Inspection on 11/01/06 for Slade House

This inspection was carried out on 11th January 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Slade House 18/12/06

Slade House 19/07/05

Slade House 08/06/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 Slade House 17 Huckleberry Close Purley on Thames Berkshire RG8 8EH Lead Inspector Stephen Webb Unannounced Inspection 11th January 2006 11:00 DS0000057641.V272670.R01.S.doc Version 5.0 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 DS0000057641.V272670.R01.S.doc Version 5.0 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. DS0000057641.V272670.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Slade House Address 17 Huckleberry Close Purley on Thames Berkshire RG8 8EH 0118 942 7608 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) rachelk@purleyparktrust.org Purley Park Trust Limited ***Post Vacant*** Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Physical disability (2) of places DS0000057641.V272670.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents with the PD category only to be accommodated in ground floor bedrooms. 19th July 2005 Date of last inspection Brief Description of the Service: Slade House is one of five recently built units to replace the old main house on the Purley Park site. It is now one of eight smaller units on the attractively landscaped site, together with a separate club-house.The house opened in May 2004 and accommodates eight adult service users with a learning disability in a two-storey house. Like all of the units on site, it now has a designated manager and staff team, who meet the needs of the service user on a day-to-day basis. The site is enclosed apart from at its entrance, and provides a community within which service users can circulate freely, without the need for direct staff support. Service users are able to visit friends in the other houses.When off-site, all of the service users are supported by a staff member to varying degrees DS0000057641.V272670.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out between 11.00am and 4.15pm on the 11th of January 2006. The inspection included discussion with the manager and staff, examination of various records, a tour of most of the unit and brief discussion with several service users. The inspector also had lunch with service users. There was a relaxed atmosphere in the unit and the relationship between serviced users and staff was a positive one. Service users were very happy with their bedrooms and enjoyed living in the unit. They liked the food and the freedom to visit other houses. One was pleased that he looked after his own cat in his room. What the service does well: There are good records of the individual needs, likes and dislikes of service users, and each has developed and become more confident as they have settled into the unit. Each service user has two reviews of their progress each year, and these are planned centrally and provided as a schedule to the unit. Detailed health records are maintained, including records of relevant healthcare appointments, which indicate regular attendance where appropriate. Good progress has been made in increasing the opportunities for individuals to make their own decisions about day-to-day activity and life around the house; and the increasing confidence of service uses is evident in their interactions with staff and the inspector. Arrangements for the management of service user finances are sound, though there may be room for further development of involvement in this for some. Within an appropriate risk assessment framework, service users enjoy a good level of freedom within the site and largely determine the pattern of their day. The unit has an appropriate complaints procedure, which is verbally explained to service users. The unit is provided with appropriate adaptations to meet the current needs of service users. The staff team has begun to consolidate, following some recent recruiting, though two posts remain to be filled. The staff communicate effectively and there is a relaxed and good-humoured atmosphere in the team. DS0000057641.V272670.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000057641.V272670.R01.S.doc Version 5.0 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 DS0000057641.V272670.R01.S.doc Version 5.0 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): EVIDENCE: None of these standards were examined on this occasion. Standards 2 and 5 were examined at the previous inspection. A requirement arising from that inspection, to arrange for remaining service user contracts to be countersigned, had since been addressed. DS0000057641.V272670.R01.S.doc Version 5.0 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): 6, 7 The needs and goals of service users are reflected in essential lifestyle plans, which are discussed with them. Service users are enabled and supported to make decisions about their daily lives with support provided where necessary. EVIDENCE: Each service user has an essential lifestyle plan containing detailed information on their likes, dislikes, needs, appropriate interventions etc. which is compiled by the keyworker. Each service user has two reviews per year to explore progress and agree on new goals. The schedule of reviews is maintained and administered centrally, and the unit receives a regular schedule of review bookings. It was evident from the records and from conversation with service users, that they had continued to develop their skills and confidence, and had settled well together as a group. They also talked about their summer holiday, which had clearly been enjoyed and were already planning the next one. DS0000057641.V272670.R01.S.doc Version 5.0 Page 10 Appropriate arrangements had been made to support a service user through the grieving process after the death of a close friend, which included being taken to lay flowers on their