Inspection on 12/03/07 for Loddon Court

This inspection was carried out on 12th March 2007.

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.

Other inspections for this house

Loddon Court 23/02/09

Loddon Court 01/03/06

Loddon Court 17/09/05

Loddon Court 10/02/05

Loddon Court 26/10/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

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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 Robert Dawes Unannounced Inspection 12th March 2007 11:00 DS0000057907.V331254.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 DS0000057907.V331254.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. DS0000057907.V331254.R01.S.doc Version 5.2 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) www.new-support.org.uk New Support Options Limited Miss Tracey Katherine Mallett Care Home 8 Category(ies) of Learning disability (8) registration, with number of places DS0000057907.V331254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st March 2006 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. Fees are £154.65 a night. DS0000057907.V331254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced site visit, which took place during the day on the 12th March 2007. The pre-inspection questionnaire, four houseguests’ questionnaires and one comment card from a visiting professional were returned to the inspector before the site visit. These, together with the site visit, were the main sources of information for the key inspection. During the site visit the inspector spoke with two of the four houseguests resident in the home on the day of the site visit; interviewed the manager and two members of staff; toured the premises; looked at records; case tracked; and observed the interaction between houseguests and staff. Twenty-two standards were assessed during the site visit of which twenty one were met and one was exceeded. One recommendation was made. What the service does well: What has improved since the last inspection? What they could do better: Produce an Equality and Diversity policy. DS0000057907.V331254.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. DS0000057907.V331254.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 DS0000057907.V331254.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): Quality in this outcome area is good. There is a clear criteria and procedure regarding the admission of new houseguests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Detailed pre admission assessments are completed before houseguests are admitted to the home. The home has appropriate admission procedures. DS0000057907.V331254.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): Quality in this outcome area is good. All houseguests have individual plans, which are reviewed annually. Houseguests make decisions about their lives with assistance as needed. Houseguests are supported to take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the houseguests’ files looked at had detailed individual care plans, which had been reviewed annually with the houseguest, parent/carer, care manager and home’s staff. The files also contained daily notes, behavioural guidelines, risk assessments and a photograph of the houseguest. In response to the question in the professionals’ questionnaire ‘if you give any specialist advice is this incorporated into the care plan?’. The profesional replied ‘yes’. DS0000057907.V331254.R01.S.doc Version 5.2 Page 10 The keyworker system is being reviewed and houseguests are to be given the choice of who they would like to be their link worker. Records of houseguests’ meetings showed houseguests were consulted about meals, activities and outings. Houseguests without families are found advocates to assist them make decisions about their lives. In response to the question in the houseguests’ questionnaire, ‘do you make decisions about what you do each day?’ four replied ‘usually’. Houseguests can choose the room they use for their stay when ever possible. Houseguests are encouraged to be as independent as possible, i.e. make hot drinks, and assist with the preparation and cooking of food. The inspector was informed that houseguests go out on their own with the permission of the parents. Risk assessments have been completed. DS0000057907.V331254.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): Quality in this outcome area is good. Houseguests are able to take part in appropriate activities, which reflect their diverse needs; they participate in the local community and are enabled to keep in touch with their families and friends. Houseguests’ rights are respected and responsibilities recognised in their daily lives. Houseguests are offered a healthy diet and enjoy their meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At present houseguests attend day services, therapeutic work placements or undertake paid employment in the community. Activities are only provided in the home during the day if day services are shut or other circumstances such as college holidays necessitate a houseguest coming to the home during the day. Under a new contract the local authority has agreed with the organisation a range of activities will be provided during the day, including skills workshops and outreach work, to improve houseguests’ independent living and employment skills. DS0000057907.V331254.R01.S.doc Version 5.2 Page 12 At weekends houseguests are enabled to access facilities in the community such as cinemas, shops, bowling alley, swimming pools, pubs and theatres. The home has an adapted vehicle which enables houseguests to go out on day trips. In the evenings a range of activities are available such as play stations, table football, DVDs, music and television. Records of houseguests’ meetings showed they were asked about activities and outings. Houseguests said, I am taken out by staff if Iwant to go anywhere, we had a lovely party at Christmas and for New Years eve, and ‘we get taken out at weekends to the cinema’. When a driver is available houseguests are enabled to attend religious services in the community. The cultural background of the houseguests is respected and reflected in the range of churches, mosques and synagoges houseguests attend. Family and friends can visit houseguests at any