Inspection on 06/06/05 for Tregona

This inspection was carried out on 6th June 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 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

Tregona 10/11/08

Tregona 09/11/06

Tregona 05/01/06

Tregona 09/12/04

Tregona 08/06/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

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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 TREGONA 3 Edith Road Maidenhead Berkshire SL6 5DY Lead Inspector Katy Brown Unannounced 6 June 2005 @ 11:00 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. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tregona Address 3 Edith Road Maidenhead Berkshire SL6 5DY 01628 789433 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) Milbury Care Services Ms Annie McDermott Care Home 3 Category(ies) of Learning Disability (LD) registration, with number of places TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 09/12/04 Brief Description of the Service: Edith Road cares for three adults with learning disabilities and associated physical disabilities. It is set in a residential area close to local amenities and the town centre. The home is a bungalow and there is a variety of aids and adaptations around the building to allow residents to move about more independently. All of the bedrooms are single and none of them have ensuite facilities. There are two communal toilets and one communal bathroom, which has bathing and showering facilities. TREGONA H52-H01 11271 Tregona V227913 060605 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 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. Two of the staff on duty were spoken to. The residents’ at the home have complex needs and did not take part in discussions during the inspection. What the service does well: The staff keep good records of the things that happen in the residents lives. Staff regularly talk to the residents and although they are not able to speak back to them, the staff are aware of their sounds and body movements and can understand most of what is being asked or said. Residents are comfortable and relaxed with staff and were smiling and laughing during the visit. Staff always offer choices to the residents, whether it is what clothes to wear, meals or an activity or an outing. The residents’ take part in different activities and events that are happening in the community and staff also take them on holidays. When residents are ill, the staff always contact the doctor or nurse and make sure that they keep appointments for them and when residents are ill or dying, they treat them with dignity and make sure that the residents wishes and their relatives wishes are met. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 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. TREGONA H52-H01 11271 Tregona V227913 060605 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 TREGONA H52-H01 11271 Tregona V227913 060605 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 are able to meet their assessed needs. EVIDENCE: Individual records are kept for each resident and an inspection of the records for the two residents’ currently living at the home, confirmed that their identified needs were being met and that specialist support had been implemented when required. TREGONA H52-H01 11271 Tregona V227913 060605 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) 6, 7 and 9 Residents are involved in their care planning process and are provided with a good standard of care that is consistent with their identified needs and risk management plans. EVIDENCE: Individual plans of care are available for all residents and they contain all the information about their healthcare, personal care and social care needs. Staff keep a daily record of residents’ activities and health related visits and clear guidance is in place to ensure that these needs are met. Risk management plans have been completed for the residents and staff are aware of these risks and adhere to procedures. Reviews of the care provided and risk management strategies are completed every month, with residents and their key workers in attendance. Staff say that although the residents’ have complex needs, they still offer choices of clothes, meals and activities. The residents respond to staff by using gestures and sounds. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 10 Staff confirmed that although the residents do not have advocates, their families are involved in decisions made about their lives. TREGONA H52-H01 11271 Tregona V227913 060605 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, 14, 15 and 16 Residents are provided with opportunities to take part in activities and holidays of their choice and relationships with families and friends are encouraged, supported and maintained. Relatives and representatives are provided with opportunities to discuss the way the home is run on behalf of the service users. EVIDENCE: All residents have individual activities programmes, which enable them to be aware of what things they will be doing each day. The activities that are provided include, massages, trips to the local pubs and restaurants, horse riding, the use of a sensory room and visits to a day centre. One resident that is visually impaired has a sensory switch to enable her to turn her radio on and off. The residents go on holidays and take part in the selection process by using sounds and gestures to make their preferences known. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 12 Staff confirmed that they support residents’ to keep in contact with previously made friends and family and encourage visitors to the home for meals and social events. They also said that relative’s views are sought regarding ways to improve the residents’ lives and they are always invited to reviews of care. Due to their complex needs, residents are not provided with their own regular meetings; however, there is a key worker system in place that allows opportunities for staff and residents’ to identify likes and dislikes and residents do attend staff meetings that are held at the home. The residents are not able to manage their responsibilities in the home independently. However, staff confirmed that the residents are with them when they complete domestic tasks, such as cleaning their bedrooms and meal provision. TREGONA H52-H01 11271 Tregona V227913 060605 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) 19 and 21 The residents’ are provided with a good standard of care that