Inspection on 24/01/06 for 60 Wood Lane

This inspection was carried out on 24th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

60 Wood Lane 19/08/08

60 Wood Lane 22/06/07

60 Wood Lane 03/05/06

60 Wood Lane 01/07/05

60 Wood Lane 04/01/05

60 Wood Lane 13/07/04

60 Wood Lane 14/01/04

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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 60 Wood Lane Sonning Common Oxfordshire RG4 9SL Lead Inspector Lilian Mackay Unannounced Inspection 24th January 2006 05:25 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 60 Wood Lane Address Sonning Common Oxfordshire RG4 9SL 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) 01189 722080 New Support Options Limited Mrs Jennifer Pearce Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of persons that may be accommodated at any one time must not exceed 3 1st July 2005 Date of last inspection Brief Description of the Service: 60 Wood Lane is a three-bedroomed house situated in a quiet residential area of Sonning Common, close to shops and other amenities. It provides residential care for up to three adults with a learning disability, either under or over 65 years of age. All those being supported are admitted on a permanent basis. The physical dependency of those being supported is increasing as they become older and consideration was being given at this time as to how these needs could be met in the future, possibly through building an additional two ground floor rooms. Social and Community Services purchase all the places in the home. The home is owned and managed by New Support Options Ltd, a charitable organisation with experience of providing residential, supported living and outreach services for adults with a learning disability. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place between 5.25pm and 8.25pm on a weekday. The purpose of this visit was to see how the home is meeting the National Minimum Standards for Care Homes for Younger Adults. The inspector spoke at length with the two women and the man being supported at this time and the one member of staff on duty. The inspector examined the staff rota, the personal care plan [PCP] of one of those being supported, the complaints file, a safety report on the gas fire and monthly management reports [Regulation 26 visits]. The home has an informal, relaxed and domestic atmosphere and whilst those being supported socialise with each other they also enjoy spending time in their rooms doing activities of their choice. The inspector observed kind, caring and supportive interactions between the staff member and those being supported and they appeared to be comfortable and relaxed with each other. No feedback was forthcoming from GPs and social and health care professionals who visit the home. None of those being supported have a named care manager and the home uses the “on call” duty officer for the care management team of the Learning Disability Team [South]. The inspector would like to thank those being supported and the staff member on duty at this time for their assistance, hospitality and courtesy during this inspection. What the service does well: The key working system ensures that responsibility for individual care needs lies with an identified member of staff. The home has a people carrier for transporting those being supported to activities in the community. Twice yearly management audits are carried out. The home provides continuity for those it supports. There is good teamwork and communication amongst staff. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 The needs and aspirations of those being supported have been assessed and these are documented in personal care plans. [PCPs]. EVIDENCE: The inspector confirmed the accuracy of one personal care plan with one person being supported at this time. This identifies what the person being supported can do independently and those tasks she needs assistance with. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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): 6,7,9. The personal care plans of those being supported are drawn up and reviewed regularly to meet their developing needs. Those being supported are encouraged to make their own decisions. A system is in place for supporting those being supported in taking risks. EVIDENCE: Staff receive training in Planning Alternative Tomorrows with Hope [PATH] which trains them to identify and meet the dreams, hopes and aspirations of those being supported. Each person being supported has a named keyworker who has responsibility for ensuring that their needs, as outlined in their personal care plans, are met. Those being supported sign to confirm they have received a copy of their personal care plan. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 10 Those being supported chose the colour of the new carpets for their bedrooms and the landing. Those being supported assist in drawing up their person-centred care plans with staff and attend regular house meetings to discuss any issues arising. Those being supported are assisted in completing the “Are You Getting A Good Service” workbook prior to reviews of their care. Risk assessments are in place and these are regularly reviewed. Behavioural guidelines are drawn up for individuals as required. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Those being supported participate in a range of appropriate leisure activities. Those being supported are part of the local community. Those being supported are encouraged to maintain links with family members and friends. Those being supported have regular house meetings where they can discuss concerns. The individual needs and choices regarding food and mealtimes of those being supported are identified and respected. EVIDENCE: Those being supported have regular holidays. At home they participate in a range of activities such as watching TV and videos, listening to music, having manicures and pedicures, cooking, doing domestic chores, typing, pottery and gardening. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 12 Those being supported participate in a range of activities within the community such as attending Donkin Hill Day Centre, going bowling, attending a club in Henley, attending church, going to discos and parties, dancing, doing drama, singing, going to cafes, shopping, going for walks and trips into town, visiting family and friends and attending jumble sales and fetes. One resident works full-time on a nearby farm and has done so for a number of years. The home has a people-carrier and drivers to take those being supported out to activities in the community. The important relationships of those being supported are identified in their personal care plans. Evidence was seen that these relationships are encouraged and supported. One person being supported sees her brother and all three of those being supported have lived together for a good number of years. Two already knew each other before coming to live at the home. Those being supported are given a Service User Guide in a format they can understand, which outlines their responsibilities. All those being supported are expected to attend house meetings to discuss any issues arising. Those being supported confirmed that their privacy is respected and evidence was seen in personal care plans of this. Dietary guidelines are drawn up when required. Those being supported confirmed that they enjoy the food they are given. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Personal care plans have been developed to identify the hopes and aspirations of those being supported. The physical care needs of those being supported are met promptly when they arise. Staff administer medication to all those being supported. EVIDENCE: Those being supported have their needs and preferences, likes and dislikes clearly outlined in their personal care plans. At this time a referral for an occupational therapy assessment of the bath was about to be made with a view to making this safer for those being supported to use as they become older and frailer. Following a recent accident an occupational therapy assessment of the stairs was undertaken and, following this, the steps were edged in a contrasting colour to make them easier to see. A podiatrist visits the home every eight weeks. All of those being supported are unable to self–medicate and designated and trained staff administer this to them. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The complaints procedure was not followed on one occasion recently. Not all staff have received adequate training in the protection of vulnerable adults from abuse. EVIDENCE: The complaints procedure is in the Statement of Purpose and the Service User Guide. The complaints procedure in the latter needs amending to indicate the CSCI rather than the NCSC. None of those being supported raised any issues with the inspector during this visit. One complaint received from a neighbour since the last inspection was resolved by inviting her into the home to meet the residents and see the home. To comply with the Regulations the action taken in response must be recorded. It is recommended that details of the investigation and the outcome should also be recorded. Vulnerability analyses are carried out and reviewed annually. These identify training in the protection of vulnerable adults and training on values and attitudes as central to the prevention of abuse. Not all staff have received training within six months of employment and every two years thereafter on the protection of vulnerable adults from abuse, and not all staff have received training on values and attitudes. The home has a copy of the inter-agency guidelines on the protection of vulnerable adults from abuse. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. The home’s refurbishment programme has been delayed due to subsidence problems. Improvement will be required to the external décor and windows and doors replacing. Internally the gas fire and the electrics require urgent attention. Apart from the bathroom floor the home was clean, hygienic and fresh smelling. EVIDENCE: The bathroom floor was due to be replaced the week following this inspection as the floorboard were rotten. Improvements are required to the maintenance of the home, both internally and externally. The home’s exterior is shabby and two bedroom windows and the front door need replacing. However, the home is unable to address this until the insurance company has confirmed that subsidence has ceased, which will take several months. The inspector recommends that management bring this timescale forward. In the kitchen and bathroom either radiator guards or low surface temperature radiators must be fitted for safety. Use of the gas fire in the sitting room must be discontinued until it is certified safe. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 16 One electric light was reported to have sparked and this light was out of use at this time. In these circumstances, whilst an electrical review was reported to be imminent, immediate action must be taken to bring this forward. In the last 12 months the kitchen and bathroom have been refurbished, a new kitchen ceiling fitted and a new window for one bedroom has been provided. Since the last inspection the property has had a new back door, two new kitchen windows, all bedrooms and the landing newly carpeted, the edge of the stairs highlighted, one bedroom redecorated, the bathroom window restricted for safety, trees removed from the garden and new dining chairs provided. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35. Staff work long shifts due to staff shortages. Not all staff have received adequate training in values and attitudes and the protection of vulnerable adults from abuse. EVIDENCE: To meet the home’s staffing requirements the manager does sleep-ins. The home continues to be short-staffed. The support worker on duty at this time was working from 07.30 this morning until 15.00 the following day. Such long shifts are not in the best interests of either staff or those being supported. It is recommended that these staffing arrangements be reviewed. New Support Options has its own bank of staff and it was reported that the use of agency staff has stopped. Staff receive in-house induction training within six months of employment from the home’s manager. This includes training on the protection of vulnerable adults from abuse. However, this is not currently refreshed every two years. Staff have attended Planning Alternative Tomorrows with Hope [PATH] training which trains them to identify and meet the dreams, hopes and aspirations of those being supported. The member of staff on duty at this time has an NVQ Level 3 in Care. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 18 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): 39, 42. The views of those being supported are sought regularly. Several health and safety issues were identified at this time. EVIDENCE: Monthly proprietor’s reports [Regulation 26 Reports] are undertaken diligently and the report sent to the CSCI as required. The views of those being supported are heard at these visits and annually as part of the review of the quality of service provision. Also, there are regular house meetings. A gas engineer visited earlier this month to carry out an annual inspection of the gas appliances and put an ‘At Risk’ label on the gas fire. One electric light was not being used as it was reported to have sparked. 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 19 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 2 34 X 35 1 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 X X 2 x 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 20 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 2 Standard YA22 YA24 Regulation 22 12 Requirement Record the action taken in response to complaints. Timescale for action 24/01/06 The premises must be made safe 24/01/06 by immediately discontinuing use of the gas fire until it is made safe and bringing forward the electrical review A written action plan for the improvements identified must be submitted to the CSCI, clearly identifying timescales for improvements. Ensure all staff refresh their training on the protection of adults from abuse every two years. 07/03/06 3 YA24 13[4] 4 YA35 18 30/06/06 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 21 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 Refer to Standard YA22 Good Practice Recommendations Amend the complaints procedure as indicated and record details of the investigation into and the outcome of the complaint. Review staffing arrangements and increase the use of ‘bank’ staff to complement the existing staff team whilst recruitment is ongoing. 2 YA33 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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. Extracts may not be used or reproduced without the express permission of CSCI 60 Wood Lane DS0000013219.V279987.R01.S.doc Version 5.1 Page 23 - 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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