Inspection on 18/12/06 for Slade House

This inspection was carried out on 18th December 2006.

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

Slade House 11/01/06

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 Amanda Longman Unannounced Inspection 18th December 2006 10:00 Slade House DS0000057641.V321944.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 Slade House DS0000057641.V321944.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. Slade House DS0000057641.V321944.R01.S.doc Version 5.2 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 Mr Nicholas Frank Willatt 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 Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents with the PD category only to be accommodated in ground floor bedrooms. 11th January 2006 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 Slade House has an appropriate equal opportunities policy and their policies and procedures reflect their desire to meet all individual service users’ needs. Fees vary depending on the level of care being received and currently range from £520 to £894 per week. Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. It was a thorough look at how well the service is doing. It took account of information received from the service provider prior to the site visit which occurred on 18 December 2006. During this visit the inspector examined policies and procedures, looked at care records and staff records. The manager, two other staff and head office staff were spoken with. All service users were spoken with and two service user questionnaires provided information in advance of the site visit. What the service does well: 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. The summary of this inspection report can Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 6 be made available in other formats on request. Slade House DS0000057641.V321944.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 Slade House DS0000057641.V321944.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. This judgement has been made using available evidence including a visit to this service. Service users have appropriate information to make a decision about living at Slade House and their individual needs and aspirations are assessed. EVIDENCE: Service user records show individual assessments and six monthly reviews, undertaken with service users, which document individual needs and aspirations are in place. Service User guides and individual contracts have been received by service users at Slade House. Management guidelines have recently been compiled with all service users, which contain up to date care plans. Slade House DS0000057641.V321944.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. This judgement has been made using available evidence including a visit to this service. Service users make decisions about their own lives, they have appropriate individual plans and risk is appropriately managed. EVIDENCE: Pre inspection information received showed activities include college courses, clubs and groups both on and off site. (There is a club house on site, which runs several clubs and groups including arts and crafts, cooking courses, a social club and horticultural activities.) In addition shopping and cinema trips are organised off site. There is free opportunity to socialise with other people living on the site. Management guidelines have recently been introduced for all service users, which contain up to date care plans, including activities and these were seen to be reviewed with service users, every six months. Risk assessments for all activities and risk management plans are in place. From discussions with service users, observations of care and discussions with staff, it was apparent that service users make their own decisions about their daily lives, including Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 10 what time they get up and go to bed, whether they stay in the house or go out, within the site. Their individual plans also show they make decisions about clubs and activities they wish to attend. From observations and service user questionnaires it appears the only limit on freedom of activity is the availability of staff to take service user off campus on an unplanned basis. Discussions with the manager and staff showed they are flexible about this but it is limited by how many staff are on duty and whether or not a driver is available. Slade House DS0000057641.V321944.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. This judgement has been made using available evidence including a visit to this service. Service users are able to take part in appropriate activities and they are part of the local community. Service users enjoy appropriate relationships, have their rights and responsibilities respected and recognised and enjoy their meals and meal times. EVIDENCE: The promotion of individualised planning for service users, including activities, personal development plans, the encouragement of appropriate relationships with families and friends and to increase the time service users spend in the community, are all included within the home’s development plan for 2007. Indeed, it was observed that staffing levels, whilst adequate to meet service users needs, may limit the ability for service users to engage in ad hoc off site activities. Planned activities are not compromised and a daily log of nonscheduled activities is also maintained which would enable this to be reviewed. A daily log of non-scheduled activities is also maintained. In discussions with staff it was apparent that relationships with families and friends were Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 12 encouraged and that staff had an appropriate understanding of the balance between respecting peoples’ privacy and protecting people. Discussions with service users on the day provided evidence that service users are encouraged to maintain relationships with families and friends. Visitors are welcomed in to Slade House and it is respected that this is the service users’ home. The manager informed that meal planning is done with service users. One service user goes in to town independently weekly to shop for individual items. Service users at lunch time were encouraged to help with preparation, laying table etc. although no formal rota exists for these tasks. Service users enjoyed their lunch (it was freshly made stew and fresh vegetables). Those needing encouragement to eat were appropriately assisted. One service user who did not want the lunch was provided with an alternative of his choice. Individual needs, such as diabetes, were catered for. Slade House DS0000057641.V321944.