Inspection on 01/03/06 for Loddon Court

This inspection was carried out on 1st March 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Loddon Court 23/02/09

Loddon Court 12/03/07

Loddon Court 17/09/05

Loddon Court 10/02/05

Loddon Court 26/10/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Loddon Court 289 Wokingham Road Earley Nr Reading Berkshire RG6 7DU Lead Inspector Mrs Rhian Williams-Flew Unannounced Inspection 1st March 2006 10:30 Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 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 Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 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. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Loddon Court Address 289 Wokingham Road Earley Nr Reading Berkshire RG6 7DU 0118 966 4494 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) New Support Options Limited Miss Tracey Katherine Mallett Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th September 2005 Brief Description of the Service: Loddon Court is an eight bedroomed short break service that provides a service for people in the Wokingham area who have learning disabilities and in some cases associated complex needs. The facility is divided into two discrete units called Honeysuckle and Bluebell. The unit is staffed throughout the 24-hour period. There are waking night staff and a sleeping staff member. The building is on one level and each unit is self-sufficient, having a lounge/dining room, kitchen, bathroom, shower room toilets and individual bedrooms. There is one room that it can be used by both units this contains Snoozellen equipment. Loddon Court is located in a suburb of Reading called Earley. It is close to all major transport links and there is a small town centre nearby. Access to the service is via Wokingham CTPLD team. The manager, to ensure that the service can meet the needs of the guests, requires that a thorough assessment has taken place. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection occurring between 10.30 and 16.30 hours. The Registered Manager was present throughout the inspection and the Area Manager for the service was present for the last two hours. The focus of the visit was to review the key standards not inspected at the last inspection in September 2005. These were primarily concerned with the medication, staffing, qualifications, management and the protection of the health and safety of guests and members of staff. One guest was present at the service during the inspection and was spoken with. This report should be read alongside the previous report in order to gain a complete overview of the service with regard to compliance to the key standards. What the service does well: What has improved since the last inspection? What they could do better: The home needs to develop a policy (in line with guidance from the Royal Pharmaceutical Society) with regard to the circumstances of administering medicines to guests who have given their consent to receive their medicines within their food and/or drinks. The training portfolios of some members of staff were not up-to-date and it was unclear as to how many care staff have achieved that least their NVQ 2. There was evidence from the Registered Manager to suggest that a small number of staff do not possess the correct attitudes and characteristics to carry out their important roles. The Registered Manager has addressed these issues with the staff members concerned. The Registered Manager must resolve these issues satisfactorily in order to reduce any potential risks that could occur. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 6 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. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 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 Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 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 the following standard(s): 20 The home should have a policy that details the circumstances for administering medicines to some guests (with their consent) within their food and drinks. EVIDENCE: The care plans for the administration of medicines were reviewed for the guests who were due to use the service during the week of inspection. From the care plans it was evident that a small number of guests receive their medicines within food and drinks. This procedure is conducted with either their expressed preference for this and/or the preference of their main carers (who are usually family members). These preferences are identified in their care plans and full details of how the procedure is to be carried out are also recorded. There are also detailed instructions for care staff as to how the medication is to be offered to the guests so that they can see and be told which food product or drink their medicines is within. There are also full risk assessments in place for this procedure. Whilst the home has a policy issued by the Provider organisation, New Support Options, with regard to the storage and administration of medicines there is no policy in the home with regard to the administration of medicines as described above. The home needs to establish such a policy as advised by the Royal Pharmaceutical Society. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 12 It was also revealed that for one guest, who only takes their medicines in a crushed form, that the members of care staff have been crushing all the medicines together. This is not considered to be good practice as if the guest were to reject some part of the offered medication it would be difficult to establish which medicine and its quantity the guest had consumed. A review of the rest of the procedures with regard to the administration of medicines was found to be satisfactory. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The Registered Manager is proactive in her investigation of any complaints or concerns from guests or their carers. She also ensures that guests are protected from any forms of abuse by ensuring her members of staff receive appropriate training and if necessary, taking action when members of staff have not complied with clear guidance. EVIDENCE: A previous requirement has been met. The complaints log was reviewed and it demonstrated that the Registered Manager does ensure that any complaints are investigated promptly and any outcomes as a result of the investigation are speedily implemented. Since the previous inspection there has only been one formal complaint received at the service, which was resolved to the satisfaction of the complainant. The Registered Manager does safeguard the guests who attend the service from all forms of abuse, neglect and self-harm. The Registered Manager has ensured that the majority of the members of staff have accessed specific training in the protection of vulnerable adults. Since the previous inspection there has been one formal protection of vulnerable adults strategy meeting for which the Registered Manager has provided written confirmation to CSCI that all actions from the meeting have either been put in place or are shortly to take place. During the week of the inspection the Registered Manager was noted to have taken appropriate action with regard to a staff member who had potentially increased the vulnerability of three guests. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32; 33; 34; 35 & 36 Members of staff are receiving training but this could not be consistently evidenced in the individual care staff training records. There are sufficient members of staff in the service however, it has been established by the Registered Manager that there are a small number of care staff who have deficit in the qualities required for good care staff. These deficits could increase the potential to place guests at risk. This matter must be addressed promptly. Members of staff are supervised regularly and the recruitment practices were found to comply with the regulations. EVIDENCE: The training portfolios for all members of staff were reviewed and were found, in some cases, not to be up-to-date. It was therefore not obvious as to what percentage of the care staff had achieved at least NVQ 2 by the end of 2005. The Registered Manager was able to evidence that all members of staff will be attending five days of training throughout April 2006. This training is being provided by New Support Options and is entitled the new approach. The Registered Manager said that the emphasis in the training will be on care delivery, care planning and communication. The National Autistic Society has Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 16 also selected the service for accreditation. Before this accreditation is achieved the members of staff in the home will have to undergo further training in the care and treatment of autism. The Registered Manager has promoted and endeavours to ensure that the guests who use this respite care service receive the highest standards of care. In order to achieve this a competent and able staff team is essential. Evidence was seen during the inspection that the Registered Manager has been attempting to instil into her staff team the imperative that guests are to be respected. Also that members of staff must be accessible, approachable, good communicators and listeners, reliable, honest, interested in their role, motivated and committed. From the evidence seen it was clear that the Registered Manager has had concerns about a small number of staff in providing all of the above qualities. There was evidence to demonstrate that she has monitored these staff members through closer supervision, provided additional training and provided mentoring. The indications at the inspection was that in spite of these additional factors some care staff were still not able to bring the above qualities to their role. These issues were drawn to the attention of the Registered Manager and her Area Manager, as there is potential to place guests at risk if members of staff do not possess the correct attitudes and characteristics to carry out their important role. The Area Manager confirmed that she had fully supported the Registered Manager and would continue to do so with regard to this issue. The service has an occupancy level of 70 . The Registered Manager confirmed that she almost has a full complement of staff. However, the service is starting a period of review where the deployment of staff and the way they work will be reviewed. She confirmed that this review will take place within the coming months and her focus is to ensure that the outcomes for the guests who use the service are improved. Appropriate rotas are kept in the home, which demonstrate there are sufficient members of staff on duty to meet the guest’s needs. Regular staff meetings do take place and they are recorded. The recruitment records of three members of staff were reviewed and all records required by regulation could be evidenced. The home does promote training for all members of staff and the Registered Manager does ensure that members of staff are able to access training. As previously mentioned some of the training portfolios of care staff were not upto-date. Random samples of supervision records were reviewed and were found to be comprehensive in their detail. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 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 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 & 42 The Registered Manager is qualified, competent and experienced to run the home. She is well respected by the guests and their carers. The management of a respite care service requires specific qualities, which this Registered Manager possesses. EVIDENCE: The Registered Manager is qualified, competent and experienced to run the home. An able Deputy Manager who is due to leave her post at the end of April 2006 has supported her for a number of years. A replacement Deputy Manager has been assigned and it has been agreed that she will commence work for four days a week increasing to full-time hours once the present occupant of the post has left. The administrative tasks in running a respite care service are considerable and the Registered Manager considers that they consume a disproportionate amount of management time. This has been accepted by New Support Options and the Registered Manager is to receive administrative support initially for three months. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 18 The service has recently taken part in a significant quality assurance project called Path. The evidence of this project was reviewed at the inspection and it was noted that it provided significant information about the value that guests and their carers have of the service. The information gathered was considerable and very informative. It is the Registered Managers intention to ensure that an annual development plan for the home is developed from this information. The Registered Manager ensures that the health, safety and well being of the guests are promoted and protected by ensuring that home is run with due regard to the legislation and regulations of other agencies. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 19 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 X 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 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 3 X 3 X X 3 X Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 20 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 YA20 Regulation 13(2) Requirement Timescale for action 30/04/06 2 YA32 18(1)(a) The home must develop a policy with regard to the administration of medication (with consent and expressed preference) in food and drink products. This policy should reflect the guidance of the Royal Pharmaceutical Society. 30/04/06 The Registered Manager must ensure that she has competent staff. They should possess the qualities required to provide good care. If there are identified deficits action should be taken. The Registered Manager and Area Manager agreed to review the circumstances revealed during the inspection. An action plan is required by CSCI to identify how the Registered Manager intends to ensure she has a competent staff team. The Responsible Individual must be made aware of this issue and advise and support the Registered Manager to achieve the actions that are identified by her and the Area Manager. Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 21 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 YA20 Good Practice Recommendations The Registered Manager should follow good practice guidance regarding the crushing of medicines if this is a guests expressed preference. Written guidance should be available to staff. The Registered Manager should be mindful that there was an expectation that 50 of her staff team should have achieved NVQ2 or above by the end of 2005. The training portfolios of staff members should be kept up to date. 2 3 YA32 YA35 Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 22 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 Loddon Court DS0000057907.V267004.R01.S.doc Version 5.1 Page 23 - 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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