This inspection was carried out on 31st October 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.
CARE HOME ADULTS 18-65
64-66 Ragstone Road Slough Berkshire SL1 2PX Lead Inspector
Jill Chapman Unannounced Inspection 31st October 2005 10:10 64-66 Ragstone Road DS0000011405.V249034.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 64-66 Ragstone Road DS0000011405.V249034.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. 64-66 Ragstone Road DS0000011405.V249034.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 64-66 Ragstone Road Address Slough Berkshire SL1 2PX 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 524869 Advance Housing and Support Limited Mrs Diane Ings Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) 64-66 Ragstone Road DS0000011405.V249034.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 26th April 2005 Brief Description of the Service: The home is two detached houses linked together by an office/reception area. The home is in a residential area, which is close to local shops at Chalvey and the Town centre of Slough. There are seven long stay beds and one short stay bed, which is in s self contained flat. There are separate aims and objectives for the two services offered. The home is staffed 24 hours a day by a team of support workers. There is 24hour management cover provided by three Assistant Managers. 64-66 Ragstone Road DS0000011405.V249034.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 morning over a period of three hours. There is one vacant bed and one resident is in hospital. Six residents were in the home that morning and some gave their views on aspects of the service. Discussion took place with an Assistant Manager and two staff on duty. A tour of the building was carried out and records were sampled. A number of the key standards were inspected. The requirements from the last report have been carried out and will be referred to in standards 33 and 42. A follow up telephone call was made to the manager on 2-11-05. What the service does well:
Records show that care plans and risk assessments are kept up to date to help staff know how to meet residents needs and keep them safe. Staff help residents regain social skills and if appropriate get back into employment. Residents confirmed that they are supported to use the facilities in the local community. A resident said that staff helped her make contact with an Asian Women’s group. Staff said that neighbours are accepting of the home and friendly towards residents. It was seen that residents’ privacy and dignity is respected. Staff help advocate for residents and liaise with others involved in their care. Residents help choose meals provided and special dietary needs are taken into account. They are supported in their daily routines. The home is well looked after and there is a programme of ongoing refurbishment and replacement. Health and safety systems are kept up to date. Although there are staff vacancies there are enough staff on duty to meet residents current needs. 64-66 Ragstone Road DS0000011405.V249034.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. 64-66 Ragstone Road DS0000011405.V249034.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 64-66 Ragstone Road DS0000011405.V249034.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): Not inspected on this visit. EVIDENCE: 64-66 Ragstone Road DS0000011405.V249034.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 help staff know how to meet residents’ needs. Risk assessments help staff keep them safe. EVIDENCE: Care plans were sampled and are up to date. Monthly summaries are carried out and they had been reviewed recently. In discussion with staff and from observation of practice it was clear that care plans are carried out. Risk assessments were sampled. These appeared relevant and had recently been reviewed. 64-66 Ragstone Road DS0000011405.V249034.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, 13, 15, 16 & 17. EVIDENCE: The ethos of the home is to help residents regain and maintain social skills affected by mental illness. Advance Housing and Support have designated staff, in a team called Advanced Working. They help residents get back into employment. One resident was helped to find a part time job. During the inspection, home staff were helping her decide whether to renegotiate her hours in her current job or to seek help from Advance Working to get a different job. In discussion with staff and looking at records it is clear that residents are supported to become part of the local community. Residents confirmed that they use local shops, transport, health resources and groups. One resident has been helped to make contact with an Asian Women’s group. Residents are registered on the Electoral Role and are supported to vote if they wish. There is a varied ethnic mix of neighbours in the road and staff said they are very accepting and friendly towards residents in the home. 64-66 Ragstone Road DS0000011405.V249034.R01.S.doc Version 5.0 Page 11 Residents confirmed that they are encouraged to maintain contact with their families and friends. Visitors are welcome in the home and some have overnight stays with their relatives. The Service users guide gives clear information about how staff should respect resident’s privacy. All residents have keys to their rooms. Residents post is delivered to their rooms so they can open it in private. It was observed that residents sometimes ask staff for support in dealing with their mail. Care plans show how residents are supported to maintain their daily routine and residents described how staff support them. There appear good relationships between staff and residents. It was seen that staff help advocate for residents and liaise with Care Managers and other professionals involved in their care. In discussion with residents and staff it is clear that arrangements for food take residents choice and dietary needs into account. Residents help themselves to breakfast and lunch. They help plan the menu for the main meals. The main meal of the day has recently changed from lunchtime to the evening after a decision made at a residents meeting. It was noted that staff and residents still tend to congregate at lunchtime and that staff help some residents prepare a hot snack. Staff support one resident who is diabetic to plan her menus. Halal meat is purchased for another resident. 64-66 Ragstone Road DS0000011405.V249034.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): Not inspected on this visit. EVIDENCE: 64-66 Ragstone Road DS0000011405.V249034.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: 64-66 Ragstone Road DS0000011405.V249034.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 Resident’s benefit from a well looked after home. EVIDENCE: A tour of the building showed that it is kept clean and well maintained. Since the last inspection the hallways, bedrooms and staff office/sleep-in room have been redecorated. New flooring has been fitted to the smoking room and a bedroom. In the kitchen there are a new dishwasher and fridge freezers. 64-66 Ragstone Road DS0000011405.V249034.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 & 34. There are enough staff on duty to meet the needs of the current residents. Copies of recruitment records are now kept in the home. EVIDENCE: There are three vacancies in the staff team. One full time assistant manager post and two full time support workers. Rotas were sampled and show that there are two support workers and one assistant manger on each daytime shift. At night there is a waking night support worker and a sleep in manager. Staff deployment appears to meet the current needs of the resident group. A requirement that recruitment records required by regulation are kept in the home has now been carried out. The manager confirmed that copies of these documents are stored securely so that they can be evidenced at inspections. 64-66 Ragstone Road DS0000011405.V249034.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): 42 Health and safety systems help keep residents safe. EVIDENCE: The arrangements for ensuring health and safety are good. Servicing and monitoring records were up to date. Regular checks are carried out on the fire safety system, hot water temperatures, fridge freezer and food temperatures. Monthly in house health and safety audits are carried out and Service Managers carry out a six monthly audit. Risk assessments are in place for the building and equipment. Following consultation with the Fire Safety Officer, residents are no longer allowed to smoke in their bedrooms. Risk assessments have been carried out and residents have been informed. Staff confirmed that this situation is monitored especially at night. It is recommended that the manager review the homes smoking policy to include what sanctions would be taken if the no smoking in bedrooms rule is breached. 64-66 Ragstone Road DS0000011405.V249034.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 x x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
64-66 Ragstone Road Score x X X x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x DS0000011405.V249034.R01.S.doc Version 5.0 Page 18 No 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. 1 Refer to Standard YA42 Good Practice Recommendations Review the homes smoking policy to include what sanctions would be taken if the no smoking in bedrooms rule is breached. 64-66 Ragstone Road DS0000011405.V249034.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
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