Inspection on 08/12/05 for White Barn

This inspection was carried out on 8th December 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

White Barn 20/05/08

White Barn 24/05/07

White Barn 20/07/05

White Barn 15/12/04

White Barn 09/08/04

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REACH Upton Court Road

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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 White Barn 45 Cressingham Road Reading Berkshire RG2 7RU Lead Inspector Kerry Kingston Unannounced Inspection 8th December 2005 11:00 White Barn DS0000011070.V266101.R01.S.doc Version 5.0 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 White Barn DS0000011070.V266101.R01.S.doc Version 5.0 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. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service White Barn Address 45 Cressingham Road Reading Berkshire RG2 7RU 0118 987 3190 0118 986 4415 paula.cox@kingwood.org.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) The Kingwood Trust Miss Paula Marie Cox Care Home 5 Category(ies) of Learning disability (5) registration, with number of places White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2005 Brief Description of the Service: Whitebarn provides twenty-four hour residential care to five service users, of both sexes, who have learning and associated behavioural difficulties. The home is a large two-storied building with all the individual accommodation on the first floor. The building is owned and the care is provided by the Kingswood Trust, a charitable organisation. Whitebarn is situated a few miles from Reading Town Centre and there are local facilities within walking distance. The home has its own vehicle and it is on a main public transport route. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place between the hours of 11am and 2.15pm on the 8th December 2005. The manager was available throughout the inspection and the residents were in and out of the home at various times. Several residents were observed and a few were spoken to, records and care plans were looked at. The home was looked at but individual bedrooms were not looked at on this occasion. The standard of care remains high, helped by a very stable staff team. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 6 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 White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 2 There have been no new admissions since 23/02/03. EVIDENCE: White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 6,7 and 9 There are detailed service user plans in place, these are regularly reviewed and amended as necessary. Service users are assisted to make as many decisions about their lives as is practicable. There are excellent and detailed risk assessments in place. EVIDENCE: The service user plans are very comprehensive, they include the daily routine, behavioural support needs, personal preferences and activity plans. The plans are reviewed and audited by the manager regularly. The manager notes any areas where work may need to be carried out and the work is completed by the allocated keyworker. There was evidence that the keyworkers respond very quickly to any requests by the manager. An example was the manager noting that a dental appointment had not been booked and the staff member ensuring that the appointment was booked within the week. Some parts of the care plan are produced in service user-friendly formats, mainly pictorial. The behaviour and progress of service users evidenced that the development and behavioural plans work well and are amended as soon as it is felt that they are no longer valid or not having a positive effect on them. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 9 Risk assessments and individual work with service users inform the staff of the ability of service users to make choices and decisions. The manager described a new system called a “positive support plan”, which will specifically address issues of liberty restrictions. The manager also attends a ‘clinic’ which discusses, in detail, liberty issues as raised by an ‘ethics committee’. The home has excellent, detailed risk assessments in place, which fully describe any risks that may or may not be taken. These are fully crossreferenced with the behavioural guidelines and care plans and are reviewed on a monthly basis by the keyworkers. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 17 Service users are offered a varied and balanced diet and comfortable surroundings for meal times. EVIDENCE: The staff team work hard to offer a varied and balanced diet, and the healthy choices have improved since the last inspection. There was evidence that the staff are aware of specific dietary needs of individuals but are also careful to allow service users choices. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 18,19 and 20 Service users receive good quality personal support and their healthcare needs are carefully met. The home administers medication safely. EVIDENCE: The home has detailed personal care guidelines included on the individual service users care plans. Appropriate records are kept of any personal care support, such as bathing routines and clothes buying. The home has individualised cross gender care guidelines and communication plans are an important part of the personal support plans. One service user described his shopping trip, where he had been to buy clothes for a special family occasion. He described how he had made choices with the help of a staff member. The home seeks assistance from specialists in the health /behavioural field, if necessary. All service users have regular health checks, including optician, G.P, dentist and psychology or psychiatry as appropriate. Healthcare records are generally up-to-date although a few more recent appointments appeared not to be included in the file. There were no errors or omissions in the medication administration records and the manager checks the recording systems on a regular basis. Only staff that are assessed as competent by the manager or deputy administer the medication. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 22 and 23 The home has a robust complaints procedure, which is produced in a service user-friendly format. Service users are protected form all forms of abuse. EVIDENCE: The home has a comprehensive complaints procedure and complaints are dealt with properly but there have been no complaints since the last inspection. The home produces the complaints procedure in a service user-friendly format but staff are aware that service users would need help to access it. The staff assess service users satisfaction by observing their body language and behaviour as many have limitations in their ability to verbalise any issues. All staff received Protection of Vulnerable Adults training within six months of starting work. There have been no Vulnerable adults incidence since the last inspection. One Vulnerable adults issue is outstanding but is being dealt with appropriately. There are excellent behavioural guidelines in place and staff are trained to deal with any specific behaviours. The home has safe recording systems for any service users monies that they hold, finances are mainly dealt with by families of local authorities. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 24 and 30 The house is comfortable and achieves adequate standards of cleanliness and hygiene. EVIDENCE: The house is an old building and consequently requires a lot of work to keep it looking clean. Staff ensure that it reaches adequate standards of cleanliness and hygiene and there are no unpleasant odours. The furniture is comfortable and the communal areas and bedrooms are very spacious. The home has just ordered a new set of furniture for the sitting room and some carpets have been replaced. The bathrooms do look a little ‘shabby’ and bare but are clean and serviceable. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 The home has robust recruitment procedures to ensure staff are safe. EVIDENCE: The manager has most of the necessary information on the premises but confirmed to the inspector that she had seen all the necessary records that were not available on the day of inspection. It was discussed that a signed checklist would evidence that she had seen all the necessary documentation. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The home has a system to ensure that it maintains its’ good standards of care. EVIDENCE: The home has an annual development plan (Team Action Plan), which is developed from the collection of the views of various people. Service users families are sent questionnaires from head office once a year and discuss at the family meeting held annually. Service users families, mainly, act as their advocates. Service users views are taken form individual work, reviews and regular care plan evaluations. Regular regulation 26 visits are carried out and the home has a new monthly quality assurance monitoring tool. White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 16 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 N/A X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 X 4 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 White Barn Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000011070.V266101.R01.S.doc Version 5.0 Page 17 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations White Barn DS0000011070.V266101.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks 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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