Inspection on 17/10/05 for Boxgrove

This inspection was carried out on 17th 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Boxgrove 06/06/07

Boxgrove 12/02/07

Boxgrove 07/07/06

Boxgrove 03/05/05

Boxgrove 26/01/05

Boxgrove 11/11/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Boxgrove Little Heath Road Tilehurst Reading Berkshire RG31 5TY Lead Inspector Susan Cledwyn-Davies Unannounced Inspection 17th October 2005 10:10 Boxgrove DS0000011190.V252301.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 Boxgrove DS0000011190.V252301.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. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Boxgrove Address Little Heath Road Tilehurst Reading Berkshire RG31 5TY 0118 943 1019 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) Choice Limited Mr Paul Robert Thwaite Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd May 2005 Brief Description of the Service: Boxgrove House is a purpose built care home for 10 adult men with severe learning difficulties. The home is situated on the outskirts of Tilehurst in Reading and is surrounded by open countryside. The home has an extensive garden which service users are encouraged to use and provides opportunities for horticultural activities. A separate day care building is situated on the site and provides a range of day care activities for service users. The staffing ratio is high to meet the complex needs of the service users. Staff have access to a wide range of training and the provider organisation have facilitated access to NVQ training for all staff. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 10.10am and 3.50pm. Included in the visit was a detailed tour of the home, discussion with the deputy manager and staff, conversation with residents and examination of records. Part of the visit was spent with residents e.g. having lunch. As agreed with the manager previously the term resident is used for service users. What the service does well: 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. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 6 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 Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 7 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): 1 The statement of purpose is available. EVIDENCE: The statement of purpose is kept centrally. The statement has been reviewed to include the new manager. As part of the complaints policy the name of the previous inspector and address of CSCI is included. It was agreed that the name of the inspector would be removed. Relatives and professionals access the statement of purpose. Residents have communication difficulties and rely on staff, relatives and professionals to assist them. A service user guide is included with the individual care plan. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 8 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): 7, Residents finance is well managed. EVIDENCE: At the last inspection records of residents finances kept in the home were not up to date. Now one member of staff is responsible for maintaining records weekly and ensuring that records are up to date. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 9 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): 13, 15 and 17 Residents take part in activities in the community. Personal relationships especially with relatives are promoted. EVIDENCE: Activities include using community resources such as Jacuzzis and swimming pools plus local shops and resources. Walks in the area are also popular. There is one large car used for transport and the manager has requested a second car with a tail lift to accommodate residents with less mobility. Relationships with relatives are encouraged. Staff drive residents and accompany them for some visits. Staff also received positive comments from relatives about the care given to individual residents. The inspector had lunch with residents. The food was freshly prepared and tasty, residents enjoyed the meal. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 10 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 and 20 Residents receive personal support in the way they prefer. Medication practice is safe. EVIDENCE: Residents are able to have a flexible daily routine, staff try to note individual preferences and respect them. Different activities and greater independence are encouraged. This was especially noted in the greater skills and independence of the last two residents admitted. The medication administration records and storage were orderly. Two staff, one person administering and one witnessing, give out medication. All staff administering medication complete an external medication training. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 11 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 and 23 Service users views are listened to and service users are protected from abuse, neglect and self-harm. EVIDENCE: There is a comprehensive complaints procedure. No complaints have been received since the last inspection. Staff spoke of having positive comments made by relatives about the care in the home. There is a good awareness of the rights of residents and staff aim to promote individual choice. Most staff have attended the Protection of vulnerable adults course. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 12 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): 25, 26, 27, 28, 29 and 30. The house is spacious and provides a homely and comfortable environment. There is some maintenance work being ordered. There were some unpleasant aromas. EVIDENCE: The house is spacious and comfortable. There is a commitment to keeping the decoration and furnishings updated. Redecorating has just finished of the office and one resident’s bedroom. A further bedroom is being decorated soon. A new kitchen has been put into the day care building and the room enlarged by knocking 2 small rooms into one. This will provide a much better area for residents and staff to use. One resident said he was very happy with his room. A new carpet is being put in on the first floor hall area. There is an unpleasant aroma by the front door and stairs that it is suspected originates in the upper hall area. Some of the residents have complex behaviours and can be destructive. Adaptations have been made to individual rooms to make sure they are Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 13 comfortable and safe. Maintaining the environment requires continuous attention. The following were noted. 