Inspection on 13/04/05 for 85 Cambridge Road

This inspection was carried out on 13th April 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

85 Cambridge Road 02/08/06

85 Cambridge Road 06/09/05

85 Cambridge Road 28/09/04

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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 85 Cambridge Road Crowthorne Berks RG45 7EP Lead Inspector Jill Chapman Unannounced 13th April 2005 09.35 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. 85 Cambridge Road Version 1.10 Page 3 SERVICE INFORMATION Name of service 85 Cambridge Road Address Crowthorne, Berks, RG45 7EP 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) 01344 780183 01753 747399 Turnstone Support Dorothy Abrey CRH Care Home 5 Category(ies) of LD 5 registration, with number of places 85 Cambridge Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28.09.04 Brief Description of the Service: 85 Cambridge Road is a 5 bed residential care home for adults with learning and associated physical disabilities. Staff support is provided by Turnstone Support, 24 hours a day 52 weeks a year. The home is in walking distance of Crowthorne village centre, with a range of cafes, pubs, and shops . 85 Cambridge Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection that took place during a weekday morning to early afternoon, for period of over four hours. The inspector looked at the building, spoke to the manager and two staff. All of the residents were at home but none were able to communicate their views. From observation, they appear well cared for and staff were seen to respond to their needs. Residents’ files, care plans, risk assessments and daily notes were sampled. What the service does well: What has improved since the last inspection? Faulty lights in the lounge have been replaced and washable flooring has been laid in two bedrooms and a smoking area. A hoist has been fitted in a bathroom. All service users have up to date contracts. 85 Cambridge Road Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 85 Cambridge Road Version 1.10 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 85 Cambridge Road Version 1.10 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) 1,2,3,4 and 5 The home provides good information to help people decide if the home can meet their needs. A full assessment is carried out before a new resident is admitted. Day and overnight visits help them get to know the home and a trial period is offered. Contracts state the terms and conditions of the placement. EVIDENCE: There is a Statement of Purpose in Place, which has recently been updated. Each resident has a very user friendly Service User Guide. Advice was given to carry out some minor alterations to both the Statement of Purpose and Service User Guides. There have been no new admissions to the home but there is an Admissions Procedure in place. The process includes assessment, pre-placement visits and a trial period. All residents have written contracts, which are also produced in a simple style to help them understand the content. Turnstone staff have signed these on behalf of the company and the resident. Advice was given to ask advocates or family to sign on the residents’ behalf if they are unable to sign for themselves. 85 Cambridge Road Version 1.10 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) 6,7,8,9 and 10. Residents have up to date care plans and risk assessments which show how their care and safety needs are met. They are involved in planning and choice as much as they are able or wish to be. Residents’ records are kept secure and their information is kept confidential. EVIDENCE: Care plans seen show that they are regularly reviewed to meet residents changing needs. Residents are encouraged to be involved in planning and review. Some care plans need to have the latest review date recorded. Examples of resident choice were seen in care plans and daily records sampled. They are involved in staff and residents meetings. Risk assessments show that individual risks are assessed and reviewed. Any restrictions in choice are supported by risk assessment. There is a record keeping and confidentiality policy. Staff are trained in this and records are kept secure. 85 Cambridge Road Version 1.10 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) 11, 12, 13,14, 15, 16 and 17. Staff help residents to maintain or improve their personal development. They are supported to enjoy a variety of activities and community resources. Staff help access their rights and advocate for them. Residents maintain contact with their families and friends, and enjoy birthdays and Christmas celebrations with them. Residents are given a healthy diet and their preferences are taken into account. EVIDENCE: Support Guidelines show that residents are helped by staff to be involved in day-to-day routines such as personal care, cleaning their rooms, personal laundry and shopping. Activities are well recorded and Day Opportunity or Home staff support residents. Outings to sensory sessions, art and drama group, bowling, music therapy, walks, cafes and garden centres are recorded. There is a home vehicle suitable for the residents needs. Records show that staff help residents keep in contact with their families and friends via visits, phone calls or in house Birthday and Christmas parties. 85 Cambridge Road Version 1.10 Page 11 Staff have spent time explaining residents right to vote and have advocated for a resident about his benefit entitlement. Residents are involved in the choice and shopping for meals. Menus are varied and food stocks were good. Likes and dislikes are recorded and taken into account. 