reasonable time. If possible it is arranged for friends to stay at the same time. The home has no policy for same sex relationships and it was recommended that an Equality and Diversity policy is developed. Houseguests were observed to have unrestricted movement around the home. Houseguests are offered keys to their rooms. Houseguests can choose to be alone. Staff were observed to interact well with the houseguests. Records and observation showed staff consult with houseguests as much as possible about the daily routines to encourage them to feel respected and responsible. In response to the question in the houseguests’ questionnaire, ‘can you do what you want to do during the day, evening and week ends?’ all four replied ‘yes’. Houseguests said ‘staff talk to me nicely and are helpful’, ‘they are nice and spend time chatting to you’, ‘they knock before entering your room’, and ‘I can stay in my room if I want’. Due to the turnover of houseguests the menu is continually changed to reflect the likes and dislikes of the houseguests and their dietary and cultural needs. Houseguests are asked what they like and dislike and the staff will do their best to accommodate their choices balanced with a healthy and nutritious diet. Houseguests said ‘they like the food and can have drinks when they like’. Those who are able help with the preparation and cooking of the food. DS0000057907.V331254.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): Quality in this outcome area is good. Houseguests receive personal support in the way they prefer and require and their physical and emotional health needs are met. Staff adhere to the medication policy and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The houseguests looked clean and presentable. Staff were observed to respond and care for the houseguests in a sensitive and professional manner. Houseguests said ‘they can go to bed and get up when they like’, ‘they like the home’, ‘staff are nice’ and ‘can have a bath when they like’, ‘staff are nice and look after you well’ and ‘clothes are kept clean’. Records of staff meetings showed houseguests’ needs were discussed. Photos of houseguests using makaton signs are on display on the walls. The manager looks at the compatability, risks and mix of houseguests when booking the rooms to ensure their diverse needs are catered for as best as possible. DS0000057907.V331254.R01.S.doc Version 5.2 Page 14 In response to the questions in the houseguests’ questionnaire, ‘do the staff treat you well?’ and ‘do the carers listen and act on what you say?’ 2 replied ‘always’ and 2 replied ‘usually’ to both questions. In response to the question in the visiting professionals’ comment card, ‘ are you able to see the houseguests in private?’ the professional replied ‘yes’. Parents of a houseguest raised concerns about the care practice their daughter was receiving. The organisation has responded robustly to these concerns. Relatives and friends have the main responsibility for ensuring the houseguests maintain good physical and emotional health. However houseguests’ files showed appropriate information about houseguests’ physical and emotional health needs are kept and issues are addressed when a houseguest is staying in the home. A member of staff was observed to keep checking a houseguest who was not interacting and appeared withdrawn and agitated. The home has appropriate medication policies and procedures. The requirement and recommendation made at the previous inspection have been addressed. The medication administration records were in order. A pharmacist visits the home twice a year to check the receipt, recording, storage, administration and disposal of the medicines. Sufficient staff are trained to administer the medication. Staff have also been trained to to administer rectal diazepan, oxygen and epipen. Several houseguests self medicate. They are provided with lockable tins and sign the administration records in front of a member of staff. In response to the question in the professionals’ questionnaire ‘is the houseguests’ medication appropriately managed in the home?’ the professional replied ‘yes’. DS0000057907.V331254.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): Quality in this outcome area is good. Houseguests feel their views are listened to and acted on. The organisation has responded robustly to the allegations of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: In response to the questions in the houseguests’ questionnaire ‘do you know who to speak to if you are not happy?’ and ‘do you know how to make a complaint?’ all four houseguests replied ‘yes’. Complaints leaflets are sent to houseguests, parents and carers before the first stay. Four complaints have been made to the home since the last inspection. All were responded to appropriately. No complaints have been made to the Commission since the last inspection. In the last twelve months three safeguarding younger adult referrals were made and two adult protection investigations took place. The organisation has responded appropriately and robustly to the allegations, thoroughly investigated when required and taken appropriate action, i.e. produced risk assessments; increased the staffing level at key times; arranged Safeguarding Younger Adults and SCIP training; and organised staff meetings. All houseguests who want to look after their own personal money during their stay have the use of lockable cabinets in their rooms. Houseguests’ personal money that is looked after by the home is kept in individual wallets and records made of all transactions. The manager audits these records every weekly. DS0000057907.V331254.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): Quality in this outcome area is good. Houseguests live in a homely, comfortable and safe environment. The home is kept clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is only three years old, purpose built and well decorated and maintained. On the day of the site visit the home was clean and hygienic. In response to the question in the houseguests’ questionnaire, ‘is the home fresh and clean?’ three houseguests replied ‘always’ and 1 replied ‘usually’. Staff currently keep the home clean but it has recently been agreed that a cleaner will be employed. DS0000057907.V331254.