1. Two toilets were missing a toilet seat. One was already reported. 2. One shower needed a new shower chair because the existing was rusting. 3. One shower has an old marked and worn base so would be impossible to clean properly. This needs attention/replacement. 4. The main bathroom on the corner was clean but had an unpleasant smell. This needs investigating. 5. That a locking container be provided for outside storage of contaminated waste. 6. That a COSHH cupboard be provided in the laundry. If the sink unit cupboard is used then this needs to be replaced. 7. That COSHH guidelines be available in the domestic store cupboard. There was discussion with the deputy manager about the cleaning of the day care building. At present care staff clean after use but residents from other homes use the area. To maintain cleanliness some domestic cover will be supplied. Staff particularly housekeeping staff work very hard to keep the home clean and fresh. Air fresheners are used but at present while the fluids are checked by the company for allergic reactions are not in use. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 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 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): 32, 33, 35 and 36 Competent staff with a sufficient staff team supports residents. Trained and supervised staff generally meets residents’ needs. EVIDENCE: There is a positive and proactive approach to training. Over 50 of care staff have achieved NVQ 2 training. Senior staff are taking NVQ 3 training. The individual training records are much improved. One member of the senior staff team has responsibility for coordinating all training. Individual staff training records were now kept. These records need to be clearly updated. One part time member of staff has had no training since 2002 and this needs to be followed up. If staff are unable to attend updating mandatory training then an assessment of their competence and resident safety needs to be made. There are a large number of training courses offered by CHOICE. The staff team adequately covers the shift in the home. there are two staff on maternity leave and vacancies are filled if necessary by agency staff. The deputy manager ensures that agency staff work in the home a number of times and are familiar with the resident. The handover in the middle of the day has altered so that more time is given to arranging the activities and duties. The morning shift team arrange drinks during handover to give more time for activities once handover is complete. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 15 This change is helping afternoon activities to take place. In discussion with the deputy and support staff there is a clear focus to provide good care for residents. Supervision is taking place more than previously. There are still some staff needing more individual supervision and this is made a recommendation. Boxgrove DS0000011190.V252301.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): 37, 39 and 42 The home is well run. Residents’ views are included in reviews and self-monitoring. The health, safety and welfare of residents is promoted. EVIDENCE: The manager has applied to register with CSCI and the registration is nearly complete. The outstanding item is for the manager to have a CRB check completed through CSCI. The quality assurance within the home includes completing annual reviews involving relatives and professionals annually. Resident questionnaires are also completed annually but there are some difficulties in communication for most of the residents. The results of this survey completed just after Xmas are not available. The manager prepares an annual business plan. The health and safety records showed good servicing and maintenance of equipment. The company audits the health and safety practice 6-12monthly. There was limited central monitoring of accidents mainly as incidents. It was Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 17 suggested that a central file be kept to monitor the number and type of accidents. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 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. 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 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 2 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 2 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Boxgrove Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000011190.V252301.R01.S.doc Version 5.0 Page 19 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 3 Standard YA24 YA30 YA35 Regulation 23 13 13 Requirement That specified bathrooms be in good repair. That a locking outside dustbin be obtained and COSSHH storage and guidelines be provided. That training is given to all support staff on an annual basis. Timescale for action 01/12/05 01/11/05 01/12/05 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 YA36 YA42 Good Practice Recommendations That all staff receive individual supervision. That accidents are monitored centrally. Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 20 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 © 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 Boxgrove DS0000011190.V252301.R01.S.doc Version 5.0 Page 21 - 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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