Inspection on 06/05/09 for 25-27 Teewell Avenue

This is the latest available inspection report for this service, carried out on 6th May 2009.

CQC found this care home to be providing an Good service.

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

25-27 Teewell Avenue 14/08/06

25-27 Teewell Avenue 23/01/06

25-27 Teewell Avenue 10/08/05

25-27 Teewell Avenue 22/02/05

25-27 Teewell Avenue 06/09/04

25-27 Teewell Avenue 18/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 25-27 Teewell Avenue 25-27 Teewell Avenue Staple Hill South Glos BS16 5NF     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: Melanie Edwards     Date: 0 6 0 5 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 28 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 28 Information about the care home Name of care home: Address: 25-27 Teewell Avenue 25-27 Teewell Avenue Staple Hill South Glos BS16 5NF 01179701573 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : max@aspectsandmilestones.org.uk Aspects and Milestones Trust care home 7 Number of places (if applicable): Under 65 Over 65 0 7 mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 7 0 May accommodate up to 5 persons aged 19 years and over with Mental Disorder May accommodate up to 5 persons aged 65 years and over with Mental Disorder Date of last inspection Brief description of the care home Aspects and Milestones, a charitable Trust own 26 and 27 Teewell Avenue, Staple Hill. It provides a home for seven adults with a mental disorder who require personal care services only. The houses are semi detached and are interconnecting on the ground floor. There are seven single bedrooms, three in one house and four in the other. The two houses operate as one care home with one manager and a single staff group. The home is situated in the residential area of Staple Hill and nearby there are small local shops, pubs and a church. Further a field, in Downend; there is a library, health Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home centre and more shops. The fees for staying at the Home are around three hundred and fourty pounds a week. Care Homes for Adults (18-65 years) Page 5 of 28 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: Melanie Edwards was accompanied by Ian Biggs,who is our Regional Director for the South West Region. We met four of the five residents who are living at the home. We spent time observing residents and staff together. We met the registered manager Mr Mike Thurger and one of the support workers. We saw residents being assisted with their needs by staff. Care Homes for Adults (18-65 years) Page 6 of 28 We looked at a selection of records relating to the day-to-day running and management of the home. The records we saw included two care plans, two assessment records, medication records, staff duty records, supervision records, accident records, fire records, and menus. We saw the most of the environment. The only areas that we did not see were a small number of bedrooms. The AQAA (an annual quality assessment document that all homes are required to complete) has been used to help form the outcomes in the report. We found the home was operating within the required conditions of registration set down by us. The conditions of registration set out the type of care and the needs of residents as well as the numbers of residents who may stay at the home. 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 28 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 28 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. Residents needs are well assessed when they move into the home. Evidence: To find out how thoroughly each residents needs are assessed, we looked at two residents assessment records. We saw that there was an informative assessment written about each residents physical, mental health and social needs. In the assessments we read information about the likes and dislikes of the person and their preferred choice of social and therapeutic activities. The assessments are written in a person centred style. This way of writing about residents helps staff to see the person as a unique individual. We saw evidence written in the records that showed the assessments records and care plans are regularly evaluated and updated. This helps to show residents needs are clearly identifed and can be met. Care Homes for Adults (18-65 years) Page 10 of 28 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. Residents needs are clearly identified by the home and their care plans explain really well what sort of help and support each person needs are met. Residents are being well supported to make decisions and to take risks in their lives. Evidence: To find out how well the residents are being helped and supported by the staff we read two care plans. We read in both care plans a very informative personal profile about the person. There was helpful information about each residents physical and mental health history as well as information about the persons family and friends. The care plans showed us what the persons physical mental and social needs are. The care plans clearly and simply explained how to help and support the residents with their full range of needs. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: The residents we met told us that the staff do talk to them and find out how they are feeling. Residents said that staff tend to talk to them in an informal way, for example if they are out together. This show us that the staff continue to support and listen to the residents. We noticed that Mr Thurger and the support worker talked and helped residents in a sensitive and respectful manner. The residents spoke to us in a positive way about how the staff help them, for example one resident said, the staff are really helpful and another resident said , on the whole the staff are really good. We saw residents getting up at different times during the day. This is a good example of how residents choices and different preferences are respected. The residents told us that they are well supported in the home to do the things that they enjoy. Residents also told us they help to make choices when planning the food menus. Care Homes for Adults (18-65 years) Page 12 of 28 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. Residents are well supported to take part in a range of different activities. Residents are able to be a part of the community and to have personal relationships. Evidence: We read in the residents care plans information that confirmed they regularly go to different community activities such as the shops and different social drop in centres. There are local community facilities for residents to use in the area near to the home. The residents told us they go out with staff, or on their own on a regular basis. One resident told us they are going on a golfing holiday with Mr Thurger. This is a hobby of theirs and they said they go with him every year. This is a really good example of the home supporting a person to do an activity that they really enjoy. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Residents often go for coffee as well as to nearby pubs and other social venues thereby helping to ensure a varied and fulfilling life. There are residents who like to go to the local church and to community based drop in activities. One resident told us about a new service being run by Aspects Trust. They said they have been going to the new drop in service and they are doing a range of vocational activities. One recent activity they have been involved in is helping to recruit new staff for Aspects Trust. This is a really good way for residents to be involved in the running of an organisation. We read the menu record of residents meal choices to see if residents are being provided with a varied and well balanced diet. We saw that residents meal choices were nutritionally well balanced and varied. The residents told us that the food at the home was very good. We were also told that residents can decide what food they would like on the menu each week. The lunchtime meal was cheese salad rolls. The residents said the lunch was really nice and one resident offered to make us lunch which was really appreciated. Care Homes for Adults (18-65 years) Page 14 of 28 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. Residents are being helped and assisted with their needs in the way they would like. Residents health and personal care needs are being met. The home is looking after residents medication safely. Evidence: We read some really helpful information written in residents care plans about each persons preferred daily routine and how they like to be helped and supported. This helps ensure residents needs are met in the way that is preferred by them. When we discussed residents needs with Mr Thurger he was clearly very familiar with the information in care plans and what sort of support the residents need. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: To support residents with their health needs they go to local GP practices. There is also extra support provided from other external professionals including the psychiatrist, dietician and the community mental health nurses. We saw detailed information in the residents daily records that showed us staff observe residents and their overall health. Staff will call the doctor if they are concerned about the person. We checked how the home look after residents medication to see if they do this safely. We read four residents medication charts. We saw a photo of the person with each record to ensure medication is given correctly to the person named on the chart. All staff administering medication must do regular training to make sure they can do this safely. We saw guidelines in place to advise staff of the preferred way that residents like to take their medication. This will guide staff and ensure medication is given to them in the way residents prefer. The stock of medication held in the home was satisfactorily organised. Medication that was no longer required was being returned to the pharmacist. The medication administration charts we read were up to date, we saw the signature of the member of staff who had given out the medication. This shows us residents medication is given out safely. The reasons for any omissions had also been written on the charts. Care Homes for Adults (18-65 years) Page 16 of 28 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. Residents feel confident and able to make complaints and to express their views about the home. Residents are well protected from the risk of harm and abuse. Evidence: We checked how many complaints there had been since the last inspection. There had been one complaint that had been dealt with thoroughly and correctly by Mr Thurger, this related to the alleged unacceptable attitude of a member of staff. All of the residents who we spoke to told us they would speak to Mr Thurger, the staff, or senior managers from Aspects Trust if they have a complaint or concern. They said that they felt their complaint or concern would be taken seriously and dealt with properly. We saw a copy of the complaints procedure on display in the reception area. This includes our name and details for anyone who wishes to contact us and make a complaint. The contact details of the owners are included in the complaints procedure and the service users guide. This helps people to make a complaint if they need to. We looked at a sample of staff records that showed staff had undertaken recent training in the topic of the protection and safeguarding of vulnerable adults. Mr Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: Thurger also told us that staff have been doing training on the subject of the Mental Capacity Act and the Deprivation of Liberty laws. It is really help for the staff to have some understanding of both these new laws, as they are to help to protect the rights of the residents. The home have their own policy and procedure in relation to the protection of vulnerable adults. This is kept in the staff office so that all staff are aware of it and what they need to do to protect people from harm and abuse. Care Homes for Adults (18-65 years) Page 18 of 28 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. Residents live in an environment that they really like. The home is suitable for residents and is clean and satisfactorily maintained. Evidence: Teewell Avenue is a newer building in a quiet residential area in the City of Bristol. The home is quite near local shops and residents go to the local amenities in the area every