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. This judgement has been made using available evidence including a visit to this service. Service users receive support in the way they prefer, their health needs are met and whilst medication is appropriately managed, the system of sharing trained staff between different homes on the site is not ideal. EVIDENCE: Policies relating to personal support were reviewed in May 2006, including privacy, dignity and choice; continence promotion and medication. Staff spoken with and care observed confirmed service users make decisions in the way in which they receive personal support. For example choice over timings for assistance with personal care and how much assistance is required. Arrangements for after death recorded on file but not for end of life care. Medication and health records are up to date on service user records and service users a re appropriately referred to medical practitioners. Staff confirmed service users can see medical practitioners privately or in the presence of a staff member to assist communication. Staff confirmed they had received medication training. Medication is appropriately stored and all individually prescribed. Medication administration sheets are all completed. Staff are not permitted to administer medication Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 14 unless they are trained to do so and all medication administering must be witnessed by a second trained carer. Staff indicated this can sometimes be problematic if no one on shift is appropriately trained or if only one carer is present, as they must then phone around other homes on the site to “borrow” appropriately trained staff. Slade House DS0000057641.V321944.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. This judgement has been made using available evidence including a visit to this service. Service users feel their views are listened to and they are protected from abuse. EVIDENCE: The Complaints procedure had been reviewed in May 2006 and an easy to understand complaints procedure has been provided to each service user. Service users’ feedback in advance of the site visit, stated they knew who to speak with if not happy and service users spoken at the site visit confirmed they would speak to a member of staff if they were not happy. No information on complaints has been received by The Commission since the previous inspection. Two complaints have been received by Slade House since the last inspection and both have been dealt with appropriately. Training has been provided and appropriate policies reviewed in May 2006 relating to the protection of vulnerable adults. Recent training in this area was confirmed by staff spoken with, all of whom were confident about whistle blowing procedures. Slade House DS0000057641.V321944.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. This judgement has been made using available evidence including a visit to this service. Service users live in a home which is safe, homely and clean. EVIDENCE: Slade House is homely and comfortable. Fixtures and fittings are of a domestic style. It was mainly clean and hygienic. There is potential tension between maintaining an odour free home and compromising service user choice and independence to manage their own care. This was seen to be well managed by staff, who actively encourage and support service user to maintain their bedrooms, but do not remove independence. Tools to deal with these tensions were discussed such as different flooring types, encouragement of hygiene. Service users spoken with were happy with the physical state of the home which was generally very clean, domestic and comfortable. The kitchen was seen to be in order and temperatures for fridge and freezer and water are monitored appropriately. Slade House DS0000057641.V321944.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 This judgement has been made using available evidence including a visit to this service. Service users a re supported by qualified staff who are appropriately recruited and trained. EVIDENCE: Staffing records are centrally stored in the administration office for Purley Park Trust. This is on site and records are accessible through the trust’s senior management. 59 of staff within Slade House are qualified to NVQ level 2 or above. Senior management confirmed that a willingness to undergo NVQ training is part of the terms and conditions for staff. Recruitment records for the two most recently recruited staff at Slade House were reviewed. These confirmed required procedures were followed. However a full employment history is not routinely asked for and explanations of gaps in people’s employment history were not recorded. This would be good practice to help ensure the safety of service users. This was discussed with the acting Care Manager for the trust and will be done. Although other appropriate or required procedures for recruitment are followed, there is no actual written recruitment procedure, which would be good practice to ensure all checks are undertaken. Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 18 Staff spoken with confirmed all mandatory training was regularly provided including training relating to the protection of vulnerable adults. Staff confirmed they had received appropriate induction and had not been allowed to start work until their CRB clearances were obtained. Procedures ensure staff sign to confirm they have read and understood the policies of the organisation. Training records are maintained for individual staff and individual training needs and personal development are recorded. A training plan is n place. Staff appeared to be well trained. Slade House DS0000057641.V321944.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. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home, where their health and safety is promoted. EVIDENCE: An appropriate development plan for 2007 is now in place which stresses the promotion of individualised planning for service users, including activities, personal development plans, the encouragement of appropriate relationships with families and friends and to increase the time service users spend in the community. A new quality system with pictorial questionnaires for service users is being developed by the managers at the trust all working together. Control of substances hazardous to health is appropriate. It may be advantageous to audit products and chemicals used in order to minimise them. Safety sheets could then be laminated for ease of access to information. Accident/incident records were seen to be maintained appropriately. Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 20 Appropriate safety checks, for example maintenance/service of equipment relating to gas were up to date. Staff have received training in health and safety matters, including fire safety. Slade House DS0000057641.V321944.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 3 X X 3 X Slade House DS0000057641.V321944.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 YA12 YA13 Good Practice Recommendations To continue to improve service users’ lifestyles, it is recommended that the registered manager pursue the home’s development plan to increase the time service users spend in the community and look at ways to enable service users to participate in more ad hoc off site activities To ensure the safety of service users through the appropriate administration of medication, the registered manager and responsible individual should review the medication procedures to ensure that appropriately trained staff are on duty within the home, at appropriate times to administer medication without the need to wait for assistance from other homes on the site. To ensure the safety of service users through the recruitment of appropriate staff, the registered manager and responsible individual should ensure a fully documented recruitment procedure is in place which includes obtaining a full employment history from DS0000057641.V321944.R01.S.doc Version 5.2 Page 23 2 YA20 3 YA34 Slade House candidates and satisfactory explanations of gaps in this history. Slade House DS0000057641.V321944.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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