Inspection on 12/12/05 for 60 Langley Road

This inspection was carried out on 12th December 2005.

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

60 Langley Road 20/06/07

60 Langley Road 26/07/05

60 Langley Road 11/01/05

60 Langley Road 24/08/04

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

CARE HOME ADULTS 18-65 60 Langley Road Slough Berkshire SL3 7AY Lead Inspector Jill Chapman Unannounced Inspection 12th December 2005 13.30p DS0000011275.V263738.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000011275.V263738.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000011275.V263738.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 60 Langley Road Address Slough Berkshire SL3 7AY 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) 01753 536935 01753 536935 Milbury Care Services Limited Mr Donald McLeod Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places DS0000011275.V263738.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users may not be admitted over the age of 65 years. Date of last inspection 26th July 2005 Brief Description of the Service: 60 Langley Road is a detached house situated in a residential area of Slough. The home is near to local transport and facilities and the Town centre of Slough. There are five single bedrooms, a lounge, kitchen/dining room, staff office/sleep in room and bathroom/toilet facilities. There is a car park to the front of the house and an enclosed rear garden. The home provides twenty-four hour care for up to five people with learning disabilities. The staff team are a Manager, Deputy Manager, Senior Support Worker and Support Workers. Service users are supported to take part in formal day care programmes and leisure activities in the community. An adapted vehicle is available to take residents out. DS0000011275.V263738.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection carried out on a weekday afternoon over a two and a half hour period. The focus of the visit was to inspect key standard not covered at the last visit. One service user was at home when the inspection started and later went out with day services for the afternoon. The other four service users were out with staff Christmas shopping in Reading for the day and had not returned when the inspection ended. The Manager and Senior Support Worker were on duty and gave information about service users care and well being. Records were sampled and time was spent discussing practice in relation to the standards inspected. There were no requirements or recommendations from the last inspection. What the service does well: The home makes sure that it only admits service users whose needs they can meet. There are clear care plans to help staff know how to meet needs. Risk assessments help staff keep service users safe. Staff only restrict choice or freedom to protect service users. Staff help residents to become more independent and take their place in the community. Personal care is given taking service users preferences into account. Staff help service users access healthcare and look after their medication well. The home is well cared for, clean and improvements have been made. There are enough staff on duty to meet service users needs and enable community access. The home is well managed by the management team, with clear systems for staff to follow. Service users views can help develop the service. DS0000011275.V263738.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000011275.V263738.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000011275.V263738.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users needs are assessed prior to admission so that staff know they can meet their needs. EVIDENCE: The admissions process for a relatively new service user was seen. An assessment of need included a Milbury Living Skills Assessment, an Adaptive Behaviour Scale and relevant personal information so that the home would know they could meet his needs. In discussion and by looking at records it was clear that the assessment process is ongoing as the service users needs change. A behaviour specialist and a psychiatrist have been contacted for specialist advice. A six week assessment period is followed by a review to decide whether the placement is suitable to meet the service users needs. DS0000011275.V263738.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 Care plans show staff how to meet service users needs. Risk assessments show staff how to keep them safe. Any restrictions on freedom or choice due to safety reasons are supported by care plans or risk assessments. EVIDENCE: The Deputy and Senior Support Worker have developed new care plans recently and these were sampled. These are clearly written and show how identified needs can be met. There is an evaluation sheet, which is completed, monthly to make sure that these are up to date. Staff sign that they have read and understood the care plans. A photograph attached to the care plan file makes sure temporary staff know whom the care plans are for. Staff spoke about the changing needs of service users and these were reflected in the care plans. Care plans and risk assessments are in place to support practice, which could be viewed as restrictive, or to limit choice. Service users risk assessments were sampled and these also have recently been rewritten. These give good information to show staff how to reduce risks. DS0000011275.V263738.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 & 16 Staff help service users lead a fulfilling life by supporting them to access day services and other activities. Staff help residents to become more independent and take their place in the community. EVIDENCE: Discussion with managers and care plans seen show that staff help service users to be as independent as possible. Although they are not able to take up employment opportunities they are encouraged to take part in the routine jobs in the home. This is an area staff are developing and the need for more day services is being raised at Annual Reviews. One service user has music lessons and others enjoy personal shopping and swimming. Staff support service users to claim the right benefits. On the inspection day four residents and staff were shopping in Reading for some of the Christmas food and other items. Care plans seen and discussion with staff show that staff are expected to treat service users with respect and preserve their privacy and dignity. Service users could have a key to their bedroom but if this is not safe there are risk DS0000011275.V263738.R01.S.doc Version 5.0 Page 11 assessments in place to show why not. Staff confirmed that relatives are consulted on this issue and advice was given for this to be added to the risk assessment. Staff help service users to register on the Electoral Roll. There is a procedure for helping service users deal with their mail. DS0000011275.V263738.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Care is given taking service users preferences into account. Staff help service users access the health care they need. Medication is stored securely and staff are trained to give this safely. EVIDENCE: Care routines are well documented and give detailed information about how to meet needs. These reflect service users choice and preferences. Ceiling hoists have been fitted to a bedroom and bathroom to help staff assist a service user with mobility needs. Care plans are in place for the use of montoring devices and cot sides. Health care needs are highlighted in care plans and there are monitoring charts for some health care needs. Records show that staff support service users to attend health appointments. The arrangements for medication were seen. This is stored securely and a monitored dosage system is used. Staff are trained before they are able to give out medication. There is a stock control system in place. One PRN medication has never been needed and the manager said he would review this with the Consultant. DS0000011275.V263738.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected on this visit. EVIDENCE: DS0000011275.V263738.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 There is an ongoing programme of redecoration and renewal to keep the premises in good condition for the service users. The home is kept clean and hygienic to help prevent infection. EVIDENCE: Standard 24 was not fully inspected on this visit but some improvements have been carried out since the last inspection. New lounge furniture has been delivered. The kitchen, lounge and bathroom have been redecorated. The home was found to be clean and fresh smelling. There is an infection control policy in place and managers are aware of what precautions are needed to prevent infection. Managers are aware of how to contact the Infection control Nurse. The home has a contract for the safe disposal of incontinence waste. DS0000011275.V263738.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 Although there are staff vacancies there are enough staff on duty to meet service users needs and enable community access. EVIDENCE: There are three staff vacancies and the manager is trying to recruit new staff. Bank staff cover vacant shifts. A new Deputy has been appointed since the last inspection. There are enough staff on shift to enable access to community resources. DS0000011275.V263738.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 The home is well managed by the management team, with clear systems for staff to follow. The organisation seeks the views of service users to help develop the service. EVIDENCE: From looking at systems and discussion with staff there is evidence that the home is well run. Records are clear and appropriate. The manager is in the process of taking NVQ level 4 / Registered Managers Award. The manager is also responsible for developing Milbury Day Services in Slough. New premises have meant that this service can be further developed. The manager said that the Deputy Manager and Senior Support Worker work well together. There is a Quality Assurance System in place. There is an annual QA audit, which includes seeking the views of service users and their families. In house service users are invited to attend staff meetings. DS0000011275.V263738.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 X X X x DS0000011275.V263738.R01.S.doc Version 5.0 Page 18 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. Refer to Standard Good Practice Recommendations DS0000011275.V263738.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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