visits, postcards, gifts and Birthday and Christmas cards. Staff have supported one service user to have a long weekend away visiting his mother. It was clear from support plans, reviews and diaries that service users are involved in their daily routines. One service user said he likes to help cut the grass in the summer. Staff told how they respect service users privacy and there are suitable locks on service users bedroom doors should they choose to use them. It was seen that service users can choose to be alone in their room or sit in the communal areas of the home. Menus show that a variety of nourishing meals are served and staff said that these are drawn up taking service users choice into account. There are no special dietry needs at present but staff said that these would be met if needed. A service user said that he likes to help with the food shopping. Staff on duty have up to date training in food hygiene. Records show that food and fridge/freezer temperatures are recorded daily to make sure they are at the correct temperatures. DS0000051746.V328566.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 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal care in the way they prefer. Their health needs are identofied and met. Staff support service users to take their medication safely. EVIDENCE: It was clear from records sampled that service users routines are flexible to their needs and enable personal choice. For example they have a choice of having a lay in and whether to eat communally or alone. Support plans seen show detailed information about how service users like to be helped with their personal care needs. There are good health care records in place showing health care needs and the outcomes of appointments with health professionals. There is an All about me form to be filled in if a service user needs to go into hospital giving information to nursing staff about communication needs, eating and drinking, personal care needs and likely visitors. DS0000051746.V328566.R01.S.doc Version 5.2 Page 14 There is a medication policy and procedure in place. Staff confirmed that they had been trained to give medication correctly and that this training is kept up to date. All medication is entered on the record and there is information kept on the file about service users medication. The storage of medication was satisfactory and any returns are recorded. One service user needs to take medication home when he visits his family and at present this is dispensed by staff into dosette boxes. It is recommended that arrangements are made to send his medication home in pharmacy labelled containers. DS0000051746.V328566.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 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff know how to help service users make complaints but need to know where the complaints record is kept. Staff are trained to protect service users from potential abuse. Service users know that their money is kept safe. EVIDENCE: No complaints from service users or their relatives have been brought to the attention of the Commission. There have been no complaints received by the home. Discussion with staff showed that they are aware of the complaints procedure and know what to do if they receive a complaint. The complaints record could not be found and its whereabouts needs to be made known to staff. The pre inspection checklist showed and staff confirmed that they have received Protection of Vulnerable Adults training. They said they were due to have refresher training soon. There is a system for the safekeeping of service users money and this was checked and found to be accuurate. DS0000051746.V328566.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clean and well cared for home and recent refurbishment has improved the environment for service users. EVIDENCE: A tour of the premises was undertaken and there have been some improvements since the last inspection. The shower tray in the communal bathroom has been mended. A requirement that an ensuite bathroom should remain for the sole use of the service user in the attached bedroom, has now been met. The kitchen units and worktops have been replaced and new flooring and a new cooker installed. The worktop has been damaged since installation buit this is due to be replaced again. New dining table and chairs have been purchased. Communal and a bedroom carpet are due to be replaced soon. DS0000051746.V328566.R01.S.doc Version 5.2 Page 17 A previous requirement to make the driveway safe has not yet been carried out but the manager said this is due to be carried out in April 2007. There are some outstanding maintenance issues, there is damp on a wall in the lounge, a shower riser is broken, the driveway drains keep blocking and some fence panels have fallen down in a recent storm. The manager said she is progressing these issues with the landlords. It was noted that there is no designated sleep in accomodation for staff and the currently staff sleep on a sofa bed in the service users lounge. The manager said that the current service users are happy with this arrangement and do not wish to access the lounge after 10pm. This arrangement should be kept under review if the needs and wishes of current or new service users change. The home is kept clean and hygenic. There are no special hygiene or infection needs at present. DS0000051746.V328566.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, 33, 34, & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from enough trained staff on duty to meet their current needs. EVIDENCE: There were two staff on duty at the time of the inspection and they were both familiar with the service users needs and the routine of the home. One has National Vocational Qualification level 2 and the other has level 2 & 3. There are only two service users currently living in the home. The staff team comprises of the manager, three full time and four part time support workers. Current staff deployment is one support worker per daytime shift and one sleep in staff at night. Staff said that these levels meet the needs of the two service users. On the inspection day there were two staff on shift to cover routine house jobs such as banking and food shopping. It was seen that some staff are working extra hours covering shifts at a group home nearby, running on to long shifts in the care home. The manager said DS0000051746.V328566.R01.S.doc Version 5.2 Page 19 this is a temporary situation and she is monitoring the situation to make sure it is safe for service users and staff. The organisation has a robust recruitment procedure in place. Staff working on the day had been transferred with the home from another employer however they were aware of the various stages of the recruitment policy. Recruitment records were not available on the inspection day because the manager was not on duty. Staff confirmed that they have recived induction and core training to the required standards. There is a system of updating core training and staff spoken to had been updated in First Aid in November 2006 and Manual handling updates are booked for February 2007. Staff have also received Mental Health Awareness training in November 2006. DS0000051746.V328566.R01.S.doc Version 5.2 Page 20 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 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by a qualified manager. The home seeks service users views to help develop the service. Regular health and safety checks and servicing of equipment helps keep service users safe. EVIDENCE: The manager is registered and has gained her NVQ level 4 qualification. The home seems well run and records and systems were up to date. Staff said there are regular staff meetings and one to one supervision to help develop practice. The registered manager said that she is leaving soon to take up employment nearer to her home. Advice was given that the registered persons should DS0000051746.V328566.R01.S.doc Version 5.2 Page 21 notify the commission of interim management arrangements until a new manager is appointed. The company is good at seeking the views of service users and others to help develop the service. Regular service user meetings, annual individual and service reviews, questionnaires and user groups are held. There were two requirements regarding fire safety from the previous inspection and these have both been carried out. Records show that a Fire Risk assessment is now in place and Fire Safety training for staff has been carried out. Health and safety records were sampled and were up to date. The pre-inspection checklist shows that equipment is routinely serviced. DS0000051746.V328566.R01.S.doc Version 5.2 Page 22 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 3 X X 3 X DS0000051746.V328566.R01.S.doc Version 5.2 Page 23 YES 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 YA24 Regulation 23 Requirement That the driveway be made safe. THIS IS A REPEATED REQUIREMNT Timescale for action 30/04/07 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 Refer to Standard YA20 YA24 Good Practice Recommendations That arrangements are made to send service users medication home in pharmacy labelled containers The current arrangement of staff sleeping in the service users lounge should be kept under review if the needs and wishes of current or new service users change. 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