Inspection on 30/01/07 for Tilehurst Lodge

This inspection was carried out on 30th January 2007.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Tilehurst Lodge 05/11/07

Tilehurst Lodge 09/01/06

Tilehurst Lodge 20/07/05

Tilehurst Lodge 25/01/05

Tilehurst Lodge 22/06/04

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Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Tilehurst Lodge 142 Tilehurst Road Reading Berkshire RG30 2LX Lead Inspector Andy McGuckin Unannounced Inspection 30th January 2007 13:00 Tilehurst Lodge DS0000011066.V320600.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 Tilehurst Lodge DS0000011066.V320600.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. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tilehurst Lodge Address 142 Tilehurst Road Reading Berkshire RG30 2LX 0118 967 4675 0118 967 4675 tl142tact@hotmail.co.uk 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) TACT UK Ltd Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2006 Brief Description of the Service: Tilehurst Lodge provides 24-hour support for up to 6 men with learning disabilities, some of whom also have mental health issues. The home currently has five residents due to a hospital admission. The men at Tilehurst Lodge are encouraged to participate in a variety of experiences and opportunities to enable them to lead fulfilled lives, which in most cases includes employment unsupported by staff from the home. These experiences and opportunities are underpinned by The Five Accomplishments to Ordinary Living by John OBrien. The aim at Tilehurst Lodge is to provide a high quality service with comprehensive care planning and risk assessing to reflect individuals’ needs and preferences. “We are committed to working to the highest professional standards on a multi-disciplinary basis to offer real community living. The objective is to provide an environment where people with learning disabilities are able to develop independence and to enjoy the everyday experiences and opportunities that the wider community enjoys and be seen in society as valued individuals.” (Extract taken from the home’s Statement of Purpose) The home now has a permanent manager who will be put forward to be considered as the Registered Manager. The home has an annual charge of between £55.000 and £65.000. Tilehurst Lodge DS0000011066.V320600.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 into account detailed information provided by the service’s manager, and any information that the CSCI has received about the service since the last inspection. The inspection took place on a weekday afternoon and involved a visit to the home. The inspector looked at core documentation relating to the regulations and standards. The inspector spent some time with the manager and staff and had informal contact with all residents. The inspector toured the building and was shown residents’ living accomodation. The inspector sat in on a staff meeting and had informal conversations with staff. The home’s medications systems were tested and found to be safe. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. The inspector would like to thank the manager, staff and residents for making the inspection process a happy one. What the service does well: The home provides a happy safe environment for residents to grow and develop. The home provides trained and experienced staff in sufficient numbers to meet the needs of its residents. The location of the home enables its residents to have easy access to all local amenities and to be part of the local community. The home assists the residents to take part in external activities including annual holidays. The home enables residents to take risk and experience new things in a safe and secure manner. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Tilehurst Lodge DS0000011066.V320600.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 Tilehurst Lodge DS0000011066.V320600.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): 1,2,3,4,5,6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence was found at inspection that the home provided sufficient information on which prospective residents were able to make an informed choice. EVIDENCE: The home provides information in a format which is appropriate to the needs of its service users. Information and decisions are usually made in a one to one situation giving residents time to gain a good understanding of what is on offer and available to them. Residents’ files evidenced that residents are being consulted and informed about possible changes and challenges which are available to them. All residents have an appropriate weekly timetable, which involves a good mix of work and leisure. New residents are encouraged to visit the home prior to making a final decision as to the suitability of the home. This also enables the home to assess its suitability to meet the residents’ care needs. Regular reviews take place to ensure that this is still the case. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 9 Service users have individual written contracts and terms and conditions. Relatives or advocates are involved in the contracting process to assist the individual resident to be safeguarded. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,910. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Evidence was found at inspection that the home promotes residents’ individual choice in consultation with the individual. EVIDENCE: All five service users’ care plans were seen. They included excellent information about personal care routines/how much support individuals need, and how to give it. Parts of the care plans are produced in user-friendly formats to assist service users to understand as much of it as they are able. Individual Lifestyle support plans include a short life history, what is vital for staff to know, likes and dislikes, achievements, level of support required, the best way to get to know me, what I like and don’t like and what worries me are all included in the residents’ file. The future needs are noted on reviews which service users are supported and encouraged to attend. Families also attend reviews and sign the review notes. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 11 There is a description on individual files of the service user’s ability/limitations with regard to decision making and how to ensure that they are given appropriate choices, such as sampling different activities before being asked what they want their daytime activities programme to consist of. There are weekly group meetings held at which various subjects are discussed, including activities for the week, the rotas, complaints, health and safety and any other issues arising. These meetings are recorded and were seen to be appropriate at this inspection. Staff use a variety of activities to keep service users interested and occupied. All residents are able to communicate their needs and any specialist need is identified and recorded on file; staff are informed of these needs and any areas of training are identified. Risk assessments seen were detailed and regularly reviewed. All documentation had been signed by all staff to evidence that they had read and understood it. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 12 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): 11,12,13,14,15,16,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with the opportunity to develop and take part in activities which will enhance their lifestyle. EVIDENCE: Evidence was found at inspection that residents are encouraged to develop through a range of activities both fun and work-based. On the day of the inspection one resident had been out travel training his route to work with the goal of him undertaking this task alone. This had proved a successful activity and should eventually lead to independent travel on this route. The staff member involved in this activity was very supportive and encouraging. The home are to be commended for this activity. The local community is very much a part of the activity programme, both for leisure and employment, but also for maintaining the household shopping. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 13 Residents are encouraged and enjoy involvement in the weekly shop. The home has much pictorial evidence of the residents’ outings and holidays. Holidays are being planned for this year. Residents are encouraged to maintain contact with family and friends both in the local community and beyond. Evidence was found at inspection that all residents have contact with family and friends on a regular basis. Residents are encouraged to have appropriate sexual relationships. Evidence was found at inspection that residents’ rights and responsibilities are being respected and that residents are encouraged to take calculated risks. Risk assessments are in place for those areas deemed to require them. Residents are involved in the daily selection of meals and are encouraged and enjoy taking an active part in its preparation. On the day of the inspection the evening meal was being prepared by a member of staff ably assisted by a resident. The meal was prepared using fresh ingredients. It was well presented and well balanced. Weekly menus are presented in pictorial form and individual requirements are catered for. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 14 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): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a range of professional health and well being services including those considered non-mainstream. EVIDENCE: Service users’ care plans are very detailed and include all the necessary information to ensure that staff can meet their individual personal support needs. How they prefer to be supported is clearly noted in the plans. Health records are well kept and accurate, service users are supported to have regular health checks and attend the GP/specialists as necessary. Residents also have access to alternative therapies. Incidents and accidents are recorded and immediate action is taken if necessary and appropriate. The medication administration system is robust and all staff receive training to administer it. On the day of the inspection a new member of staff showed the inspector how the system worked. He was very well versed and confident. The system has very good built in safety procedures involving a second member of staff counter signing. Where residents self medicate this is monitored by staff with the consent of the resident. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 15 Evidence was found in residents’ files that information on what should happen in the event of serious illness or death is being recorded and would be acted on in the event. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 16 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): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home records complaints, concerns and allegations in an appropriate manner. EVIDENCE: The complaints procedure is produced in service user-friendly format and is up-to-date. The home has a complaints book; a few minor complaints have been recorded and dealt with in a satisfactory manner since the last inspection. The Commission for Social Care Inspection has received no information about complaints or safeguarding adults issues. All staff have received Protection of Vulnerable Adults Training and staff members were fully able to describe the action that would be taken if they had any concerns about the safety or well being of service users. The inspector was assured that residents’ finances are appropriately managed and monitored by external agents on a regular basis. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 17 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): 24,25,26,27,28,29,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a good homely environment which on the day of the inspection was clean and hygienic. EVIDENCE: The home is situated in an area of similar properties. The house is an older style large house with many original features including a tiled entrance hall. The home has been recently redecorated and upgraded making it a very welcoming environment. All furnishings and fittings are recently purchased and there were no signs of non-accidental damage. With residents’ permission the inspector was shown two bedrooms. Both bedrooms were individually furnished and reflected the resident’s hobbies and personality. All residents have their own room. All but one have en suite facilities. Specialist equipment is provided to those who require it. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 18 Toilets and bathrooms in the home offer privacy and comfortable safe areas in which to bath. On the day of the inspection the home was clean and hygienic. The home is able to provide sufficient space to enable quiet private areas where residents can be quiet or alone. A possible health and safety hazard had been addressed by the addition of a fence in the back garden. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with staff who have been trained and have the experience to look after them. EVIDENCE: The inspector was informed that the home was fully staffed and with one resident in hospital staff had a little bit of extra time. The inspector was impressed by the morale of the staff. The inspector sat in on the staff handover and spoke informally to staff. The handover was both informative and professional. The manager had been in post for a short while and demonstrated good leadership skills. The manager is currently undertaking the National Vocational Qualification (N.V.Q) 4 in Management and the Registered Managers Award, which she hopes to complete shortly. Staff files showed that regular support and supervision were taking place and that staff were being trained in an appropriate manner. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 20 Staff were seen to interact with residents in a relaxed and cheerful manner. The overwhelming noise in the house was one of laughter for which the home should be commended. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 21 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): 37,38,39,40,41,42,43. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed and staffed professionally. The inspector has made one requirement and one recommendation with regard to the wider organisation. EVIDENCE: The manager is experienced and will shortly be qualified and registered. She has an in-depth knowledge of the needs of the service users. The management systems are effective and efficient. The organisation has a senior manager responsible for quality assurance. The quality assurance system consists of regular Regulation 26 visits, an annual audit by managers, a weekly service user group meeting and formal annual reviews of service user care plans. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 22 The inspector viewed the latest reports relating to the home and felt that they contained very little in the way of comprehensive information as required by the Regulation. A requirement has been made that these forms are reviewed to enable a more comprehensive overview of the strengths and weaknesses of the home. All health and safety records and checks were up-to-date. Staff have updated health and safety training. Few accidents and incidents occur but those that do are properly recorded and any remedial action necessary is taken promptly. The home has smoke alarms, which are checked weekly. Recent difficulties involving a very challenging resident have eventually been resolved for the present by his admission to hospital. The inspector could find little evidence to support that the manager and staff were being supported and assisted by senior management and will recommend a review of the organisation’s policy in these matters. The inspector has downgraded the Quality rating for this home due to the above requirement and recommendation. The inspector does however commend the manager and staff on the quality of care being provided within this home. Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 3 5 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 1 3 3 3 3 2 Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 24 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 YA39 Regulation 26 Requirement The registered person must ensure a responsible individual visits the home at least once a month to assess the standard of care provided in the home. The content of this report should be reviewed and include a comprehensive snapshot of the manager’s findings. Timescale for action 14/03/07 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 YA38 Good Practice Recommendations Senior Management of the Organisation should give consideration to better supporting homes managers and staff in difficult situations Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Tilehurst Lodge DS0000011066.V320600.R01.S.doc Version 5.2 Page 26 - 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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