Care Home: 375 Old Whitley Wood Lane

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What the care home does well The service provides a homely and safe environment for service users. The needs of service users are well understood by staff and are met appropriately.Service users are provided with opportunities to attend activities and outings of their choice. The views of service users are listened to and acted upon. Encourages and supports the involvement of parents and permanent carers where appropriate. What has improved since the last inspection? Not applicable as this is the first inspection of this service since registration. What the care home could do better: Provide all staff with fire awareness training and the opportunity to lead fire evacuation drills. Ensure that all required documentation for staff is maintained. CARE HOME ADULTS 18-65 375 Old Whitley Wood Lane Reading Berkshire RG2 8PY Lead Inspector Sally Newman Unannounced Inspection 31st July 2008 10:00 375 Old Whitley Wood Lane DS0000071730.V366946.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 375 Old Whitley Wood Lane DS0000071730.V366946.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. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 375 Old Whitley Wood Lane Address Reading Berkshire RG2 8PY 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) 01189 671878 multicare@hotmail.co.uk Mr Stephen Welton Ms Judith Ann Robertson Care Home 4 Category(ies) of Learning disability (0) registration, with number of places 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies 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 categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 4. Date of last inspection Not applicable. Brief Description of the Service: This residential home has been registered for two service users aged between 18 and 65, with learning disabilities. The semi-detached house is situated on the perimeter of a residential area within a short distance from a main link road and the M4 motorway in Whitley Wood, Reading. There are 4 bedrooms for service users, a lounge/diner, kitchen and 2 bath/shower rooms with toilets, 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 7/2/08. Fees for this service are currently £1030.00 per week. Fees do not include the cost of toiletries, clothing and items associated with hobbies and personal interests or holidays. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was the first inspection of the service since registration. It was arranged with 2 days notice and was conducted over the course of 3 days and included a visit to the service of 3 ¼ hours duration. One service user was spoken to and the manager and a support worker were spoken to at length. A range of documentation was seen and a tour of the premises was undertaken. Information held by the Commission about the service and provided by the service was also used in the evaluation of outcomes for service users. As this was the first inspection of the service since registration all the standards were evaluated. The majority of outcome areas were good. Staffing was assessed as adequate due to the need for up to date training in some areas for several staff members of staff and the need for the implementation of regular one to one supervisions and team meetings. The manager was aware of these shortfalls and was already taking steps to make improvements. No requirements or recommendations were made as a result of this inspection. The provider has a range of polices 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 the needs of individuals of various religious, racial or cultural needs. No complaints have been received about this service by the Commission since it was registered. What the service does well: The service provides a homely and safe environment for service users. The needs of service users are well understood by staff and are met appropriately. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 6 Service users are provided with opportunities to attend activities and outings of their choice. The views of service users are listened to and acted upon. Encourages and supports the involvement of parents and permanent carers where appropriate. 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. 375 Old Whitley Wood Lane DS0000071730.V366946.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 375 Old Whitley Wood Lane DS0000071730.V366946.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 Quality in this outcome area is good. Prospective service users are provided with appropriate information, have their needs assessed and are introduced to the service according to their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service user guide and the statement of purpose were seen. The statement of purpose should include some information about the type and range of needs that the service will meet. This should include areas such as mobility and challenging behaviour. The pre-admission assessments and information for all 3 current service users was seen. All contained detailed historical information and the service had used this to commence their own pre-admission assessment. This provided clear guidance for staff on service user needs and how these should be met. All 3 service users had the opportunity to visit the new house several times before moving in. Each service user has a Local Authority contract maintained on their individual file. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 9 375 Old Whitley Wood Lane DS0000071730.V366946.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): 6,7,8,9 & 10 Quality in this outcome area is good. Plans of care reflect individual and changing needs. Service users are supported to make decisions and to take risks as part of an independent lifestyle. Service users are encouraged to participate in the running of the home and information held about them is kept confidential. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All 3 plans of care were seen. They all follow a similar format and accessing relevant and important information presented no difficulties. There was evidence that formal review on 2 service users had already taken place. The other service users’ review was scheduled for a months’ time. The service should consider incorporating an internal monthly review for each service user to demonstrate the goals achieved and the progress that each has made. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 11 Daily notes are maintained for each service user that records activities, food consumed and general mood etc. The use of prompts within the recording format would enhance the standard of recording and would provide evidence that the service presents service users with choices and supports them with decisions. Risk assessments were in place for each service user and were relevant to the risks associated with them as individuals. Where interventions are required such as distraction techniques the implementation of practice guidelines should be considered. Bathing risk assessments should be reviewed to ensure that management strategies associated with each individual were clear to staff. It was evident from discussions that there was a sound understanding of the concepts of confidentiality. The service does have frequent dealings with family members’, care managers and professional health care personnel. The boundaries were understood and all written information relating to service users is kept securely. 375 Old Whitley Wood Lane DS0000071730.V366946.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 & 17 Quality in this outcome area is good. Service users are supported to participate in a range of activities according to their individual needs. Appropriate relationships are supported and rights and responsibilities are recognised. Service users enjoy a healthy and wholesome diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Plans of care indicated that all 3 service users have an individual activity programme that has been tailored to their individual needs and preferences. 2 of the service users were out at day services during the course of the inspection and the other went out with a support worker. The range of opportunities available to the current service users includes sporting activities such as swimming, walks and trampolining. Shopping trips, restaurant visits and country drives are a regular feature for service users. There was evidence from discussion with the manager that holidays are in the process of being 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 13 organised for individuals where appropriate. One service user is supported to attend church on a regular basis. The service has two vehicles that can be used for transportation and buses are used regularly. The service actively promotes the involvement of family members and friends where appropriate, and significant persons attend the home for meals quite frequently. Daily routines are flexible and are determined by individual needs in regard to timetables and preferences at weekends and days when no formal activities are planned. It was apparent that some service users were responding positively to some of the routines emerging in the home such as mealtime preparation. One service user in particular saw her role as setting the table and ensuring that preferred seating for individuals was adhered to. Mealtimes are flexible and although the service operates a 2 weekly menu in practice service users will often choose what they want for their main meal on a daily basis. Fresh ingredients are used wherever possible. Service users are encouraged to be involved and are assisted to do the food shopping and prepare meals within their individual capabilities. The service had a recent positive food safety inspection by the local Environmental Health Department and the report is awaited. 375 Old Whitley Wood Lane DS0000071730.V366946.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 & 21 Quality in this outcome area is good. Service users receive personal support in they way they prefer and their physical and emotional health needs are well met. The arrangements for medication are robust and protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have a health action plan as part of their care plan. Routine health checks are arranged by staff and service users are accompanied to attend these appointments. It was apparent from discussion with the manager and staff that the health care needs of service users is well understood. The service enjoys positive relationships with local health care professionals and is pro-active in seeking advice and guidance. The weight of service users is monitored and it was apparent that two service users were being actively supported to maintain healthy weights. One service user has the input of an advocate who visits on a regular basis. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 15 A complete audit of the arrangements for medication was not undertaken. The service uses a monitored dosage system supplied by Boots. The manager undertook to investigate whether she can access the services of the Boots pharmacist to undertake periodic reviews of the arrangements in the home. There is a secure metal medication cabinet in place and supporting documentation was seen. There is a policy in place regarding death and dying. The manager was aware and was in the process of establishing whether particular wishes applied to individual service users but it was acknowledged that this was a sensitive area and needed to be undertaken with care. 375 Old Whitley Wood Lane DS0000071730.V366946.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. Services users’ views are listened to and they are protected from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was good evidence from discussion with the manager that the views of service users are listened and acted upon. A complaint and compliments log was in place but to date had no entries. There is a complaints procedure for service users but it does indicate that service users should put their complaint in writing with the assistance of staff. As no current service users can read or write this step in the process is inappropriate and a potential obstacle and should be removed. All staff have received training in the protection of vulnerable adults. For some this was through the provision of National Vocational Qualifications. It was again acknowledged that some staff were due for updated training in this area, which it was planned to organise. The staff member on duty provided a sound account of her understanding of the potential for abuse and the action, which needed to be taken should an allegation be made or abuse be suspected. It was noted at the time of the registration of the service that the proprietor Mr Welton was required to undergo Safeguarding of Vulnerable Adults training as he does have regular contact with service users. The manager informed the 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 17 inspector that dates were awaited from the Local Authority for planned training that is to be held shortly. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 18 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. Service users benefit from living in a homely, safe and comfortable environment. The bedrooms, living accommodation and bathroom facilities meet the needs of the current service users. The home is maintained clean and hygienic throughout. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was undertaken. The house throughout is well maintained and decorated. Bedrooms are personalised and are furnished according to the needs and preferences of service users. There is a bathroom on the ground floor and the first floor for the use of service users. The shared living area is spacious and provides comfortable seating for service users. Outside there is a large garden that would benefit from the addition of garden furniture. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 19 Throughout the home was clean and tidy. A file is used for COSHH statements relating to the cleaning materials used in the home. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 20 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 adequate. Staff are caring and support service users appropriately. Formal staff support and ongoing training should be improved to ensure that job roles and responsibilities are fully understood. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All staff documentation was seen during the inspection conducted earlier in the week, at the other care home run by the proprietor situated 12 doors away. The evidence for this outcome has been taken from this previous inspection as all staff files are maintained and stored at the other property. Staff do work across the two services as and when required. Two requirements and two recommendations relating to staffing were made at the inspection of the other property and they will not be repeated as part of this report. In brief the evidence for this outcome area came from the files and supporting documentation for the 4 support staff employed. It was noted that formal interview tools such as question and answer sheets and recruitment checklists are not used. This is considered to be good practice and serious consideration 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 21 should be given to implementing such documents. The application form does not request a full employment history and a medical/fitness declaration are not obtained. A requirement was made at the last inspection to provide job descriptions and contracts of employment to all staff to ensure that they clearly set out the roles and responsibilities of staff to both the residents and to the home. There was no evidence that these had been provided and a further period of time has been allowed for these documents to be made available to all staff. There was evidence within staff files seen that an individual training profile has been implemented for each staff member. A full audit of staff training was not undertaken but it was evident that some staff were overdue for basic training such as protection of vulnerable adults and medication. The manager has tried to provide one to one supervision for all staff as no other member of staff has been designated with the task or provided with the training. This has resulted in the frequency of staff one to one supervision falling short of the standard required. There was no evidence of a team meeting having been held since the last inspection. Evidence was provided that as most of the time staff work alone in this service a handover does occur when staff come on to shift and written information in the daily notes is relied upon. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 22 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 good. Service users benefit from a well managed home. The home is run in the interests of service users. The health, safety and welfare of service users and staff are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is experienced and qualified and was described as open and approachable. The arrangements for quality assurance involve the regular issuing of service user questionnaires that are generally handed to family members who complete them on behalf of service users. Some surveys had been completed but there was little evidence that the manager or service provider had acted upon suggestions. For example the father of one service 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 23 user had suggested that the purchase of garden furniture would be of benefit to service users but there was no indication that this had been discussed within the staff team or the management team. The views of service users are ascertained through observation of their reactions and through the formal process of review with care managers and family members. There are a range of policies and procedures in place to guide management and staff. Records are appropriately maintained and are kept securely in the office, which is locked when not occupied. Service users do have access to information held about them but in practice none have shown inclination to see their files. A range of health and safety checks are undertaken including smoke detectors, emergency lighting, fridge and freezer temperature checks and hot water outlets. Supporting records confirmed that checks were mostly up to date. 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 24 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 2 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 2 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 2 32 3 33 3 34 3 35 2 36 2 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 3 2 3 3 3 3 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Not applicable 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 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 375 Old Whitley Wood Lane DS0000071730.V366946.R01.S.doc Version 5.2 Page 27 - 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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