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): Quality in this outcome area is good. An effective, competent and qualified staff team who are appropriately trained support the houseguests in a caring, respectful and equitable manner. Any evidence of poor care practice is robustly addressed by the manager and the organisation. The home operates a thorough recruitment procedure. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Over 50 of the permanent support staff have achieved a NVQ 2 or above in care. Two staff are currently studying for a NVQ. Staff interviewed demonstrated a good understanding of the houseguests’ needs and the skills necessary for the tasks they are expected to do. They said they enjoy working at the home and there are sufficient staff to respond to the needs of the houseguests. In response to the questions in the houseguests’ questionnaire ‘do the staff treat you well?’ and ‘ do the carers listen and act on what you say?’ 2 replied ‘always’ and 2 replied ‘usually’. DS0000057907.V331254.R01.S.doc Version 5.2 Page 18 Comments included in the replies were: I enjoy myself at Loddon Court and always look forward to my visit,’ all the staff are very kind to me all the staff are very nice to me Loddon Court provides an excellent service staff are kind and caring, will always listen to concerns and problems, ‘there is a big language barrier. Staff not able to understand what is said and care was alright when I started going 18mnths ago but it has fallen more recently’. In response to the questions in the Social Care Professionals’ questionnaire do staff demonstrate a clear understanding of the care needs of houseguests?’ and are you satisfied with the overall care provided to houseguests within the home?’ the professional who replied said ‘yes’ to both questions. The manager and organisation have addressed the concerns expressed in the last inspection report about a small number of staff not demonstrating qualities expected of professional carers. A review of staffs roles/responsibilities is taking palce to ensure they are clear about their responsibilities and are happy in their work. A cleaner is to be employed to enable support staff to provide more care hours and extra admin support is to be provided which will enable the manager to spend more time with the houseguests and monitoring the level of care provided. No new staff have been recruited since the last inspection when the recruitment records were found to be in order. The organisation provides an induction and foundation training programme for all new staff and necessary basic and key training courses, which the majority of staff have attended. Other courses on topics such as autism, epilepsy, makaton, and anti discriminatory practice are available to staff. Staff said there were sufficient training opportunities to undertake their duties and responsibilities. Safeguarding Younger Adults training has been arranged for all staff for 23rd March and a two day SCIP training course for the following week. The manager is planning to arrange communication passport training in the near future. Refresher training of key areas of work takes place. DS0000057907.V331254.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): Quality in this outcome area is good. Houseguests benefit from a well run home. The home operates a very effective quality assurance and quality monitoring system. The health, safety and welfare of houseguests are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is qualified, competent and experienced to run the home. Staff informed the inspector that the manager is conscientious, the care of the houseguests is her prime consideration and is clear in how she wants the home to run. Regulation 26 visits take place as required. Houseguests’ meetings took place in January and March of this year. Staff meetings have taken place in May 2006, October 2006 and two in January 2007. DS0000057907.V331254.R01.S.doc Version 5.2 Page 20 Parents forums take place four times a year. A meeting of houseguests, parents/carers, care managers and staff take place annually. Satisfaction questionnaires are sent to houseguests and parents/carers before the meeting. This annual meeting and returned questionnaires informs the annual ‘PATH’ plan which identifies the objectives for the coming year and how the home and organisation are going to achieve these objectives. The ‘PATH’ plan is put on display in the home. A recent assistive technology assessment has been carried out to identify equipment such as epilepsy sensors, enuresis sensors, wrist aid callers and pagers that should be purchased to improve the quality of care and reduce the risk of harm to houseguests. Questionnaires have recently been sent to houseguests asking them what they would like to happen when the new changes to the service and provision of day care opportunities take place. In response to the number of significant incidents that have occurred in the last year the organisation initiated two team days in January 2007, which included bank staff, to discuss the findings of the investigations and how similar incidents could be prevented in the future. The team days identified the need for a well trained work force, to improve the management and supervisory skills of the senior staff and to improve the quality of communication between staff and service users. The organisation has organised appropriate training and staff took away action plans. A follow up meeting has been arranged for May 2007 to discuss how the changes and initiatives have impacted on the service All health and safety checks and inspections are up to date and completed as required. All necessary health and safety policies and procedures are in place. An annual health and safety audit is conducted annually by the organisation. DS0000057907.V331254.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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 4 X X 3 X DS0000057907.V331254.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. Standard Regulation Requirement Timescale for action 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 YA15 Good Practice Recommendations An Equality and Diversity policy is developed. 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