Inspection on 10/05/05 for REACH Lower Cippenham Lane

This inspection was carried out on 10th May 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.

Other inspections for this house

REACH Lower Cippenham Lane 18/10/06

REACH Lower Cippenham Lane 13/10/05

REACH Lower Cippenham Lane 05/10/04

REACH Lower Cippenham Lane 25/05/04

REACH Lower Cippenham Lane 27/01/04

REACH Lower Cippenham Lane 12/08/03

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

CARE HOME ADULTS 18-65 178 LOWER CIPPENHAM LANE Cippenham Slough SL1 5EA Lead Inspector KERRY KINGSTON Unannounced 10 May 2005 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. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 178 Lower Cippenham Lane Address 178 Lower Cippenham Lane, Slough, Berks, SL1 5EA 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) 01628 666132 REACH Ltd Care Home 12 Category(ies) of Learning disability (9), Learning disablity over registration, with number 65 years of age (2), Mental disorder, excluding of places learning disability or dementia (1) 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No Date of last inspection 5 October 2004 Brief Description of the Service: 178 Lower Cippenham Lane offers twenty four hour residential care to twelve, male and female adult service users who have a diverse range of learning and associated disabilities. The house is a large two - storied detached building with accommodation on both floors. The home is situated in a residential area of Slough and the town is accessible by means of the the homes own transport and via the public transport system. There are local facilities, within walking distance, and the home is an integral part of the community. The building is owned and the care is provided by REACH Ltd. Although the home is relatively large, staff ensure that its domestic ambience is retained. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector carried out a routine unannounced inspection, which lasted approximately four and a half hours. There were nine residents and four staff in the home. The team leader and most of the residents were spoken with and some records and resident files were checked. The three requirements from the last inspection had not been met but this did not appear to be having any negative effective on the service users that the inspector met on the day of inspection. What the service does well: What has improved since the last inspection? What they could do better: Staff could make sure that residents, who were at home, were more involved in what was going on and talk to them more. Staff could be supervised more often to make sure that they worked in the right way. Please contact the provider for advice of actions taken in response to this 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 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 standard(s) 2 The new service users’ needs were assessed and his views were taken into account. More detailed recording of the service users’ preferences and the homes’ ability to deal with his needs would have been beneficial. EVIDENCE: The new service user had a care management and residential assessment, on file but there was no admission panel paperwork or evidence that the home could meet his specific needs. First review notes were not available to evidence how the home had been meeting his needs and there was no specific plan for the necessary specialist interventions. The service user told the inspector that he was ‘settling’ in, which had been difficult at first and that he was ‘spoilt’ by the staff who looked after him well. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 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 standard(s) None of the above standards were assessed at this inspection. EVIDENCE: 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 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 standard(s) None of the above standards were assessed at this inspection. EVIDENCE: 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 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 standard(s) 18,19 and 20 Service users receive good quality personal support and their physical and emotional health needs are well met. The home operates safe medication administration procedures. EVIDENCE: Service users care plans noted what support they needed and how they preferred it to be given. Service users told the inspector that they were well looked after. Cross gender care guidelines are noted on individual plans. Healthcare appointments are recorded and any health issues were seen to be responded to very quickly, one service user said that he was very happy to be home after a prolonged stay in hospital. The four files examined showed that the service users had attended all necessary routine health checks. The mobility of one service user, has improved greatly since her admission. There were no errors noted on the medication records but the guidelines for the use of P.R.N. medication could be more detailed. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 12 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 Service users are aware of the complaints procedure and are willing to use it. They are, in general, protected from abuse but there are issues around the way monies are dealt with. EVIDENCE: There have been no recorded complaints by service users since the last inspection, but there was evidence that the complaints procedure is discussed at resident meetings and complaints have been made and responded to in the past. One service user was observed making some minor complaints to a staff member who dealt with them appropriately, on the day of inspection. Most of the staff team have been trained in the Protection of Vulnerable Adults and are to be trained in Non Violent Crisis Intervention during the coming few months (the training plan was available for examination) The Inter Agency procedure is adhered to, when necessary and there has been one vulnerable adults issue since the last inspection. Service users cash records were not accurate, as they had been lending money to the house for shopping and to each other, as a matter of convenience. The senior staff member was advised that this was not acceptable practice. There was no evidence that the home had reviewed the practice of service users paying for staffs’ out of pocket expenses and the staff available had no knowledge of whether this was still happening or not. The reasons for service users purchasing their own soft furnishings for their bedrooms were not noted on their files. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 13 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 house was homely and comfortable and had high standards of cleanliness and hygiene. EVIDENCE: The home is well decorated and the furniture and fittings are domestic but of good quality. Service users were relaxed and making good use of the communal facilities, on the day of inspection. The house was very clean and tidy and there were no unpleasant odours or areas of disrepair. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 Staff were not appropriately supervised. EVIDENCE: Supervision records showed that staff had received only one supervision session in a twelve-month period. The quality of the supervision was good but the frequency was inadequate. Staffs’ general attitude to service users, on the day of inspection, with regard to engaging them in the day to day routines and communication with them showed that staff require some direction in their work practice. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 15 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 and 42 The home is adequately managed. The home ensures that service users are kept safe. EVIDENCE: The home has not had a registered manager for several years and whilst it is adequately managed it would benefit from a stable manager to ensure standards are maintained and consistency in the care offered. (See standard 23 and 36) All Health and Safety maintenance records were up-to-date and staff were participating in training up-dates. Radiators had been risk assessed but advice was given that the assessments need to be more specific to cover individual risk to service users or areas where there was a more significant risk. Accident and incident reports are kept but further detail would be beneficial, as would cross referencing with individual service users daily notes. 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 16 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 2 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x 1 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 178 LOWER CIPPENHAM LANE Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 x H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 17 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 2 23 Regulation 14.1(d) 16.2 (m n) 13.6 Requirement To confirm that the home is suitable to meet the assessed needs of the service user. To review the practice of servivce users paying staffs out of pocket expenses (3rd repeat of requirement) To ensure cash records are accurate. To ensure staff are adequately supervised(2nd repeat of requirement) To appoint a suitably experienced and qualified manager. (4th repeat of requirement) Timescale for action 01.07.05 01.06.05 3. 4. 36 37 18.2 8.1 01.06.05 01.09.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 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 178 LOWER CIPPENHAM LANE H51-H01-S11286 178Lower Cippenham LaneV217748-100505-Stage 4.doc Version 1.30 Page 19 - 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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