Inspection on 19/07/05 for Slade House

This inspection was carried out on 19th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Slade House 18/12/06

Slade House 11/01/06

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 Hucklebury Close Purley-on-Thames Berkshire RG8 8EH Lead Inspector Steve Webb Unannounced 19 July 2005 @ 10:00 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. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Slade House Address 17 Hucklebury Close Purley-on-Thames Berkshire RG8 8EH 0118 942 7608 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) Purley Park Trust Limited Vacant Care Home 8 Category(ies) of Learning Disability LD registration, with number of places SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Four service users may be over 65 years of age. Date of last inspection 08/06/04 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 H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, carried out between 10.00am and 4.30pm on 19/7/05. The new unit manager was present. The inspection included brief conversation with unit staff, discussion with the manager, observation of care practice and interactions, examination of records and files, and discussion with service users. The inspector also had lunch with service users, and was shown round the building. This was a positive inspection overall, and the morale of the staff team appeared very good. Service users were happy and content with the care they received. Some safety issues emerged which are detailed below and in the body of the report. What the service does well: What has improved since the last inspection? There have been improvements in care plans since the last inspection with an increased focus on developmental goals; and in the risk assessment process, which is now integrated into the review cycle to ensure they remain relevant. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 6 The medication management system has been improved. The preferences of most service users or their representatives around funeral arrangements, have been ascertained and recorded. 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. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 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 SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 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) 2,5 Prospective service user’s needs are fully assessed, and their individual likes, dislikes and preferences are identified. Each service user has an individual contract, though some remain in need of signing by the service user or their representative. EVIDENCE: The newly appointed manager had yet to undertake a pre-admission assessment, but talked about the process from his perspective and that of the organisation. The process would include visits to the unit by the prospective service user and their family, and would also involve a comparison of their needs with those of the existing resident group to try to ensure compatibility. There is a detailed Purley Park Trust assessment format, which is completed as well as obtaining the care manager’s assessment. The process would include risk assessments, and the completion of an essential lifestyle plan, which identifies details about care preferences, likes, dislikes and interests. From the information obtained, a care plan is drawn up which is reviewed regularly. Improvements have been made in care planning to include developmental goals. The manager also indicated the need to ensure that the staff team had the necessary experience and training to meet the needs of the prospective service user. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 9 Examination of previous documents indicated this process to be in place. A previous requirement to get all contracts/compacts signed by the service user (if able), or their next of kin/advocate, had been partially addressed. Outstanding contracts should be signed by the service user or their representative. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 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) 9 Service users are supported to take risks within the context of an appropriate risk assessment strategy, to maximise their independence. However, staff should countersign these documents to confirm they have read them. EVIDENCE: There were good individual risk assessments in place for the basic issues and various one-off issues. However, although a risk assessment had been done for trampolining, no copy was available in the unit. This should be rectified and a copy placed in relevant collective and individual files. The review of risk assessments is going to be integrated into the regular review cycle to ensure that risk assessments remain current, and the manager will seek to involve service users in the process to a greater degree. It was noted that risk assessments were not being signed by staff to confirm they had read them. It would be best practice for all staff to sign risk assessments to confirm they had read them. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 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) 12,13,14,15 Service users take part in a wide range of appropriate activities on and off-site and are actively involved, within both the on-site and local communities. Appropriate relationships are encouraged, and staff work to maintain family contact and support visits where necessary. EVIDENCE: Service users access a wide variety of activities both on and off site. These include attending a local church, bible studies sessions, trampolining, bowling, karaoke at the local pub, pottery, local cafes, cinema and sewing. Individual interests are also provided for, for example train-spotting, golf and cookery. Service users may also go out on one-to-one trips with keyworkers to shop for clothing, toiletries or food. On site college sessions are run by Reading College on literacy and numeracy, and horticultural therapy is available on and off site. Service users can also access local day centres sessionally. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 12 The on-site clubhouse provides a venue for several activities as well as for parties and other celebrations. Some service users also attend supported or voluntary work placements. All of the service users will have holidays, one has already had one, and two are due to go in August. Whilst the issue of local authority funding for annual holidays has been addressed for all new service users, long-standing service users are not usually funded for holidays, though the organisation has worked to try to secure funding from local authorities for this. Two service users have struck up a close friendship and such relationships are encouraged where appropriate. Most of the service users have regular contact with family, but not all. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 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) 18,20,21 Service users receive personal support in the way they would prefer it, as far as possible. Their views on this are sought and recorded. Though none is able to manage their own medication, an appropriate system is in place to manage this on their behalf. In the context of the ageing of the service user group, the views of service users regarding their preferred funeral arrangements are being obtained. EVIDENCE: Where possible service users receive any personal care support from staff of the same gender, and on occasions a staff member familiar to them is borrowed from another unit to facilitate this. The individual likes and dislikes of service users are established through completion of the essential lifestyle plan with each person. This would include aspects of care, activities, hobbies and interests and dietary preferences. None of the current service users is able to manage their own medication. The home uses a dossette system for managing medication, but the manager is not fully happy with the current system and wants to review alternatives. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 14 The medication management system has been improved and now included a second signatory who checks each dosage as it is administered. The quantities of medication received are now recorded on the medication administration record (MAR) sheets, and returns are logged. Each service user has a photo and medication profile with their MAR sheet. Copies of medication information sheets are held in a separate file. Additional staff have received medication training. Staff are offered this once they have completed induction and foundation training. The preferences of most service users or their next of kin, with regard to funeral arrangements, have been sought and recorded in order to respect these wishes when the time comes. This is good practice. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The views of service users are listened to via the complaints system, but also through the regular house meetings. Service users could also raise issues directly with the head of care or chief executive. EVIDENCE: An appropriate complaints procedure was in place and the unit now has a complaints log. There was one entry from a service user with support from their keyworker to record it. The service user had also signed the entry. This was a relevant issue regarding having missed out on an activity solely because of the transport being unavailable. (Being serviced). The manager reported that two further vehicles were due to be obtained by the service which should help with this issue, and agreed that should such a situation recur, consideration would be given to using a taxi so the service user does not miss out. Regular residents meetings are held in the unit (seven in the past year), where service users are encouraged to attend and express their views, though not all opt to attend. Service users also have access to the head of care and chief executive, who are both available on-site daily, and visit the units regularly. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 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 standard(s) 24,25 Service users live in a homely, comfortable and safe environment , which was purpose built last year. Homeliness continues to develop as service users become more settled. Individual’s bedrooms suit their needs and specialist equipment is provided where necessary. The bedrooms reflect the individual personality and interests of service users. EVIDENCE: The unit is purpose built and has a spacious and airy atmosphere. Mobility about the unit is impeded at present by a number of faulty fire door restraints, which necessitate the doors being closed rather than held open. This is being actively pursued by the management. The homeliness of the unit has developed over the past year, and the manager has plans to further this through service user involvement in the choosing of some new pictures and paint colours for communal areas. Bedroom colour changes will also be considered where there have already been changes of occupant. The bedrooms have developed individually to reflect the personality, hobbies and interests of their occupant. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 17 There are a few plaster cracks evident, which will also be addressed as areas are redecorated. A small number of additional lampshades are required. Previous issues with poor drainage from showers have been addressed, though it was evident that some areas of flooring were not adhering to the substrate as they should be. This should be monitored in case it becomes a hazard. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The needs of service users are met by an appropriately trained and consistent staff team. EVIDENCE: The organisation now has a dedicated lead person for training issues who provides the induction and foundation training on a rolling programme as required as well as arranging one-off courses. The organisation has a detailed and effective core training programme, and each unit has a spreadsheet of training attended by individuals. Training for the manager on administration of rectal diazepam is upcoming as a precaution, although no one in the unit has this need, (it is an issue in other units). This is good practice as it will help to ensure that sufficient staff across the service have been trained. The manager is exploring autism training for staff in relation to the needs of one service user. Service wide training on dealing with challenging behaviour is also upcoming. Good progress has been made on NVQ. The manager has completed his NVQ level 4 and registered manager’s award, one care staff has level 2; one has almost completed this; one is undertaking level 4 and one is due to start their level 2. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 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 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) 42 The health and safety of service users is promoted, and protected, though the absence of electrical appliance testing, could expose service users to potential harm, and should be addressed. The fire risk assessment should also be drafted promptly. EVIDENCE: The majority of the required safety and servicing certification was available in the unit, with the exception of records of electrical appliance annual testing which remains outstanding despite a previous requirement. This must be addressed as a priority and annually thereafter. Regular fire drills had taken place and weekly fire alarm testing was in place. Risk assessment systems were improved, though a copy of the risk assessment for trampolining needs to be available in the unit. Also there is a requirement to produce a fire risk assessment for the unit detailing the individual evacuation plans for service users. Some of the necessary information was already available but needs combining in a single document. SLADE HOUSE H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 20 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 x 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x 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 SLADE HOUSE Score 3 x 3 3 Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 21 YES 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 5 Regulation 5 Requirement Outstanding contracts should be signed by the service user (if able), or their representative. Timescale for action 21/9/05 2. 3. 9 42 13 13 This requirement is outstanding from the previous inspection. A risk assessment for the 21/9/05 trampolining activity should be compiled and copied to the CSCI. The testing of all portable 21/10/05 electrical appliances must be addressed as a priority. This requirement is outstanding from the previous inspection. A fire risk assessment must be compiled for the unit and copied to the inspector. 4. 42 23 21/10/05 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 9 Good Practice Recommendations It would be best practice for all staff to sign to confirm they had read all of the risk assessments. H52-H01 S57641 Slade Hous V235284 190705 Stage 4.doc Version 1.40 Page 22 SLADE HOUSE 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. 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