reflects their identified wishes and meets their health needs and the illness and death of the residents is managed with sensitivity and dignity. EVIDENCE: Staff that were spoken to have a good awareness and understanding of the residents’ health needs and individual records are kept for all health related visits. Staff are proactive when a residents health changes or deteriorates and records indicate that all appointments with health professionals are kept. The residents’ needs that have been identified during health related appointments, are followed through carefully by staff; however, records identified that staff had not made dental appointments for the residents that had required follow-up visits. There has been a recent death at the home, following a deteriorating illness of a resident. Staff confirmed that health professionals and relatives were involved in the process during this time and records indicate that the relatives were extremely satisfied with the way both the illness and death of the resident was managed by staff and the manager. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Residents and relatives are supported to make complaints and all complaints are taken seriously and investigated properly. EVIDENCE: The home has a complaints procedure that has been adapted to symbols and pictures to help the residents to communicate their needs. Staff keep a satisfactory record of all complaints that are made at the home. The CSCI has not received any complaints in respect of this service. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 15 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 27 Residents are able to be as independent as possible, while living in an environment that is safe, homely and comfortable and has sufficient toileting and bathing facilities. EVIDENCE: A tour of the premises identified that the home is clean and well decorated and the furniture looks nice and homely. The home is on one level and all residents have their own spacious bedrooms. There are separate dining room facilities and a lounge area with a conservatory. A ramp has been provided to enable the residents’ easy access to the garden and staff said that the senior management are currently looking at ways to make access to the conservatory easier for the residents. There are two toilets in place with aids and adaptations that promote independence for the residents. The bathroom has a bath and a showering facility and the previously rusted toilet frame has now been replaced. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 16 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. Staff receive an induction to the home 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 are required to. Staff that were spoken to, confirmed that they receive training that helps them meet the needs of residents and said that they have recently completed a number of refresher courses. They also said that training is provided on a rolling programme to ensure that all training is up-to-date. Inspection of records identified that staff receive an induction when starting work at the home and that training is provided on a regular basis. However, the induction for the most recently recruited member of staff was not compliant with TOPSS specifications and had only included the policies and procedures and care practices specific to the home. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 17 TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 18 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, 42 and 43 The manager and staff at the home do make attempts to seek the residents’ views and opinions and run the home in a way that reflects their wishes. The safety and welfare of residents’ is met through the health and safety policies and care practices at the home; although recommendations made by other regulatory agencies must be adhered to, to reduce the risk of harm to residents. EVIDENCE: The home is currently sending questionnaires to relatives, representatives and other people involved in residents lives, to seek their views and opinions about the services provided at the home. Staff confirmed that changes would be made if any issues were identified. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 19 The home has satisfactory health and safety policies and procedures in place and an inspection of records identified that regular maintenance checks are completed for equipment that is used. And fire checks and drills are carried out in accordance with the fire officers’ requirements. A requirement made by the Environmental Health officer requesting that hand washing facilities are provided in the kitchen, has not been complied with. The operations manager for the service has advised the Commission that she will consult with the Environmental Health Officer to resolve this issue. Representatives from Milbury Care make monthly-unannounced visits to the home and then provide the manager with a report of their findings. These visits are required by regulation and the proprietor must also forward a copy of these reports to the Commission. These reports are not being received on a regular basis. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 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 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 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x x Standard No 11 12 13 14 15 16 17 x 3 x 3 3 3 x 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 TREGONA Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 2 H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 21 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. 1. Standard 42 Regulation 13 Requirement That the registered person contacts the environmental health officer to inform them that the requirement for handwashing facilities to be provided in the kitchen, has not yet been met. That the registered provider supplies a copy of the monthly report on the conduct of the home to the Commission. Timescale for action 6th July 2005 2. 43 26 6th July 2005 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. 2. Refer to Standard 19 35 Good Practice Recommendations That staff ensure that dental appointments are made for residents when required. That staff receive an induction that meets TOPSS specifications. TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI TREGONA H52-H01 11271 Tregona V227913 060605 Stage 4.doc Version 1.30 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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