Care Home: 77 Russell Street

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What the care home does well The respite service at 77 Russell Street creates a comfortable, fresh, clean and homely environment for the people who live there, and supports residents to live a fulfilled and valued lifestyle in keeping with the choices they make. The home has a staff team who are committed to meeting the needs of the residents, and keeping those residents safe. Staff always treat residents with dignity and respect. Staff receive good training to support and meet the needs of the residents who live there. Residents and their representatives are given all the information they need to complain should they be unhappy about the quality of the care and support provided, and know that staff and managers within the home would listen and act upon any concerns or complaints that they may have. Resident views are listened to by management and this helps the home to decide what works best for the people who use the service. What has improved since the last inspection? The commission did not make any requirements of the service at the last key inspection in June 2007. The service reports within their AQAA of always looking at new ways to improve the service provided. What the care home could do better: The home should complete the repair and refurbishment programme currently in place to ensure the safety and comfort of the people who use the service. Key inspection report Care homes for adults (18-65 years) Name: Address: 77 Russell Street 77 Russell Street Reading Berkshire RG1 7XG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Yvonne Souden     Date: 2 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: 77 Russell Street 77 Russell Street Reading Berkshire RG1 7XG 01189393623 01189595795 j.woods@jigsawcreativecare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Jill Woods Name of registered manager (if applicable) Mrs Jill Woods Type of registration: Number of places registered: care home 3 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 3 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 77 Russell Street provides a twenty-four hour residential respite and extended respite service for adults who have learning and associated behavioural difficulties. The home has three beds and can cater for both sexes. Jigsaw Care provides the care and the building is owned by Pro Autism, a locally based charity. The home is within walking distance of Reading Town Centre and has its own transport. 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 24 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: three star excellent 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: The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. The service completed an Annual Quality Assurance Assessment (AQAA), which is a legal document provided, by the commission. The AQAA was used by the manager and provider to review their service and inform the commission of their findings. The AQAA was used as part of the evidence to inform this report. Other evidence used to inform the report included a three hour site visit to the service by one inspector. This enabled the inspector to observe care practises and speak to people who use the service, staff and management of the home. Other evidence used to inform this report was surveys sent by the commission to people who use the service and care staff, and documentation viewed by the inspector during the site visit. Care Homes for Adults (18-65 years) Page 5 of 24 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 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 6 of 24 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 7 of 24 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. People who want to use the respite care service have their needs assessed prior to their admission, and have their health and social care needs reviewed regularly. Evidence: The service said within their Annual Quality Review Assessment, In respect of the respite unit we invite Care-Managers, Parents and the person we have been asked to support to the respite unit to look round and discuss their individual needs. Discussions with staff and records viewed identified that in the past eighteen months prior to this inspection three additional people are using the respite service. We viewed the files of two people who use the service Records show that health and social care assessments had been completed by the persons placing authority and by the service prior to the persons admission. This gave the home the information they needed to make a decision on whether they could meet the persons health and social care needs. Records also demonstrated that the persons personal, health and social care needs are reviewed, to make sure they continue to Care Homes for Adults (18-65 years) Page 8 of 24 Evidence: receive the support they need, to live a valued and fulfilled lifestyle whilst receiving respite care. Care Homes for Adults (18-65 years) Page 9 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have a care plan that promotes their independence and decision-making, whilst risk assessments promote their safety within the decisions they have made. Evidence: The service said within their Annual Quality Assurance Assessment (AQAA), Our staff team are committed to provide the best possible standard of care and help in any way they can to improve the quality of life to the people we support when they stay with us. We respect the people we support and treat everyone as an individual. Discussions with staff and records that we viewed support this statement. Records identified that residents have an up to date written support plan detailing how their health, personal and social care needs and goals are to be met. Care staff spoke knowledgeably of residents health and social care needs, and of reviews undertaken with involvement of the resident and their representative. Records of care planning were well written clear and concise that included, for example, details Care Homes for Adults (18-65 years) Page 10 of 24 Evidence: of the persons day to day preferences and routines. Care plans and risk assessment demonstrate that the service promotes the residents chosen lifestyle around the decisions they have made. Risk assessments clearly outline how staff can support the person whilst minimising associated risks. It was evident from observation of staff assisting residents, that they support the choices made by the residents within a risk management framework. Daily records written by staff demonstrate that residents chosen daily activities are promoted. Care Homes for Adults (18-65 years) Page 11 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the respite service are supported to maintain contact with family and friends, and are supported to maintain their chosen lifestyle. Evidence: The range of activities available to people who use the service remain commendable as had been identified at the services last inspection June 2007. The service stated within their Annual Quality Assurance Assessment, We assist the parents and families in providing safe, secure and reliable cover enabling them the opportunity to have a break from their own caring responsibilities. We understand the anxieties of those on the Autistic Spectrum with compulsions, rituals and routines being essential in their day to day activities - these are accommodated and, if not possible, we communicate to the person/people we support in advance to prepare them for any changes. Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: At this inspection we observed a very relaxed and friendly atmosphere between staff and residents, with positive verbal and non-verbal communication. Residents were observed to freely walk around the home and observed to go out in to the community with their support worker, each receiving one to one care and support. Residents daily records demonstrate various activities undertaken by the residents that were planned, with clear support plans in place to enable the resident to fully participate within their chosen activity. Menus were observed to be in picture format for those residents who cannot verbally communicate, to ensure residents have choice and are involved in menu planning. The home has a private rear garden that has been designed to enable residents to fully enjoy the seating area and trampoline in the warmer months. Care Homes for Adults (18-65 years) Page 13 of 24 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. People who use the service receive support from staff to meet their health, psychological and personal care needs in a dignified and respectful manner, and as identified within their care plan. Evidence: Information within each file, for example, the use of daily diaries and care plans clearly record the persons health care needs, detailing the support the person requires to enable the person to receive personal care in the way they prefer. Staff have received training so that they have the skill and knowledge to support the person within their personal and health care needs, for example, training within, first aid, autism and administration of medication. Staff were observed to be polite, caring and respectful toward the residents, and residents appeared well cared for and comfortable with staff. It was evident from records viewed that staff follow the homes medication policies and procedures to minimise the risk of mistakes happening within the administration of residents medication. Care Homes for Adults (18-65 years) Page 14 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are listened to and know how to make a complaint should they have a concern. Policies, procedures and staff training protect the people who use the service from abuse. Evidence: The home has a complaint procedure that is accessible to the people who use the service and their parents / guardians. The service has an open door policy that allows people to raise any concerns that they may have, that includes staff. Residents were observed to communicate verbally and non verbally to staff at ease, and staff were observed to listen. The service has received two complaints about the service provided and have responded to those complaints within the timescale of their complaints procedure. The commission has not received any complaints about the service provided at 77 Russell Street. The service has demonstrated that they follow multi agency safeguarding procedures to protect the people who use the service. Staff have said in surveys sent by the commission that they would not hesitate to protect residents from abuse, and know the procedures to follow to protect residents from abuse. Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: The home has a copy of Berkshire Safeguarding Adults Policy and Procedures, and a whistle blowing policy. Staff have received training to protect the people who use the service from abuse. Care Homes for Adults (18-65 years) Page 16 of 24 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. People who use the service live in a comfortable, homely and hygienic environment that that meets their diverse needs. Evidence: On the day of the inspection a tour of the premises took place. The home offers a safe and comfortable environment that is in the process of a repair and refurbishment program to ensure the safety and comfort of the people who use the service. Television and music facilities are fitted in the lounge area and residents are able to access the rear garden from the kitchen. Residents have personalised their bedrooms; there are no en suite facilities. Infection control is promoted, for example, protective clothing was available for staff to use when assisting residents with personal care, and to use within the laundry area of the kitchen. Staff have received training within food hygiene and fire safety. Regular checks of fire extinguishers, fire alarms and emergency lighting takes place. Care Homes for Adults (18-65 years) Page 17 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a trained staff team who are caring, enthusiastic and sufficient in numbers to support and meet the needs of the people who use the service. The homes recruitment procedures protect the people who use the service. Evidence: Staff were observed to be very caring and attentive toward the people who use the service that contributed to a happy and homely atmosphere. Care staff were knowledgeable of the residents health and social care needs and records demonstrate that staff receive relevant health and safety training to promote the safety and well being of the residents. Training and supervision records of staff identify that care staff are supported to meet their training and development needs by accessing internal and external training. Over 50 of care staff have a qualification in care and there was clear evidence that new staff are supported through an in-depth induction. We looked at the files of four staff. Records within each file demonstrate that the Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: service follows a thorough recruitment process that includes a criminal record bureau check (CRB), and references from previous employers to evidence the persons suitability as a carer, and to protect the people who use the service. Observation and records of the staff rota clearly demonstrate that people who use the service receive one to one support from support staff throughout the day. Waking night and sleep in staff are on duty at night. Care Homes for Adults (18-65 years) Page 19 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is a competent and caring manager who has the qualifications and experience to ensure the safety of the people who use the service and staff team, and to promote continual improvement of the service provided. Evidence: The registered manager has the qualifications and experience to effectively manage a care service. The manager also manages the organisations domiciliary care service. The manager said that she receives excellent support from the team of staff to manage the service well, and spoke of plans to improve the service provided, and management structure of the home, which would ensure a registered manager has a full time presence within the home. The service has an unregistered manager who has the qualifications and experience to manage the service, and who reports directly to the registered manager. Records show that regulation 26 inspections have been undertaken regularly as part of the homes quality assurance monitoring. Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: Other quality assurance procedures are in place to gain the views of the people who use the service and stakeholders to ensure the views of the residents are listened to. Policies and procedures are regularly reviewed and an annual development plan is in place to promote the aims and objectives of the service provided. Health and safety checklists are completed to ensure the safety of residents, staff and visitors that include fire safety. Staff attend health and safety training and training within for example, fire safety and manual handling. Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 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 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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