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Inspection on 06/09/05 for 85 Cambridge Road

Also see our care home review for 85 Cambridge Road for more information

This inspection was carried out on 6th September 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

Care plans and risk assessments were up to date and showed that they had been reviewed. There is detailed information to help staff meet residents` needs and keep them safe. Staff help residents access local resources and activities. They are involved in their daily routines. Residents preferred routines are written down so that staff know how they like to be helped. The home supports residents to access healthcare. Staff know how to deal with complaints and they are trained to know how to protect vulnerable adults. Staff are trained to meet the needs of individual residents and there is a programme of NVQ training in place. There are enough staff on duty to meet residents needs. There is good guidance for staff on the key worker responsibilities for each resident. The home is well cared for and near to local facilities.

What has improved since the last inspection?

There has been progress on some maintenance issues.

What the care home could do better:

There have been delays in the maintenance provider responding to some maintenance requests. A requirement is in place about a fire door that needs replacing.

CARE HOME ADULTS 18-65 85 CAMBRIDGE ROAD 85 Cambridge Road Crowthorne Berkshire RG45 7EP Lead Inspector Jill Chapman Unannounced 6 September 2005 at 10:00 am 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 H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 85 Cambridge Road Address 85 Cambridge Road Crowthorne Berkshire RG45 7EP 01344 780183 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) Turnstone Support Dorothy Abrey Care Home 5 Category(ies) of Learning disability registration, with number of places 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13 April 2005 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 H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on a weekday morning over a period of three and a half hours. The focus was to follow up progress from the previous inspection and to inspect some of the standards. All residents were at home for part of the inspection and they all were at home for lunch. Although residents are not able to verbalise their views, staff assisted a discussion about their routine and activities and they were able to contribute according to their ability. Discussion took place with the manager and staff on duty. The communal areas of the home were seen. There has been progress with the recommendations and requirements from the previous inspection and these will be referred to in the body of the report. What the service does well: Care plans and risk assessments were up to date and showed that they had been reviewed. There is detailed information to help staff meet residents’ needs and keep them safe. Staff help residents access local resources and activities. They are involved in their daily routines. Residents preferred routines are written down so that staff know how they like to be helped. The home supports residents to access healthcare. Staff know how to deal with complaints and they are trained to know how to protect vulnerable adults. Staff are trained to meet the needs of individual residents and there is a programme of NVQ training in place. There are enough staff on duty to meet residents needs. There is good guidance for staff on the key worker responsibilities for each resident. The home is well cared for and near to local facilities. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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 H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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) Not inspected on this visit. EVIDENCE: 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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 & 9 Care plans show staff how to meet residents’ needs. Risk assessments help staff keep residents safe. EVIDENCE: Care plans for two residents were sampled and these were clearly written and had been reviewed. For one resident a further review is planned because his needs have changed. Risk assessments for two residents were sampled and covered relevant health and safety and medical issues. They had been reviewed recently. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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) 14 & 16 Staff help residents access leisure activities to give them a better quality of life. Residents are encouraged to be involved in the routines of the home to improve their independence skills. EVIDENCE: Residents have a programme of activities outside of the home. Day Services staff came to the home on the morning of the inspection to take individuals out to Music Therapy and in the afternoon two went out to watch trains at a local station. Staff helped residents show how they enjoy other activities and their recent holidays. There is a good-sized home vehicle to enable group outings. Residents are involved in house routines according to choice and ability. Staff are giving extra support to one resident who has health problems. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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 Residents personal care routines take their wishes into account. Staff monitor residents health and support them to keep health appointments. EVIDENCE: There is good information in guidelines and care plans to show how residents like to be assisted with their personal care. This includes which gender of staff they would prefer. There is a key worker system, which helps focus on individuals needs. There is good written information about residents health needs and records of health care appointments are clearly organised. There are monitoring charts for specific health needs. On the inspection day staff supported a resident to attend the surgery for a blood test. Staff said that they have a good working relationship with the local GP who communicates well with the residents. It is recommended that the consultant psychiatrist be asked to validate PRN medication guidelines. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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 There is a system in place for dealing with complaints. Staff receive training to help protect residents from abuse. EVIDENCE: There have been no complaints received either by the home or by the Commission for Social Care Inspection. A requirement from the last inspection, to update staff on the procedure and to know where the complaints book is kept, has been carried out. All staff permanent staff have received training on the protection of vulnerable adults. A requirement from the last inspection that staff are updated on the vulnerable adults procedure has been carried out. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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 The home provides spacious and well-kept accommodation that is near to local resources. A warped fire door compromises fire safety. EVIDENCE: The home was found to be clean and tidy. It is near to local shops and other resources. Two requirements from the last inspection have been carried out. Cracks in the walls have been investigated and are being monitored by the maintenance provider. Quotes have been received to replace faulty windows and the manager said that the timescale for this work is due to be agreed. A leak above a fire door has caused it to warp and it no longer fits properly into the frame. This should be replaced to ensure fire safety. The manager said that the lounge furniture is due to be replaced in the next financial year and that an OT will be consulted regarding the type suitable for residents needs. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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. Residents benefit from a trained staff team and there are enough staff to meet their needs. EVIDENCE: Staff spoken to were confident in their roles and responsibilities. A key worker system is in place and there are key worker responsibilities written in individual files to help staff meet residents’ needs. Two staff were interviewed and confirmed that they had the relevant training to meet the needs of the residents. A programme of NVQ is in place. Six staff have NVQ 2 or above. The staff team is complete apart from a 16-hour vacancy. Turnstone sessional staff cover vacant shifts. Rotas were sampled and show that there are three staff on daytime shifts and one waking night staff. An on call system operates to support staff working alone at night. Staff deployment appears to meet the current needs of the resident group. 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 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) Not inspected on this visit. EVIDENCE: 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 Page 16 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 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x x x 3 x 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 85 CAMBRIDGE ROAD Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 Page 17 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(4)a Requirement Replace a bedroom fire door which has warped. Timescale for action 6-10-05 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 19 Good Practice Recommendations It is recommended that the consultant psychiatrist be asked to validate PRN medication guidelines 85 CAMBRIDGE ROAD H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading 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 H51 - H01 85 Cambridge Road V243948 060905 Stage 4.doc Version 1.40 Page 19 - 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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