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Inspection on 26/04/05 for 64-66 Ragstone Road

Also see our care home review for 64-66 Ragstone Road for more information

This inspection was carried out on 26th April 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There are sound procedures and information to help potential residents decide whether to come and live in the home and for the home see if they can meet their needs. There is good written information about how the home meets care needs and risk assessments show how residents are kept safe. Healthcare needs are well met and staff support residents to access healthcare appointments. Residents can use the complaints procedure to express concerns and there is a procedure and training for staff to help them protect vulnerable adults. Residents` benefit from well cared for accommodation. There is an enthusiastic staff team, which is trained to meet the residents needs and the home is well managed.

What has improved since the last inspection?

Since the last visit redecoration has been carried out to communal areas and the staff accommodation. New kitchen units have been fitted and the drive has been resurfaced.

What the care home could do better:

There is a need to add the homes policy on emergency placements to the admissions procedure. Although risk assessments have been carried out, further clarification from the fire officer is needed about whether the home should allow residents to smoke in their bedrooms. This matter should also be checked out with the homes insurers. Staff recruitment records are not held in the home and available for inspection.

CARE HOME ADULTS 18-65 RAGSTONE ROAD 64 - 66 Ragstone Road Slough Berkshire SL1 2PP Lead Inspector Jill Chapman Unannounced 26 April 2005 @ 12:50 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 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 Stationary 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. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Ragstone Road Address 64 - 66 Ragstone Road Slough Berkshire SL1 2PP 01753 524869 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Advance Housing and Support Limited Mrs Diane Ings Care Home 8 Category(ies) of Mental Disorder (MD) - 7 registration, with number Mental Disorder over the age of 65 years of places (MD)E)) - 1 RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12/10/04 Brief Description of the Service: There are seven long stay beds and one short stay bed, which is in a flat with its own facilities. There are separate aims and objectives for this facility but the staff team covers both the home and short stay flat. There is 24 hour, management cover, provided by three assistant managers. There is a minimum, of two project support workers on daytime shifts. At night there is one waking night staff and a sleeping in manager/assistant manager. The home is situated within walking distance of local shops, the town centre of Slough and transport links. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on a Tuesday, over a period of three hours, from lunchtime. At the time of the inspection, the staff team were attending an on site training session and two agency staff were providing care for the residents. The manager came out of the session to take part in the inspection. One service user was willing to take part in the inspection and two others were in the home for part of the time. There has been progress with some of the requirements from the previous inspection and others require further work. What the service does well: What has improved since the last inspection? Since the last visit redecoration has been carried out to communal areas and the staff accommodation. New kitchen units have been fitted and the drive has been resurfaced. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 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. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 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 standard(s) 2 & 4 Residents’ benefit from a proper assessment to find out if the home can meet their needs. They can stay and visit the home before deciding to move there. It is not clear whether the home takes emergency admissions. EVIDENCE: There is a corporate admissions policy, which is being updated. The Service Users Guide gives good information about the process. There is a referral application form, which seeks full admissions information, including mental health needs. Files sampled showed that CPA and Care management assessments are provided to help the home know potential residents needs. The admissions procedure includes pre placement visits and a 12-week trial period. The homes policy on emergency admissions should be added to the procedure. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 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 standard(s) 6,7 & 9 There is good evidence of how the home meets residents’ needs and keeps them safe. Residents are able to make choices about their lives and are protected if choices make them unsafe. EVIDENCE: Care plans and risk assessments for three service users were sampled. These are up to date and are reviewed. Monthly summaries of care show that staff are monitoring progress. Care Program Approach reviews show that the home works with other professionals to provide care. Risk assessments seen were relevant and up to date. A service user confirmed that she is able to make choices about her life. Risk assessments are in place to show that staff sometime need to override residents choice to keep them safe. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 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 standard(s) These standards were not inspected on this visit. EVIDENCE: RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 11 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 standard(s) 18, 19 & 20 Staff give good support to residents to help them look after themselves. Residents are helped to access physical and mental healthcare. Residents are supported to take their medication and this is safely kept. Residents’ benefit from staff who are trained about their health needs and medication. EVIDENCE: Care plans show that residents need prompting support from staff rather than full personal care. Discussion with a key worker and a resident show how support is given. There is good written evidence about how healthcare needs are met. A service user told of how staff are supporting her to attend her GP, Dental and Optician appointments. In discussion with staff, it was obvious that they are knowledgeable about residents’ mental health needs and how to respond to them. Discussion with staff showed that staff are trained to give medicines to residents. They have recently received training from Boots about general medication and on the day of the inspection were being given training related to psychiatric medication. There is a safe system for the storage of medication with regular checks carried out. A service user explained how she self medicates and risk assessments are in place. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 12 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 standard(s) 22 & 23 Residents are able to express their concerns and staff respond to these. Staff are trained to keep residents safe. EVIDENCE: There is a Complaints Procedure in place and it was seen that residents know how to use this. Complaints received about other service users have been dealt with appropriately. There is a Vulnerable Adults Procedure in place and staff confirmed training related to this. Training specific to residents with mental health needs has been undertaken. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 13 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 standard(s) 24 & 30 Residents are provided with spacious accommodation that is well cared for and clean. EVIDENCE: The communal areas of the premises were seen and these were clean, well furnished and decorated. Replacement flooring in the smoking room and a bedrooms is due to be fitted in May. Since the last visit redecoration has been carried out to communal areas and the staff accommodation. Residents were involved in the choice of colour schemes. New kitchen units have been fitted and the drive has been resurfaced. There are day and night cleaning routines and these are monitored at handover. There is an infection control policy in place. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, and 36. Residents benefit from the support of a staff team who are clear about their role and know what to do to help them. The staff team receives training that enables them to understand the mental health needs of residents. EVIDENCE: In discussion with staff they are clear about their roles and responsibilities. A resident told of the support given by her Key-worker. Staff meetings and handover records show that there is good communication. Records show that staff liase with other professionals involved with residents and that they have relevant training to meet their need. Some staff have NVQ certificates and others are due to start this. Although there are vacancies for two deputy managers and one support worker, staff deployment remains satisfactory. Staff confirmed that they receive regular supervision. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 and 42. The home is well managed and residents are able to express their views about the service. There are good arrangements to ensure the health and safety of residents. It is not clear whether it is safe for residents to smoke in their bedrooms. EVIDENCE: The manager has completed the NVQ4/Registered managers’ award and is an NVQ Assessor. Staff said she is firm but fair and friendly. There is a Quality Assurance system in place, which includes seeking the views of residents and Annual Service Performance Review. There are good health and safety arrangements in place, which include a Health and Safety Audit every 6 months. Monthly in house health and safety checks are carried out. A requirement to seek the view of the Fire Officer about residents smoking in bedrooms has been carried out but it is still not clear whether this practice should continue. The registered persons should consider advice given by the RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 16 Fire Officer, seek further clarification if required and check with the homes insurers regarding this matter. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 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 2 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 RAGSTONE ROAD Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 2 x H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 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. 1. Standard 34 Regulation 18 Requirement Ensure that records required by regulation to be kept in the home This is outstanding since 13-04-04. Regarding smoking in bedrooms, the registered persons should consider advice given by the Fire Officer, seek further clarification if required and check with the homes insurers regarding this matter. Timescale for action 26-07-05 2. 42 23 26-07-05 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 4 Good Practice Recommendations The homes policy on emergency admissions should be added to the procedure. RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale, Reading Berkshire 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. Extracts may not be used or reproduced without the express permission of CSCI RAGSTONE ROAD H51-H01 11405 Ragstone Road V212932 260405 Stage 4.doc Version 1.30 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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