Care Home: 353 Old Whitley Wood Lane

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What the care home does well Provides a good standard of care for service users. Provides a safe and homely environment for service users. Promotes the involvement of relatives where appropriate. Service users are supported and encouraged to make decisions about their lives. Encourages service users to live as independently as possible. What has improved since the last inspection? The implementation of a key worker system has provided a more personal service for service users. The kitchen has been refurbished and the downstairs shower room has been completed for the benefit of service users. The recruitment of a permanent manager to provide consistency for service users. What the care home could do better: Ensure essential documentation is kept up to date. Provide more opportunities for service users to participate in outside activities. Promote more physical activity for service users to enhance their health and well being. Incorporate symbols into the complaints procedure to assist those service users who cannot read. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 353 Old Whitley Wood Lane 353 Old Whitley Wood Lane Reading Berkshire RG2 8PY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sally Newman     Date: 0 3 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 353 Old Whitley Wood Lane 353 Old Whitley Wood Lane Reading Berkshire RG2 8PY 01189313939 01189672369 multicare@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Multi Care Ltd Name of registered manager (if applicable) Mrs Adama Mahan Challe Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 2 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Learning disability( LD) Date of last inspection Brief description of the care home This residential home has been registered for two service Users aged between 18 and 65, with learning disabilities. The house is situated on the perimeter of a residential area within a short distance from a main link road and the M4 in Whitley Wood, Reading. There are 2 single bedrooms for Service Users, a lounge/ diner, 1 bath/shower room with toilet, separate shower/toilet, a kitchen, staff sleeping in room/office and a large garden to the rear. The home is owned by an individual proprietor and was registered on 7/01/02. The home has been providing short-term respite care since July 2004 and Care Homes for Adults (18-65 years) Page 4 of 25 care home 2 Over 65 0 2 Brief description of the care home is unoccupied periodically. Fees are £221.00 per day and do not include purchase of toiletries and some activities. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection conducted over the course of 3 days and included a visit to the service of 4 1/2 hours. The current acting manager and the wife of the proprietor who works in the home were spoken to at length. A support worker on duty in the home and the service user staying at the time of the visit were both spoken to briefly. A range of documentation was seen and information provided by the service prior to the visit was used to formulate a judgement about the outcomes for service users. The acting manager is nearing the end of the registration process and has been in post since January 2009. She has been reviewing documentation maintained in the home and has made improvements such as implementing key working. Requirements made Care Homes for Adults (18-65 years) Page 6 of 25 at the last inspection were followed up and were found to be met. No requirements or recommendations were made as a result of this inspection. The provider has a range of policies and procedures relating to equality and diversity. From the evidence seen the inspector considers that this service would be able to provide a service that meets of individuals of various religious, racial and cultural needs. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users can be confident that their needs will be fully assessed prior to a place being offered. Evidence: There was evidence from information seen and from discussion with the acting manager and staff that appropriate and comprehensive details had been obtained in respect of a recent but short term emergency admission. A comprehensive needs assessment had been obtained from the placing authority and in house assessment documentation had been implemented. Daily records were in evidence and it was confirmed that a visit to see the individual had been undertaken prior to his move to the home. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Plans of care reflect the assessed needs of service users. Service users are encouraged and supported to make decisions about their lives and to take managed risks as part of an independent lifestyle. Evidence: Care plans were seen for the current four service users who use the respite service. They were all comprehensive and provided useful historical information. The acting manager was in the process of transferring relevant information in respect of individual needs into an easier to read format. This involved identifying individual needs and specifying clearly and succinctly how these were to be met. It was apparent from discussion with staff and from observations involving the current resident that decision making on the part of service users is encouraged and supported. This could be better reflected in paperwork by the use of prompts to guide staff in identifying when individual decisions by service users have been made and Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: recording them appropriately. Risk assessments were seen and were individually focused. It was evident from discussion that circumstances relating to some risks had changed but these changes were not reflected in the written assessments. The acting manager was aware of this and undertook to update all risk assessments without delay. The acting manager has introduced key working by allocating individual staff to service users to ensure that essential documentation and related matters are kept up to date. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported to engage in activities and relationships appropriate to their needs and preferences. Food is provided that is healthy and appetising. Evidence: It was evident from discussion with staff and from the documentation seen that service users are supported to access the local community and to pursue their interests whilst staying at the home. Information provided by the acting manager prior to the visit to the home identified that further exploration of outside activities is to be undertaken. The service has access to two vehicles and is near to a main bus route into the local town. The families of service users are very involved with the home as was evident from the visitors book and from discussion with the acting manager and staff. Relatives are kept Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: fully informed about the progress of service users and any ailments they may have. Daily routines are flexible according the needs of individual service users. The current resident was in bed when the inspector arrived and got up in his own time to smoke a cigarette and to have a shower before going out to the local shops. The menu was seen and provided evidence that a healthy diet is provided. The meals are flexible and any changes are recorded in individual service users daily notes. Service users are encouraged where appropriate to assist with preparing meals and relevant risk assessments were in place. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users physical and personal support needs are met and medication is handled safely and appropriately. Evidence: There was sufficient evidence from information supplied by the service prior to the visit, from documentation seen and from discussion from staff that the support and health care needs of service users is well understood. The service is planning to introduce more physical activities to promote healthy living and to assist with appropriate weight control. All plans of care contained health action plans which were completed to different degrees. It was confirmed by the acting manager that the home no longer holds stocks of homely remedies such as paracetamol. Where required an individual prescription is obtained. Currently no service user using the service manages their own medication. Evidence from information supplied by the service prior to the visit confirmed that all staff have received administration of medicine training updates. Care Homes for Adults (18-65 years) Page 15 of 25 Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The views of service users are listened to and acted upon and they are protected from abuse. Evidence: The service has a complaints procedure and it plans to introduce a version using symbols for those service users who cannot read. The complaints record was seen and contained no entries. It was apparent through discussion with the acting manager and staff that the service addresses concerns and comments whether made by service users or relatives immediately. This ensures that issues do not remain unresolved and avoids the need for formal complaints to be made. Information provided by the service stated that all staff had received training in the protection of vulnerable adults. This could not be fully ascertained from records on the day as the service maintains staff training records across the their homes. It was clear however, that two members of staff had attended training this year and another was booked onto a forthcoming course. The acting manager undertook to view the maintenance of the staff training record to ensure that it is easily accessible, up to date and covers all staff who work in the home. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a safe, clean and homely environment. Evidence: Since the last inspection the downstairs shower facilities have been completed and there are plans to refurbishment the upstairs bathroom. The kitchen has been completely upgraded and provides a much improved facility for the home and service users. Throughout the home was clean and any maintenance issues were acknowledged and were in hand. Garden furniture has been purchased and there are plans to resurface some of the garden area. Overall the home provides a domestic in nature and homely environment for service users. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a caring and experienced staff team. They are protected by the arrangements for staff recruitment. Evidence: Since the last inspection no new staff have been recruited to the service. The acting manager and wife of the proprietor confirmed that all shortfalls in relation to staff documentation identified at the last inspection have been addressed. A support worker job description was provided and staff spoken to confirmed that they had been supplied with contracts of employment. The staff training record seen did not include all staff that work at the home. Information provided by the service prior to the visit confirmed that all staff are up to date with core training such as fire evacuation, health and safety, first aid and food hygiene. The senior staff spoken to undertook to review the staff training records and incorporate all staff into one comprehensive format. As all staff work across both of the organisations homes it would assist access and auditing to have just one all inclusive training record. The acting manager confirmed that all staff were NVQ qualified but written confirmation was not seen at the time of the visit. Care Homes for Adults (18-65 years) Page 19 of 25 Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well run home where their views and those of their relatives underpin all planning. They are protected by the homes health and safety practises. Evidence: An acting manager has been in post since January 2009 and is awaiting the final stage of her registration. She has commenced NVQ 4 training and has undertaken some review of the policies and procedures. She has also commenced implementation of a new format for identifying individual service users needs and their management and has introduced key working. The service does attempt to obtain formal feedback from the relatives of service users but have found that surveys are not completed and returned. There is constant contact with relatives and it was confirmed that satisfaction with the service has been expressed. As a result of surveys undertaken by the Commission prior to the last inspection a relative identified that the home would benefit from the purchase of Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: garden furniture. The service had acted on this feedback and furniture had been purchased and was evident in the garden. Development with individual service users has been demonstrated despite the relatively little time they spend in the home. An example was provided where one individual had been supported to reduce his medication and is now medication free much to the delight of his family. The health and safety policy was seen and was considered to be brief. Information provided by the service and the acting manager during the course of the visit confirmed that a range of health and safety checks are undertaken including fridge and freezer temperature checks, hot water outlets and smoke detectors. During the tour of the premises it was noted that electrical safety checks had been undertaken on the washing machine and tumble dryer. Since coming to post the acting manager had arranged three fire evacuation drills. The fire risk assessment could not be located and must be made available in the home. The manager undertook to forward a copy to the Commission. There was evidence that few formal Regulation 26 proprietor visit forms are completed, however, it was stated that the proprietor does visit the service on a regular basis. Due to the periods of time that the home is unoccupied it was recommended that a simplified version of the form be implemented to make the task less arduous and ensure that the regulations are complied with. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!