grave. Service users are involved in making day-to-day decisions about their lives and How they would like to spend their time, withy support from staff where necessary. One was very proud of her attendance at classes run by Reading College (in the on-site clubhouse), others talked about supported employment or involvement in the on-site day services or horticultural therapy. They are actively encouraged to express their views and to contribute to reviews, and discussions about plans for the house. Although residents meetings are not frequent, there are often informal discussions over the meal table, which are reported to be effective for the group. The units report to a review is gone through with the service user before the meeting and they are asked for their opinions. Most are becoming more confident to express their views as they settle in the group. There are risk assessments in place for individuals to manage their personal allowance though individuals only hold small amounts of money at a time, and any service users money is tracked by monitoring form and signatures. Receipts are also retained. One service user’s finances are managed by a parent. The unit retains a maximum of £20 per service user at a time, unless funding for a specific item has been obtained, and amounts over £20 have to be countersigned by senior management. DS0000057641.V272670.R01.S.doc Version 5.0 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 the following standard(s): 16, 17 The rights of service users are respected and they are encouraged to take appropriate responsibility for aspects of their daily lives and decisions. Service users are provided with a healthy diet and enjoy their meals in pleasant and homely surroundings. EVIDENCE: The daily routines are flexible to suit the needs of individuals, and service users enjoy a high level of choice in terms of how to spend their time, and a degree of independence of movement about the site, (within the context of a risk assessment system), including the freedom to visit friends in other units. Service user’s mail now comes to the unit unopened, (it used to be opened centrally), and is given to the service user to open. Some open their own letters, other ask staff to help or to read it to them. Observation of service users interactions confirmed they relate well to staff and feel comfortable enough to share a joke or even initiate one at times. They are DS0000057641.V272670.R01.S.doc Version 5.0 Page 12 free to spend time in their rooms or with the group. Service users are involved to varying degrees in household tasks like shopping, cleaning and cooking. In this unit the pattern of service user involvement in activities means that the main meal is in the evening, with a lighter meal ant lunchtime. Service users take part in some food shopping and meal preparation. The likes and dislikes of individuals are addressed within the menus, which are discussed with service users. There are currently no special dietary requirements, but these would be addressed if required. Feedback from service users indicated they enjoyed the food and confirmed they were involved to some degree in its provision. The lunchtime was orderly and pleasant with all but one of the service users eating together in pleasant and homely surroundings. DS0000057641.V272670.R01.S.doc Version 5.0 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 the following standard(s): 19 The physical and emotional health needs of service users are met effectively by the service. EVIDENCE: The service user’s individual files contain a section on health care, which includes record sheets for contact with various external medical/healthcare services. The records indicate recent appointments where appropriate, and annual medicals if a service user has not seen the GP in the past 12 months. The manager is planning to review the medication for all service users with their GP over the next few months. Two of the service users have diabetes but this is diet controlled for both, and service users have few other ongoing health issues. The level of day-to-day interaction with service users enables staff to monitor their emotional health on an ongoing basis, and seek professional advice if required. DS0000057641.V272670.R01.S.doc Version 5.0 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 the following standard(s): 22, 23 The views of service users are listened to on a day-to-day basis and issues tend to be resolved promptly. Service users are protected from abuse, neglect and self-harm, though the staff do need to attend accredited adult protection training. EVIDENCE: The unit has an appropriate complaints procedure, which is explained to service users. A version in symbol form is also available. However, Regulation 26 visitors should countersign the complaints log to evidence their required monthly checks. All of the service users in the unit would be able to raise a concern for themselves, and the relationship between service users and staff means that most issues are dealt with at an early stage before they need to become a complaint. Service users also know the head of care and Chief Executive by name and both are readily accessible on-site. One of the service users has an independent advocate, and some others have regular family contact. There were no recorded complaints since July 2005. The views of service users are also sought regarding their reviews. Although house meetings are infrequent, informal discussions often take place over the meal table. DS0000057641.V272670.R01.S.doc Version 5.0 Page 15 The unit has the organisational vulnerable adults protection procedure as well as a copy of the local multi-agency adults protection protocol available. Service user finances are protected by the recording and management system in place, though there may be room for some service users to develop greater involvement in managing these. Although all of the staff have received some in-house adult protection training via video, none has received accredited training in this area. The organisation needs to set up this training as a priority. DS0000057641.V272670.