Inspection on 09/05/05 for The Walled Garden

This inspection was carried out on 9th May 2005.

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

The Walled Garden 09/10/08

The Walled Garden 31/10/06

The Walled Garden 01/12/05

The Walled Garden 06/12/04

The Walled Garden 15/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 THE WALLED GARDEN Calcot Grange Mill Lane Reading Berkshire RG31 7RS Lead Inspector Katy Brown Unannounced 9 May 2005 @ 15:30 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. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Walled Garden Address Calcot Grange Mill Lane Reading Berkshire RG31 7RS 0118 945 1712 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) Residential Community Care Limited Mrs Cate Lovelock Care Home 10 Category(ies) of Learning Disability (LD) registration, with number of places THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 06/12/04 Brief Description of the Service: The Walled Garden is a residential care home offering twenty-four hour personal care to ten adults of both sexes who have learning and associated behavioural difficulties. The home is a two-storey building and is not able to provide a service to people with severe physical disabilities, as there is no lift access to the first floor. The home has eight single and one double bedroom but the double bedroom is used as a single and will be for the foreseeable future. The bedrooms have wash hand basins but do not have en-suite facilities. The home is situated in a quiet residential area approximately five miles form Reading Town Centre. There are local facilities within walking distance of the home. The home has its’ own vehicle and service users are able to access public transport, as appropriate. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over four and a half hours. There have been no additional visits made since the last announced inspection. A tour of the premises took place and staff records, residents’ care records and some of the homes’ records were inspected. Three members of staff that were on duty, the manager and six residents were spoken to. What the service does well: What has improved since the last inspection? What they could do better: The water temperature needs adjusting in one residents’ bedroom; she has requested that this be fixed but it has not yet happened. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 6 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 WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 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 THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 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) 3 The staff employed at the home and the services and facilities that are available to residents meet their assessed needs. EVIDENCE: Individual records are kept for each resident and an inspection of the records for three residents’ living at the home, confirmed that their identified needs were being met and that specialist support had been implemented when required. The residents that were spoken to said that staff and the facilities at the home meet their needs and that referrals are made to the appropriate professionals when required. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 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) 7 and 9 The residents do make decisions about their lives and are provided with a good standard of care and support that is consistent with the information within the risk management plans. EVIDENCE: Most of the residents are able to make their needs known through verbal or written communication and the residents that were spoken to, confirm that they can and do, make decisions about their lives. Any changes or limitations to residents their daily living have been discussed between residents and the home and a signed agreement has been completed. Limitations identified by health professionals have also been signed by them. Residents’ are registered to vote and two residents voted in the recent election. A resident said that she is working with an advocate that provides support with her financial interests, as she is not happy with the currently proposed system. There are three residents who have support from advocates; the manager confirmed that the other residents are currently on a waiting list for when advocates become available. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 10 Staff that were spoken to said that they always offer choices of clothes, meals and activities to the residents and will use objects of reference for the residents who have non-verbal communication. Several staff use makaton to communicate with the residents and are able to offer them choices and provide support to make decisions about their lives. An inspection of individual records and discussion with residents’ and staff indicated that residents’ needs are being met and that clear risk management plans and appropriate guidance is in place. Residents are supported to take sensible risks and the manager has sought the advice of health professionals when required. Reviews of the risk management strategies are completed on a regular basis. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 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) 12,15 and 17 Residents take part in a variety of activities and maintain relationships with families and friends. Meals provided at the home are varied, well balanced and meet the assessed needs of residents. EVIDENCE: The home has recently appointed an artist to provide art as therapy for three residents. They are encouraged to be creative by using paints and other materials and make collages, paintings and pottery items. Individual day care programmes are developed for individual residents and two residents attend college on a weekly basis to learn daily living and life skills. One resident talked about his favourite hobby, which was fishing; he goes fishing with a friend from another home every month and they are accompanied by a member of staff. There is also a sensory room for the residents that has a variety of therapeutic equipment that relaxes and stimulates them. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 12 Residents determine when they see their friends and relatives and one resident has even specified the times that he wishes to spend with his parents. Staff support residents’ to write letters and residents confirmed that they are able to use the telephone if they wish and that visits to the home are welcomed and encouraged. One residents’ boyfriend regularly visits the home and another resident said that he is able to visit his girlfriend who lives in another home. A resident that was spoken to said that he is in regular contact with his brothers and that staff have an arrangement with his family to share the transport provision, as the journey is quite lengthy. Residents confirmed that staff have a good relationship with relatives and keep them up to date with relevant information. A record is kept of the residents’ dietary requirements and meals are provided in a way that reflects identified need. Residents’ confirmed that their likes and dislikes are incorporated in the menu planning process and that they are involved in the preparation and cooking of the meals if they choose. All the residents that were spoken to say that they enjoyed the meals at the home and that they get enough to eat. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 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 and 19 The residents’ are provided with a good and flexible standard of care that reflects their wishes and meets their health and social needs. EVIDENCE: Staff that were spoken to had a clear awareness and understanding of individual residents’ needs, likes and dislikes and were seen treating them with respect and dignity. A detailed record is kept of residents support plans, risk management strategies and guidelines and staff are aware of this important information and adhere to the procedures. Residents that were spoken to said that they visit the doctor, dentist and optician and that the staff make appointments for them when they require medical support. Individual records are kept for health related visits and staff support the residents with any concerns or health issues that they might have. One resident said that she had recently been in tremendous amounts of pain and that staff had supported her to visit her GP, the pain specialist and a hospital consultant. And another resident said that he previously had sores on THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 14 his legs but they had now healed due to the support that he had received from the doctor and the staff. The residents confirmed that staff treat them well and provide a service that meets their needs. The residents that were spoken to were aware of the restrictions and intervention techniques that are in place for them. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 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 Residents and relatives do make complaints and all complaints are investigated properly. EVIDENCE: There is an up-to-date complaints procedure, which is also produced in a language that the residents can understand. Staff keep a satisfactory record of all complaints that are made at the home and all complaints are treated seriously. The CSCI has not received any complaints in respect of this service. Residents said that they do complain if they are unhappy with anything and that the manager and staff do resolve any issues or concerns that they might have. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 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 and 26 Residents are able to be as independent as possible, while living in an environment that is homely, safe and comfortable. EVIDENCE: A tour of the premises identified that the home is well decorated and a new three-piece suite and carpet has recently been purchased for the lounge. There is a separate dining room where residents are encouraged to eat their meals. The home has a spacious garden, which is available for all residents and a section of the garden is used to grow vegetables and herbs. A smoking shelter with seating has been provided for residents that wish to smoke Residents’ that were spoken to said that they liked their home and were happy with their bedrooms. They have selected their own colour schemes and had decorated their rooms with their own personal items including ornaments, pictures and photographs, televisions and music systems. One resident said that the water in her bedroom was still not hot enough, although she had reported this to staff. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 17 THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 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) 34 and 35 The procedures for the recruitment of staff are robust and provide safeguards for the residents and staff receive a good induction and a variety of training that enables them to provide a good service to the residents that live there. EVIDENCE: The home has a satisfactory policy for the recruitment of staff. The staff file for the member of staff most recently employed at the home identified that all the necessary recruitment checks had been completed and that the home keeps all the correct information about staff that they should. Staff that were spoken to, confirmed that they receive training that helps them meet the needs of residents and said that the training they receive enables them to provide an effective service to the residents. A member of staff that was recently recruited at the home confirmed that he had received an induction and mandatory core training. Several of the residents at the home have challenging behaviour and staff are trained in the use of de-escalation techniques. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 19 THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 20 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) 39 Residents views and opinions are sought and the manager ensure that they are reflected in the way that the home is run. EVIDENCE: The quality assurance questionnaires for residents, relatives and representatives have recently been reviewed and amended, as the previous ones were difficult to understand and the questions were not clear. In the past, the residents have completed questionnaires about the services that are provided at the home and said that the manager does change things if they are unhappy. The manager collates the findings from the quality assurance findings and then completes a development plan for the home, outlining the strengths and THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 21 weaknesses. The manager confirmed that changes would be made if any issues were identified. THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 22 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 3 x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x x Standard No 11 12 13 14 15 16 17 x 3 x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 THE WALLED GARDEN Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 23 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 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 Good Practice Recommendations THE WALLED GARDEN H52-H01 11145 Walled Garden V217221 090505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 2nd FLoor 1015 Arlington Busines 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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