Inspection on 24/04/07 for Hazeldene

This inspection was carried out on 24th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hazeldene 20/10/05

Hazeldene 12/07/05

Hazeldene 01/02/05

Hazeldene 07/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hazeldene 127, 129 and 131 Wantage Road Reading Berkshire RG30 2SL Lead Inspector Catherine Kane Unannounced Inspection 24th April 2007 11:15 Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 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 Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 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. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hazeldene Address 127, 129 and 131 Wantage Road Reading Berkshire RG30 2SL 0118 950 0567 0118 956 6936 christianbales@choiceltd.co.uk 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 Christian Bales Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2005 Brief Description of the Service: Hazeldene offers twenty-four hour residential care to nine, male service users with varying degrees of learning disability and associated behavioural difficulties. The home consists of two adjacent properties, one with three bedrooms and one with six. The homes are spacious with small but functional gardens. The properties are owned and the care is provided by C.H.O.I.C.E. Ltd. The home is situated approximately ten minutes walk from Reading Town Centre and is a few minutes walk from a large park, public houses and local shops. The home has its own transport and public transport is easily accessible. The fees for this home range from £1,500 to £2077 per week. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 11.15am on Thursday, 26 April 2007. The inspector was in the service for just over four and a half hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the service and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The manager was present at time of the inspection visit. Four members of staff were on duty for the morning shift and four for the afternoon shift. The inspector spoke with five residents. The inpsector saw staff and some residents take part in afternoon activities, prepared for their lunch and saw how staff help residents look after and take their medicines. She also looked at residents care plans and other records kept in the home and made a tour of the part of premesis. The inspector would like to thank the manager and his staff team for their assistance with the inspection. She also thanks residents and visitors and all those who responded to questionnaires for sharing their experience of this home. What the service does well: Staff had a good understanding of residents’ support needs. Residents like how they can make their own meals and say they are good. Personal care and healthcare support provided in this home is excellent. The home would be able to meet the needs of individuals of various religious, racial or cultural backgrounds. Residents indicated they generally like living in their home. Residents’ relatives made positive comments about this home. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 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 Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. Quality in this outcome area is good. The admission procedure is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of this inspection the home had no vacancies. There has been one new admission to this home since the last inspection. The inspector viewed the homes pre-admission assessment; this was a comprehensive document and indicated that the home could meet the individual’s needs at the time of admission and a review process was in place. Another manager from the organisation carried out the pre-admission assessment and the decision to accept the new resident had been made during while the home manager was on holiday. Senior staff confirmed that they had been involved in the process. Initial referral documents from the funding authority were not available in the home. Generally, admissions would not made to the home until a full needs assessment has been undertaken. The home would then be able to confirm that they can meet the needs of the individual through the service they deliver. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9. Quality in this outcome area is good. The care planning system in place to provide staff with the information they need and for assessing risk is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection the inspector viewed three residents’ care plans. These were easy to understand, written in plain language, considered all areas of the individual’s life including health, personal and social care needs. The plan is regularly reviewed and includes comprehensive risk assessments. The inspector became aware that the home was using a listening monitor for one resident to alert staff should the resident require assistance at night. Another listening monitor is also being used in the home as part of specific strategy when responding to incidents of challenging behaviour. The manager informed the inspector that he understands the decision taken to put limitations, which could compromise residents’ privacy, dignity or restrict their Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 10 freedom, that may be in the best interest of the resident must be done only though a full care planning process. He confirmed reviews that would involve the individual or persons who would be able to act on the resident’s behalf if they were not able to give their consent, for example, their relatives or advocate and other social care or healthcare professionals would be held and clear guidelines will be drawn up for the use of listening monitors in the home. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. Opportunities for people who use this service to take part in a variety of interesting activities are excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection the inspector was in the home during late morning and the afternoon. She met five residents but spent considerable time with two residents and the staff on duty. All of the residents met by the inspector had excellent verbal communication skills, were confident and able to tell her about their experience of the home. Seven residents completed a CSCI questionnaire; six residents were helped by staff to fill out the form. Five residents indicated that they are happy living in this home; two indicated they would rather live elsewhere. All knew whom they could speak to if they were unhappy or wished to make a complaint. One Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 12 resident said “I get on OK with the staff, I can tell Christian (the manager) he listens”. Many activities provided in house were based on what residents prefer to do in their leisure time; art and craft, football, budgeting and reading skills, travel training. Residents have a full programme of regular activities outside the home that include college courses for cookery, pottery, independent living skills, computers and horticulture, visits to the local library. The relatives of six residents returned surveys where they all indicated that the home provides good care. One relative said “They have gone out of their way to meet his needs which has been very encouraging and he has definitely made progress independence wise since going to live at Hazeldene.” The inspector was in the home when some residents were preparing their own lunches. Each resident plans their own menu, do their own shopping and with the support of staff prepare their own meals as part of developing independent living skills. One resident confirmed this system worked well for him. Samples of residents’ menus were seen; while some popular meal choices were based on convenience foods there was evidence of fresh foods including fruit and vegetables with a home cooked roast dinner for all residents on a Sunday. Regular drinks and snacks are available. Residents special dietary needs could be catered for catered for. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is excellent. The personal and healthcare needs of residents are generally well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Essential information needed by staff to be able to provide personal and health care support was included in residents’ files. Staff help residents to look after their own medication and see they get to see their local GP and other community healthcare services when needed. The inspector saw how the home helped residents to access specialist healthcare support when this was needed. A consultant psychologist was present in the home during the inspectors visit. The home works closely with a team of psychologists provided by CHOICE. Their involvement includes assisting individual residents as necessary, links to local psychology and psychiatry services and specific related staff training. One comment card was returned from residents’ GP; this indicated that they were satisfied with the overall care provided in this home. They commented that the home has always worked well and in partnership with them. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 14 Residents’ medicines are securely kept in a locked medicines cabinet. The home uses a pharmacist produced medication administration record (MAR). Records seen were neat and well maintained. Most residents medicines are supplied in pharmacist produced monitored dose system. Records were kept of staff assessed as competent to administer residents’ medicines. During the inspection two members of staff confidently demonstrated how a residents’ medicines are looked and how residents are helped to take their medicines. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is adequate. The homes complaints procedure is good. The home has a protection from abuse policy but this needs to be adhered to when concerns or allegations relating to safeguarding vulnerable peoples are raised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Commission has received no information relating to complaints in the last year. The home keeps a record of all complaints received and this was made available during the inspectors visit. One complaint had been logged in the last year. The complaints log indicated that this matter had been responded to through the homes complaints procedure and the manager confirmed that homes staff disciplinary procedures were also implemented. However, the nature of the concern relates to safeguarding vulnerable people from abuse and the appropriate policy and related local procedures had not been put into practice. All staff have attended, or are booked to attend, safeguarding vulnerable adults training. Staff who spoke with the inspector were clear about their responsibilities and were aware of the homes ‘whistle blowing’ policy. The Commission has received no information relating to adult protection issues since the last inspection. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is adequate. Areas of the home seen by the inspector on the day of her visit were tidy but general cleanliness in certain areas could be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection a new kitchen has been fitted but the quality of the finish is poor. Some communal areas of home are in need of redecoration and the manager confirmed that this was planned for late summer. The manager related that each resident has a responsibility to maintain a good standard of cleanliness throughout the home as part of developing independent living skills. During the visit the inspector indeed observed residents undertake some of these tasks. However, the home has a responsibility to cover any shortfall in areas where maintaining good hygiene is essential, for example kitchens and bathrooms. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 and 35. Quality in this outcome area is good. This homes recruitment procedures and training for staff to do their jobs well is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection visit the inspector met with several members of staff and observed a shift handover. She spoke with one member of staff on duty and by telephone with one other member of staff the following day. The home has a core of well-established staff that understands residents’ needs. Four staff members have left and five new members of staff have been recruited since the last inspection. Staff stated that morale is generally good. One staff member commented that more female staff on the team has been an improvement; this has benefited residents with a calming atmosphere. One staff member said that there are good clear guidelines for staff. Another staff member said “not all of the management team lead by example”. Comments received from relatives were generally complimentary of the staff team. One relative said “it’s a very good Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 18 care home that could be even better with slightly better communication – is there a rift between the staff team?” This organisation has a formal agreement with CSCI for it to hold centrally some specific staff recruitment documentation and maintain a signed checklist within the home. The inspector viewed three staff files and these were well organised and the manager was taking action to acquire any missing necessary documentation as agreed. The manager confirmed that the home intends to renew the Criminal Record Bureau (CRB) disclosures made on staff every three years. The home keeps a record of training completed by staff; staff spoken with confirmed details of the training they have undertaken. This was a comprehensive training programme. The manager places importance on quality training for his staff team. Of 22 care staff 18 staff members have completed a relevant National Vocational Qualification (NVQ). Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 41 and 42 Quality in this outcome area is good. The registered manager has a good understanding of management areas in which the home needs to improve and has plans in place to address this. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The experienced registered manager is competent to run the home and meet its stated aims and objectives. He has sound knowledge and experience in care of people with a learning disability, autism and behavioural needs, quality assurance systems, equal opportunity issues, development and implementation of the services policies and procedures, good people skills, strong leadership of staff, responds to need and provides a good role model and manages the service efficiently. He has a strong ethos of being open and transparent in all areas of running of the home and is aware of current Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 20 developments both nationally and by CSCI and plans the service accordingly. The manager is well respected by members of his staff team and is trusted and well liked by the residents of the home. The registered manager confirmed that an annual quality assurance audit had been completed and a report produced; the inspector did not see this during the visit but was provided with details of the current development plan for the home. The organisation routinely carry’s out unannounced monthly visits and produces a report of their findings; these were made available in the home for inspection. The home has sound policies and procedures in line with current thinking and practice. Efficient systems are in place to monitor staff adherence to policies and procedures during their practice. The home works to a clear health and safety policy and checks take place to ensure the home meets relevant health and safety requirements and legislation. Records kept were good and are routinely completed. Where issues have been identified these have been acted upon successfully to ensure residents’ care is not compromised. CHOICE, who run this service, has financial and accounting systems subject to internal and external audits. Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X 3 3 X Hazeldene DS0000011088.V333918.R01.S.doc Version 5.2 Page 22 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. 1. Standard YA23 Regulation 13(6) Requirement To provide CSCI with full details of the complaint received on 30/08/06, and full details of the actions taken and the reasons why local safeguarding vulnerable adults procedures were not implemented. Timescale for action 30/06/07 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 YA30 Good Practice Recommendations The manager should ensure that a good standard of hygiene and cleanliness is maintained in the home. 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