day. Since the last inspection parts of the home has been redecorated and refurbished. We found the fixtures, fittings and decoration looked homely and relaxing for people to live in. We found the environment looked clean tidy and satisfactorily maintained in all the parts we saw. There is an open plan lounge/dining room for people to use. We noticed how people looked really comfortable and really relaxed sitting in the lounge area. There is also a second lounge and second kitchen that backs onto a conservatory. The conservatory is Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: used for people as a designated smoking area. We saw a bathroom with adapted bath to help people who may have reduced mobility. We saw toilets near near to communal areas and bedrooms. We noticed bathrooms and toilets were clean and stocked with hand towels and soap to help minimise risk from cross infection. We saw a garden and seating area for people to use in warmer weather. Care Homes for Adults (18-65 years) Page 20 of 28 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. Residents get the help and support they need from enough competent trained staff. Evidence: We checked how many staff are on duty every day, by looking at the staff duty rota for the last two weeks. We saw that there is a minimum of two staff on duty every day and there is one staff member at night. There are also extra staff on duty in the week to offer additional support to the residents. We noticed how Mr Thurger and the support worker were calm and polite to the residents they were helping. We observed residents being well supported by Mr Thurger and the support worker. Based on what we found during the inspection and from what the residents told us, the number of staff on duty is meeting peoples range of needs. We asked for staff recruitment records of two bank staff who work in the home regularly. Bank staff are employed by the Trust to work in a number of their homes. We were sent the information we needed after the day of the site visit. We found that staff records confirmed the necessary checks on all new staff are being carried out. Specifically there are two written references taken up for all new staff before they start Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: work. We also saw there are criminal records bureau disclosures checks and protection of vulnerable adult first checks carried out on all new staff. This helps show us that people are kept safe by the homes recruitment practices. We checked the training records of three care staff to see if they are keeping up to date with their knowledge of residents mental health needs. We saw evidence that showed us staff had done training on subjects related to residents mental health needs over the last year. Care Homes for Adults (18-65 years) Page 22 of 28 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. Residents live in a home that is well run and run in their best interests. There are creative and effective ways being used to monitor the quality of care and service in the home. The health and safety of residents and staff is well protected. Evidence: We have quoted some of this section from the last key inspection report as the information in it is still current. Mr Thurger is a qualified mental health nurse. His career record shows that he has a number of years of experience working with people who have a range of complex mental health needs. He is registered with us as the manager of the home. This helps demonstrate Mr Thurger is considered suitable and qualified to be registered manager. The residents we met were very positive about Mr Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: Thurger. Examples of comments made by residents included, oh yes hes a very good manager, he is very busy, he listens to you and hes very helpful. Aspects Trust have a really good system for monitoring the quality of the care and the service that residents receive. There is a service user representative employed by the Trust who has been seeking the views of the residents about the home and the way it is run. We also saw the information that had been obtained from a recent in house quality monitoring exercise. This had been undertaken by another registered manager who works for the Trust.They had checked on the quality of the level of care and support that residents are receiving. We saw that residents are well consulted about a varied range of matters to do with the service. We found the residents records we saw were satisfactorily maintained and in order. The records relating to the management of the home were up to date and in order. The records are kept secure in the home and are available to staff when needed. We have referred to other records in other sections in the report. The home look after some residents personal spending money for them. We checked two residents finance records. We saw receipts for items bought and two signatures for money taken out.The records were up to date and correct. We saw where possible residents themselves sign for their money. This is a good way for residents to have some control in their lives. We found that the environment looked safe and satisfactorily maintained in the areas we checked. We saw evidence that staff do regular training in handling food safety. This is a really good way for staff to help residents to prepare and cook food in a safe way. Residents who wish to, are able to do some training in safe food handling put on by the Trust. The staff do training in health and safety matters including first aid, infection control and fire safety. This should help protect residents if staff know how to try and maintain their health and safety. We checked the fire book and we saw that the required weekly and monthly tests of the fire alarms and the fire fighting equipment are done and are up to date. We saw records that showed staff check the temperatures of all high risk cooked food before it is served to make sure it is hot enough and safe to eat. One of the residents we met told us that they have done some food hygiene training. Care Homes for Adults (18-65 years) Page 24 of 28 Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 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. 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