85 Cambridge Road Version 1.10 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 standard(s) 18, 19, 20 and 21. Residents’ health and care needs are well met. There is a safe system for giving medicine to residents. There are guidelines in place on how to deal with the death of a resident and their funeral wishes are documented. EVIDENCE: Personal and health care is well documented in care plans, contact records, guidelines and records of healthcare appointments. These show that care needs, health, weight, mood and behaviour are monitored. Staff recently supported a resident while he was in hospital and have arranged specialist assessments for his changing needs. There is a system for the safekeeping and administration of residents. Medication. The system was spot checked by the inspector and found to be accurate. Staff check this regularly and liase with the chemist when they find dispensing errors. Staff are trained to ensure they are competent to give medication and have regular training updates. There is a policy to help staff deal with the death of a service user and residents have been consulted about their wishes. 85 Cambridge Road Version 1.10 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 standard(s) 22 and 23. The home has a Complaints and Vulnerable Adults procedure to safeguard residents. Some staff would benefit from updating on these procedures. EVIDENCE: There is a Complaints procedure in place and a pictorial version helps residents understand this. No recent complaints have been received but there is a need to ensure all staff know where the complaints book is held. There is a Vulnerable Adults procedure in place and staff receive training on this. In discussion with staff it was clear that some would benefit from an update. 85 Cambridge Road Version 1.10 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 standard(s) 24, 27 and 30. The house provides a mostly safe environment for residents. It is kept clean, hygienic and is generally well maintained and decorated. The condition of the windows and secondary glazing pose a risk to staff and residents and there is an outstanding requirement about the cracks on internal walls. A hoist has been installed to a bathroom, to help one resident. All residents have a large bedroom, which is well decorated and furnished. EVIDENCE: The inspector looked at the premises and discussed some maintenance issues with the manager. There is an outstanding requirement about some cracks on internal walls. Although this has been investigated no action has taken place yet. The registered persons have identified that the windows are in need of repair or replacement, some secondary glazing is a health and safety risk and wooden frames and windowsills are in poor repair. The registered persons should forward details of what action is to be taken and the timescale for this work to be carried out. The home is well decorated and clean. There are cleaning routines in place and a good standard of hygiene is achieved. Residents bedrooms are large, well furnished and decorated. 85 Cambridge Road Version 1.10 Page 15 Since the last inspection, washable flooring has been provided in two bedrooms and a smoking area. The lounge lights have been replaced because they were unsafe. A hoist has been provided one bathroom to meet the changing needs of one resident. 85 Cambridge Road Version 1.10 Page 16 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) 32 33 and 35. Staff are given training related to residents needs. There are enough staff on each shift to meet the residents needs. EVIDENCE: There is a programme of NVQ in place and four staff have NVQ 3 and one has nearly completed this. The home is nearly on target to meet 50 trained to NVQ and above by 2005. There are 26.5staff hours vacant at present and the Deputy is seconded to manage another home. Agency staff are used to cover vacant shifts. Current staff deployment appears to meet the needs of the residents. Staff spoken to had received training relevant to the needs of the residents and regular updates are given. 85 Cambridge Road Version 1.10 Page 17 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’ health and safety is mostly safeguarded. There is a Quality Assurance System to seek feedback about the service from residents and others. EVIDENCE: The manager has NVQ4/Registered managers award and has many years experience working with people with a learning disability. Staff said she is approachable, enabling, and efficient and has a good sense of humour. There are good corporate management systems and the manager sets high standards. A Quality Assurance System is in place and this is being further developed. Records sampled show that generally there is a good standard of health and safety. Two shortfalls have been highlighted under standard 24. 85 Cambridge Road Version 1.10 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 3 x x 3 Standard No 11 12 13 14 15 85 Cambridge Road 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x Version 1.10 Page 19 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x 85 Cambridge Road Version 1.10 Page 20 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 24 Regulation 23 Requirement That the cracks in the walls be investigated and repaired.This requirement has been outstanding from 1-06-04 The registered persons should forward details of what action is to be taken regarding the windows and the timescale for this work to be carried out. Timescale for action 13/06/05 2. 24 23 13/06/05 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. 2. Refer to Standard 22 23 Good Practice Recommendations that the registered persons ensure staff know where the complaints record is kept and that staff are updated on the procedure. that staff are updated on the vulnerable adults procedure. 85 Cambridge Road Version 1.10 Page 21 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 85 Cambridge Road Version 1.10 Page 22 - 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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