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Service users live in a homely and comfortable unit, purpose built recently to address their needs, and provide a safe environment. The unit is clean and hygienic. EVIDENCE: The environment generally remains in good condition, though the décor in the dining area would benefit from attention. The unit is well furnished and the level of homeliness has improved as the group has settled in. There have been some problems with the heating system, but contingency plans are in place should this be problematic. Service user’s bedrooms are very much individualised to reflect the interest and personality of their occupant. The service users confirmed they liked their rooms and had everything they needed. During the tour of the building it was noticed that one of the wires running below the handrail on the balcony had become loose. The manager undertook to report this for urgent attention. DS0000057641.V272670.R01.S.doc Version 5.0 Page 17 There are some adaptations in place to meet the needs of individuals, including walk-in showers and an adapted bath with an integral seat and a hoist. The corridors are also spacious and the doorways wide. One service user has a cushion provided to raise the height of the chair for them. The unit was clean and free of any unpleasant odours. DS0000057641.V272670.R01.S.doc Version 5.0 Page 18 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 Service users are supported by a competent staff team, though there is a need to fill the vacant posts and provide vulnerable adults protection training. EVIDENCE: Service users are supported by an able staff group, who have gelled well as a team, despite several recent appointments. One of the new staff confirmed she had received some of her induction training, with other courses to come; though as already noted, there is a need for all staff to receive training on the protection of vulnerable adults. The unit does have one team leader and one senior support worker vacancies, which need to be filled to enable the number of staff on shift to increase, so as to maintain the level of service user involvement in outside activities. These posts are apparently being advertised internally at present. The manager has received his NVQ level 4 and Registered Manager’s Award, and progress is being made on NVQ generally. The organisation now put new staff onto NVQ once the complete their induction. Observation of the staff handover, indicated that staff communicated effectively, and there was a relaxed atmosphere in the unit. DS0000057641.V272670.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The views of service users and relevant others, are not currently obtained systematically as part of a quality assurance strategy, though they are taken account of on a day-to-day basis. An effective cycle of quality assurance needs to be established. There is insufficient evidence available in the unit, to confirm that Regulation 26 visits are `taking place monthly, in the absence of any reports since September. There is a need to produce an annual development plan for the unit for the period from April 2006. EVIDENCE: Examination of the Regulation 26 reports available in the unit revealed that the most recent was for September, so it was not possible to establish that these visits had taken place monthly as required. Regulation 26 monitoring visit should take place monthly and a copy of the resulting report should be made available to the unit manager. DS0000057641.V272670.R01.S.doc Version 5.0 Page 20 The views of service users and relevant others, are not currently obtained systematically as part of a quality assurance strategy, though they are taken account of on a day-to-day basis. An effective cycle of quality assurance needs to be established, and the format copied to the inspector. A copy of the resulting annual report should be provided to the inspector. The manager had yet to devise the annual development plan for 2006/7. The cycle of annual review of service, quality assurance survey, annual development planning was discussed with the manager. The manager should forward a copy of the annual development plan to the inspector on completion. The manager was providing supervision regularly to the staff, though not yet to the organisational expectation of every 4-6 weeks, owing to the current team leader vacancy. DS0000057641.V272670.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000057641.V272670.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO 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 3 Standard YA22 YA23 YA39 Regulation 26 13, 18 26 Requirement The regulation 26 visitor should countersign the unit’s complaints log to evidence their monitoring. Adult protection training from an accredited trainer should be provided to all staff. Regulation 26 visits should take place monthly and a copy of the resulting report should be sent to the unit manager at the unit. A systematic quality assurance system should be established and details forwarded to the inspector, together with a copy of the report on the annual review of the service. An annual development plan for the unit should be produced and copied to the inspector. Timescale for action 16/02/06 16/04/06 16/02/06 4 YA39 24 16/04/06 5 YA39 24 16/04/06 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 Standard Good Practice Recommendations DS0000057641.V272670.R01.S.doc Version 5.0 Page 23 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 DS0000057641.V272670.R01.S.doc Version 5.0 Page 24 - 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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