Inspection on 20/06/07 for 60 Langley Road

This inspection was carried out on 20th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

60 Langley Road 12/12/05

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 Yvonne Souden Unannounced Inspection 20th June 2007 13:30 60 Langley Road DS0000011275.V339389.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 60 Langley Road DS0000011275.V339389.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. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 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 www.milburycare.com Milbury Care Services Limited Ms Iona Campbell Care Home 5 Category(ies) of Learning disability (0), Learning disability over registration, with number 65 years of age (0) of places 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 categories: Learning Disabilities (LD) 2. Learning Disabilities, over 65 years of age, (LD (E)) The maximum number of service users to be accommodated is 5. Date of last inspection 12th December 2005 Brief Description of the Service: 60 Langley Road is owned by Milbury Care Services and provides twenty-four hour care and accommodation for up to five people with learning disabilities. The home is a detached house with five single bedrooms, a lounge, kitchen/dining room, staff office/sleep in room, one bathroom and cloakroom. There is a car park to the front of the house and an enclosed rear garden. Staff are able to escort service users to appointments and activities within the community using the homes minibus. Public transport is accessible from the home. 60 Langley Road has a Statement of Purpose and Service Users Guide available on application to the home. Milbury Care Services website address is www.milburycare.com the home does not have an email address. Information CSCI received 20/06/07 confirms that weekly fees start from £1200 to £1588.19 with additional charges for Hairdressing, Podiatrist, Toiletries and Aromatherapist. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is a report for the key inspection, which included a routine unannounced site visit. Information gathered to support this report was gained over two days that included the site visit. The inspector looked at documentation received from the home, inspection records and returned CSCI surveys, ‘Have Your Say About 60 Langley Road’. The site visit enabled the inspector to observe care practice within the home, hear the views of the service from staff and management and view further documentation and residents care plans. From the evidence seen by the Inspector and comments received, the Inspector considers that the service would be able to provide a service to meet the needs of individuals of various religion, race, or culture. The home follows the organisation’s policy and guidelines to manage issues relating to equality and diversity. What the service does well: What has improved since the last inspection? Redecoration within most areas of the home has improved the environment for the residents and management and staff are in the process of developing picture formats of communication to promote the residents’ choice and independence. The home has a full complement of permanent staff. 60 Langley Road DS0000011275.V339389.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. 60 Langley Road DS0000011275.V339389.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 60 Langley Road DS0000011275.V339389.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): 1 and 2. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The Service Users Guide does not ensure service users are informed. Service users needs are assessed prior to admission and are reviewed regularly following admission so that staff know they can meet their needs. EVIDENCE: The home has a Statement of Purpose and Service Users Guide that have been brought up to date to reflect management and staff change. The Service Users Guide has not been developed to a format that would enable prospective service users to have an understanding of what the service has to offer. The manager spoke of developing a user-friendly Service User Guide that can be sent to the prospective service user or their representative on application. Although there have been no admissions of service users since the last CSCI inspection in 2005, discussions with management and documentation within the homes diary identified that the admission process of a prospective service user had begun with arrangements made for the service user to visit the home. It was clear from discussions with management and records viewed that the assessment process of the service users needs is ongoing. As quoted by a care manager within a CSCI survey I had three clients at 60 Langley Rd, their needs were assessed in a person centred manner. 60 Langley Road DS0000011275.V339389.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 and 9. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans are clearly written and promote the service users decision-making, independence and choice. Staff support service users to live their lives as detailed within the service user’s plan of care. EVIDENCE: Care plans identify the service users needs and associated risks, and have an action plan that details how the service user would want those needs to be met and risks minimised. It was clear from discussions with staff that they are aware of the diverse needs of the service users. Staff spoke of key worker roles and monthly evaluation records that they complete to reassess the service users needs. Care plans are supported by health and social care professionals’ recommendations, and records identify that multi-agency reviews take place. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to be as independent as possible, and are supported to access events within the local community, and maintain links with family and friends. Service users enjoy a healthy diet. EVIDENCE: On the day of the site visit a service user indicated that he was looking forward to going out that afternoon in the home’s minibus; staff confirmed that all staff and service users were planning to go out in the community that afternoon. Care plans and observation of staff and service user interaction identify that staff assist service users to be as independent as possible. Staff spoke of ways in which they promote service users choice as quoted we always ask what they want to wear, choice of food etc and whether they want to go out. Activity plans indicate that service users take part in various activities within the home and within the community for example arts and crafts, swimming and trips to shops, pubs and parks. CSCI returned relative/representative 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 11 surveys indicate that the home helps the service users to keep in touch with family and friends. Picture formatted menus and activity programs have been developed to promote service users choice, and discussions with management and records viewed identified that the home is proactive in developing picture formatted documents to assist service users with decision making in their lives for example: choosing weekly groceries and menu planning. The home has a four week menu plan that appeared to be nutritionally balanced with fresh fruit, vegetables and salad evidently used. The inspector observed service users enjoying lunch within an unhurried and comfortable surrounding. Discussions with staff and observations identified that some service users have limited or no verbal communication skills, and that staff are able to communicate with the service users mostly from body language; service users were observed to understand what staff were saying to them, and able to make gestures in response, that was understood by staff. Management confirmed that service users have been assessed by speech therapists and that the current service users do not use specialist communication methods. The manager confirmed that Milbury Care Services would send staff on specialist training for example MAKATON should this be a communication need of future service users. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users preferences are taken into account in the delivery of their care, and staff assist service users to access health care services. Staff are trained in the administration of service users medication. EVIDENCE: Care routines continue to be well documented and give detailed information about how to meet the service users needs that reflects service users choice and preferences. Ceiling hoists have been fitted to the bathroom and service users bedrooms to meet the service users changing needs. Records identify that multi-agency reviews take place. CSCI G.P comment cards indicate that the home communicates clearly and works in partnership with them and that staff demonstrate a clear understanding of the care needs of service users. One comment stated that there is not always a senior member of staff to confer with. 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, and on the day of the inspection the inspector observed that a service user was escorted to a hospital appointment. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 13 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 administer medication, and stock in place matched records kept. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 14 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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are protected from abuse by the home’s adult protection policy and procedures in place. The home has a complaints procedure that is made available to service users and their representatives. EVIDENCE: The home immediately followed adult protection policies and procedures when an allegation of abuse was made, and records identified that a multi agency strategy meeting was held to safeguard the service users. The home reports that five incidences of restraint have been used since the last inspection in 2005. Discussions with staff identified that they are fully aware of adult protection policies and procedures that includes the home’s whistle blowing procedure. Training records and discussions with staff identify that staff have attended safeguarding adults training, non-violent crisis intervention and behaviour awareness training. No complainant has contacted the commission with information concerning a complaint made to the service since the last inspection. Service users relatives and health and social care professionals indicate within CSCI surveys that information on how to make a complaint about the care provided within the home is made available to them. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 15 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. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is clean comfortable and hygienic but this could be jeopardised by poor infection control measures within the home’s laundry. EVIDENCE: 60 Langley Road is a five bedroomed bungalow within a residential area of Slough near to the town centre. There are three attic rooms; one is used as a service user’s bedroom, one as the staff office/sleep-in room and the third as the home’s laundry. On the day the site visit the home was observed to be clean, fresh and comfortably furnished. Service users bedrooms were personalised, as far as the service users could tolerate, and adaptations have been added to the home to meet the changing needs of a service user. Maintenance of the home is managed as reported by the home to Milbury Care Services and the home’s last manufacturers fire equipment check was 02/10/06. Fire safety checks are completed weekly. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 16 The home has a contract with a company for the disposal of soiled waste and staff use protective clothing to promote infection control. Since the last inspection several improvements have been made as listed, new electronic bath, redecoration of the bedrooms, hallway and dinning room, a kitchen refit and the purchase of a washing machine and dryer. The inspector observed that the laundry was narrow and situated within the eaves of the building that could be restrictive for staff whilst carrying out laundry tasks. It was also observed that the walls within the laundry were not sealed and could harbour bacteria. There was no wash hand basin for staff to wash their hands following handling contaminated laundry and protective clothing was not available within the laundry. The manager informed the inspector that the original wash hand basin had been removed to accommodate the new washing machine and dryer. The home must ensure equipment/facilities are available to enable staff to promote infection control and should complete a risk assessment of the home’s laundry to promote staff safety within the home. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s recruitment policy, and have their needs met by a trained and competent staff team. EVIDENCE: Observation of staff identified patience and understanding of the individual service users needs, and discussions with staff identified a caring staff team who were knowledgeable of the diverse needs of the service users. Recruitment of four new staff has taken place since the last inspection and staff appeared sufficient in numbers on the day of the site visit to meet the needs of the service users. The home has an equal opportunity policy to promote equality and diversity. Separate interviews of three new staff confirmed that the process of recruitment followed was as detailed within the home’s recruitment policy and procedure and Schedule 2 of the Care Homes Regulations. Staff records are held within a Milbury Care Services head office and were not viewed on the day of the inspection. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 18 Staff spoke of their induction and of training received since commencement of their employment and training records confirmed that staff have attended mandatory and specialist training. 20 of care staff have an NVQ 2 and 50 have applied to commence a National Vocational Qualification in care. 60 Langley Road DS0000011275.V339389.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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager follows clear corporate policies and procedures within the management of the home, and is supportive of the staff team to ensure the diverse needs of the service users are met. The home seeks the view of service users and their representatives to develop the service. EVIDENCE: The home has quality assurance systems in place that monitors health and safety and care practice. Surveys are sent to health and social care professionals, service users and their representatives to seek their views of how well the service is managed. Senior management within Milbury Care Service undertake a monthly Regulation 26-audit inspection of the home reporting their findings to the registered manager and CSCI. Staff are confident in the management team and feel supported to do their work well. 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 20 The manager is new in post 16/04/07 and has the qualifications and skill to manage the care home. The registered manager also manages another Milbury service that is in close proximity to Langley Road. 60 Langley Road DS0000011275.V339389.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 2 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 4 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 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 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X X 3 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 YA30 Regulation 13. (3) Timescale for action The home must forward a plan of 20/07/07 action to CSCI detailing how they propose to promote infection control within the home’s laundry. The plan must detail 1. The immediate aims of the home to provide hand washing facilities and protective clothing for staff to use within the home’s laundry so that staff and service users are protected against infection. 2. The aims of the home to ensure the walls within the laundry are not porous and therefore promote infection control. Requirement 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 23 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 YA1 YA24 Good Practice Recommendations The home should develop a Service Users Guide within a format that is suitable for the people who use the service. The home should carry out a risk assessment/moving and handling assessment of staff working within the home’s laundry, as staff movement was observed to be restrictive due to the narrowness of the room and slant of the wall due to its position within the eaves of the building. 60 Langley Road DS0000011275.V339389.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 60 Langley Road DS0000011275.V339389.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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