Inspection on 03/10/07 for 74 Wilson Avenue

This is the latest available inspection report for this service, carried out on 3rd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

74 Wilson Avenue 21/02/06

74 Wilson Avenue 02/08/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 74 Wilson Avenue 74 Wilson Avenue Rochester Kent ME1 2RL Lead Inspector Christine Lawrence Key Unannounced Inspection 3rd October 2007 10:50 74 Wilson Avenue DS0000064370.V352036.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 74 Wilson Avenue DS0000064370.V352036.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. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 74 Wilson Avenue Address 74 Wilson Avenue Rochester Kent ME1 2RL 0208 3082900 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) www.theavenuestrust.co.uk The Avenues Trust Ltd Post vacant but application in process Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24 July 2006 Brief Description of the Service: Wilson Road is a purpose built home, providing care and support for four people with severe learning disabilities and physical disabilities. The home is located in a residential area, within walking distance of shops and local amenities and has its own specially adapted vehicle for the benefit of residents. The home is also close to a bus route. It is a large, spacious, detached bungalow, providing accessible accommodation on the ground floor. It has a lift to enable residents to access the first floor where the sensory room and office are situated. Information provided by the manager at the time of the visit to the home confirmed the current fees as from £1180.29 to 1301.34 per week. Fees vary according to individual needs. Information about the home, including the previous inspection report from the Commission for Social Care Inspection, would be made available on request. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit was unannounced and started at 10.50 and finished at 15.20. I looked at various records in the home Information from the previous inspection was also referred to. A tour of the house was undertaken. I made observations of staff interacting with and supporting residents. Staff chatted informally with me and I had discussions with the manager. She has been in post since January and has applied for registration. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual aspirations and needs will be assessed. EVIDENCE: There has been no new admission to the home for some time. The manager explained the process that would be undertaken. It is clear that new residents would only be admitted after a detailed assessment process which would include getting information from the placing authority’s representative. Any prospective resident would visit as part of a Transition Plan and staff would also visit the prospective resident in their current situation. The assessment information would be used to compile a care plan. The format being used in the home is based on person centred planning and focuses on an individual’s wishes as well as their needs. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported and helped to make choices and take risks to enable as independent lifestyle as possible. EVIDENCE: Two individual records were looked at for this inspection. There is a lot of information on each person and therefore it is separated out by an index. A broad range of subjects is assessed including communication, expression of emotions and choice, finance, spiritual and cultural needs, and more. The daily records written by staff are kept in an individual diary and these provided lots of information about how needs are identified and responded to. The staff are working in keeping with ‘person-centred active support’ (personcentred active support is a way of helping people with learning disabilities to engage in meaningful activity and relationships as active participants. Instead 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 9 of doing things for people or to people, it involves working with people to enable them to take part in all the activities of everyday life, no matter how disabled they are). I observed them to be committed to this and they were patient with residents, for whom this is also a new way of working. Residents have very complex needs but the staff look for ways of enabling choices to be made. The home offers ‘opportunity sessions’ which are structured and recorded, to help residents make choices. Currently staff are working with residents about choice of decoration in bedrooms and planning next year’s holiday. The manager is aware of the need for decisions to sometimes be made on behalf of residents but that this should always be in that individual’s best interests. Risk assessments are in place. They are individual and up to date. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from being offered a healthy diet and a pleasant setting for mealtimes. EVIDENCE: The daily records showed that residents have a variety of activities. There is a less formal structure for these and staff try to be spontaneous as well as making specific plans. There are lots of things that happen within the community and this includes daily living activities such as shopping (both local and further away from the house) as well as outings to various venues including eating out. The home has a minibus and all residents have bus passes. This past summer residents have gone out on a variety of days out and staff are working with residents at the moment to plan holidays for next year. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 11 The manager gave me lots of examples of how residents are supported to maintain contact with their families. Although residents are limited in their ability to be independent with regard to their mobility, the staff continue to always look at opportunities for residents to make choices about getting up, going to bed, when to be in their own room on their own, when to be with others in communal areas. Residents are involved in shopping and preparing food. The menus looked satisfactory and staff are aware of likes and dislikes and special needs. There is sufficient space for everyone to sit at the table but residents sometimes choose to sit elsewhere. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 12 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s policies and procedures regarding medication and their physical and emotional needs will be responded to. EVIDENCE: The individual care plans and assessments, combined with my observations and discussions with the manager, all reflect that as far as can be ascertained residents receive personal care and support in the way they prefer. There are clear guidelines available to staff. Each person has their own en suite bathing/shower facility. Equipment is in place to allow residents to access their baths and showers. Records seen and discussions with the manager showed that routine and specialist health services are available to residents. The manager also said that she and the staff are continuing to work on health action plans. Storage of medication is satisfactory and the records of administration were appropriately completed. Staff who give residents their medication have received appropriate training. Assessment of this is also undertaken in the home. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 13 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and their relatives/representatives views on their behalf are listened to and acted on where appropriate. EVIDENCE: There is a complaints procedure and the records show that any concerns, complaints and compliments are recorded. The home tries to ensure that anything expressed by a resident’s relative/representative is responded to whilst still in keeping with the ‘best interest’ ethos. Staff have received training regarding safeguarding adults and the organization has a range of relevant policies and procedures. Staff spoken to were clear about their responsibilities towards the residents and confirmed that they were aware of the procedures for whistle blowing. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 14 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable and safe for the residents. EVIDENCE: There is a large lounge area leading to an open plan dining area and kitchen. There are plans for the kitchen to be upgraded to allow wheelchair users to use more of the facilities. The rest of the building allows access for people who use wheelchairs. There is a lift to the first floor were there is a sensory/activity room. There are plans to redecorate bedrooms and some of this is due to start this month. The house is comfortable and clean and is very much a part of the local area. The manager showed me plans to improve the garden area. The laundry facilities are satisfactory and staff clearly are aware of the importance of 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 15 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): 32, 33, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sound recruitment procedures as well as training provided to staff will have a beneficial impact on residents. EVIDENCE: The deputy and senior support worker both have national vocational qualifications (NVQs) level 3, as does one of the night support staff, and three support workers have NVQs level 2. One person is currently working towards her level 2 NVQ. The staff on duty at the time of the inspection were knowledgeable about the residents and their individual needs, which are complex. A Cultural Needs Assessment has been completed for each person which helps staff to understand any particular need relating to the individual such as their religion. I observed members of staff to be interested in the people they were supporting. The staff team have recently completed person centred active support (PCAS) training and they were clearly working hard to involve residents in every aspect of daily life. There are still two vacancies and recruitment is still happening. The manager explained that there is consistency with regard to ‘bank’ staff that are used and 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 16 she always tries to ensure consistency in the use of any agency staff. The manager and staff confirmed that the process of recruiting new staff includes a criminal records bureau check, two written references, application forms and interviews. Staff have written terms and conditions of employment and are all given a copy of the General Social Care Council’s code of practice. There is a programme of training, including detailed induction training which covers a range of subjects relating to the care of people with learning disabilities and physical disabilities. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 17 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, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. EVIDENCE: The manager qualified (NVQ Level 4, care) as well as being an assessor. She is planning to undertake further modules to ensure she gains her NVQ in management. She is experienced and keeps up to date with periodic training as well as accessing relevant information through the Internet. She has been in post over eight months and was previously registered at another home and therefore has appropriate experience. The organization seeks the opinions of residents’ relatives/representatives and other stakeholders about the home. A letter is sent to everyone who is 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 18 involved giving results and information from the quality assurance process. They carry out visits under Regulation 26 ie they visit the home regularly to undertake their own checks on quality. There are audits carried out also. Policies and procedures are regularly reviewed. The person centred planning and use of the keyworker groups, as well as the opportunity sessions to provide residents with the chance to try new things and make choices about them, underpins the commitment to find out residents’ wishes. The training programme covers a range of aspects of health and safety such as first aid, food hygiene, manual handling and fire safety. The organization has relevant and appropriate policies and procedures and a spot check on maintenance and service contracts showed that these were satisfactory and up to date with the exception of the electrical installation certificate. This may just be a case of paperwork missing but subsequent to this site visit, the manager informed me that a new inspection of the electrical installation was planned for 17 October. 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 19 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 X 3 X X 2 X 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation 13(4)(a) Requirement An up to date and satisfactory periodic inspection of the electrical installation must be in place Timescale for action 31/10/07 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 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Maidstone Local 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 74 Wilson Avenue DS0000064370.V352036.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!