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Inspection on 09/08/05 for New Wokingham Road 95

Also see our care home review for New Wokingham Road 95 for more information

This inspection was carried out on 9th August 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

From discussion with staff on duty and observation, the inspector gained the impression of a relaxed and well managed home. There is a good rapport between service users and the staff team. Staff on duty were friendly, helpful and professional in their approach to service users. There is clear evidence that all service users are offered choice and enabled to make decisions about their lives.

What has improved since the last inspection?

A new kitchen has recently been fitted and new appliances purchased. The upstairs bathroom has been refurbished and the home is to be redecorated internally and externally this year.

What the care home could do better:

Some first floor windows have been fitted with window restrictors. However, the two upstairs bedroom windows and bathroom window, used by service users could pose a risk of falling. Risk assessments relating to whether window restrictors are required are not in place. The dining area of the home and rear garden are accessible by steps which could pose a risk of an accident to service users.

CARE HOME ADULTS 18-65 95 NEW WOKINGHAM ROAD Crowthorne Bracknell Berkshire RG45 6JN Lead Inspector Marie Carvell Unannounced 9 August 2005 at 11.30am th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 95 New Wokingham Road Address Crowthorne Bracknell Berkshire RG45 6JN 01344 771369 N/k N/K New Support Options Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Jimmy Bala Care Home 4 Category(ies) of Learning Disability LD registration, with number of places 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 06/10/04 Brief Description of the Service: The home provides care and accommodation to four service users with learning disabilities, aged between eighteen and sixty five years. The home is situated within a short distance from Wokingham and Bracknell town centres. A range of local amenities and shops are easily accessible within walking distance. The home has its own vehicle and there is good access to public transport. The property is detached and accommodation is provided on two floors. Windsor and Maidenhead Housing Association own the property and the care is provided by New Support Options. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection on a weekday from 11.30am until 4.15pm. This was the first visit to the home for the newly allocated lead inspector. A tour of the communal areas of the home and several bedrooms, at the invitation of service users were seen. A sample of records required to be kept in the home were examined. Time was spent with the four service users and staff on duty. Feedback was given to the deputy manager at the end of the inspection. At the last inspection in October 2004, one requirement and four recommendations were made. These were regarding the reviewing of service user plans, maintenance issues in respect of the kitchen, training information to be collated, developing quality monitoring tools and the reviewing of some documentation in the home. These have been complied with. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Some first floor windows have been fitted with window restrictors. However, the two upstairs bedroom windows and bathroom window, used by service users could pose a risk of falling. Risk assessments relating to whether window restrictors are required are not in place. The dining area of the home and rear garden are accessible by steps which could pose a risk of an accident to service users. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 7 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. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2,4 and 5 There is a detailed admissions procedure, which includes a full assessment of need and a programme of induction to the home. Copies of contracts between the purchasing authority and service provider are kept on file. EVIDENCE: The four service users have lived together in the home for many years. One service user’s records were examined. Information regarding the initial assessment and background information was available on file and well documented. Each service user has a copy of the home’s Service User Guide, which includes terms and conditions. This is in pictorial format 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 and 9 Service users have detailed service user plans and are involved as much as possible with decision-making. Risk assessments are in place and regularly reviewed. There is a need to carry out additional risk assessments. EVIDENCE: Service users are encouraged to exercise their right to make decisions and choices. These are recorded in service user records. Risk assessments are in place and regularly reviewed. There is a need to carry out risk assessments for those service users accommodated in first floor bedrooms and use the first floor bathroom, as the windows which open wide could pose a risk to service users falling. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16 and 17 Service users enjoy a wide range of activities and leisure opportunities. Staff assist service users to maintain and develop appropriate relationships. Service users are assisted to make informed choices regarding daily living. The menus are based on the food choices of service users. EVIDENCE: Service users have a weekly activities timetable and activities book, which are completed by the staff team. The staff team are flexible and will change their duty shift in order to accompany service users to planned activities and outings. The inspector gained the impression of a good rapport between the service users, relatives and staff team. Service user birthdays and other events in the home always include families and friends. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 12 Daily records and service user reviews record regular contract between friends and family members. Service users are involved with food shopping and menu planning. Meals served are repetitive with cheese sandwiches served frequently for the evening meal and chicken dishes served for several consecutive days. The deputy manager confirmed that these were the meals requested by service users. However, on several occasions members of staff have suggested to service users to try a new dish such as Goat curry. This has proved to be very successful. Food stocks were plentiful with fresh fruit, vegetables and salad. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 Service users physical and personal care needs are well met. Medication is administered in a safe and appropriate manner. EVIDENCE: Service users physical and personal support needs are detailed in service user plans. Personal care provided is recorded in service user records. Service user records clearly evidence that regular healthcare checks take place and when declined by the service user this is also recorded. Medication administration records were seen to be well maintained with no obvious gaps in recordings. All staff who administer medication have received appropriate training. Medication was stored securely in locked cabinets. Medication policy, procedure and guidance are in place. The home’s policy is that no members of staff administer medication PR to service users. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The home’s complaints procedure needs to be available to service users in pictorial format. Staff need to receive training in the protection of vulnerable adults from abuse. EVIDENCE: The home’s complaints procedure needs to be available in pictorial format as the inspector was advised that only one service user was able to read. Some members of staff, when asked said that they had not received training in the protection of vulnerable adults from abuse. The home has a copy of the multi-agency procedures, although staff were not familiar with the contents. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The home is comfortable, homely and clean and currently meets the needs of the service users. EVIDENCE: The home is reasonably well maintained, although there are delays in getting routine minor maintenance tasks completed. The kitchen and upstairs bathroom have recently been refurbished to a good standard. The interior and exterior of the house are due to be redecorated this year, although no date is yet known. Some first floor windows have been fitted with restrictors. However, the two first floor bedrooms and bathroom used by service users could pose a risk a risk of falling. The dining area of the home and rear garden are accessed by steps which could pose a risk of an accident to service users. The home was found to be fresh smelling, clean and homely. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Staff individually and collectively were able to demonstrate that they have the skills, knowledge and experience to effectively meet the needs of the service users. EVIDENCE: Many of the staff on have been in post for a number of years. Staff on duty had detailed knowledge of the service users needs and the inspector gained the impression of a good rapport between service users and staff on duty. The home currently has vacancies for two full time support workers; bank staff is covering these hours. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39 and 42 This is a well managed home. Policies and procedures are in place. Records relating to health and safety were well maintained and up to date. EVIDENCE: Staff in the home are very positive and feel well supported and valued by the manager. Policies and procedures are reviewed on a regular basis. There is an annual management audit undertaken by the Service Manager and Proprietor representative visits are undertaken on a monthly basis. A sample of records relating to fire safety, fridge, freezer and hot water temperatures were up to date. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 18 Since October 2004 there has been twenty seven accidents recorded in the home. It was not possible to identify whether these were accidents to service users or staff, as the completed forms were not available for examination. These will be examined at the next inspection. 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 2 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 95 NEW WOKINGHAM ROAD Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 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 9 Regulation 13(4) Requirement That the manager carries out risk assessments and takes appropriate action to reduce the risk of falling from first floor windows. That the manager introduced a varied menu offering service users a choice of foods. That the manager produces a complaints procedure for service users in an appropriate format. That the manager makes arrangements for all staff to receive training/updating in the protection of vulnerable adults procedures. That the manager seeks the advice of an Occupational Therapist regarding the steps in the dining area of the home and rear garden. The CSCI are to be advised of the outcome. Timescale for action 09/10/05 2. 3. 4. 17 22 23 16 22 13(6) 09/10/05 09/11/05 09/11/05 5. 24 23 09/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 21 95 NEW WOKINGHAM ROAD Standard 1. None made 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Reading RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 95 NEW WOKINGHAM ROAD H52-H01 50661 95 New Wokingham Road V235095 090805 Stage 4.doc Version 1.40 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!