Inspection on 27/04/09 for Avalon Residential Home

This is the latest available inspection report for this service, carried out on 27th April 2009.

CQC found this care home to be providing an Excellent 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

Avalon Residential Home 11/10/05

Avalon Residential Home 21/06/05

Avalon Residential Home 02/02/05

Avalon Residential Home 21/10/04

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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: Avalon Residential Home Sexburga Drive Minster On Sea Sheerness Kent ME12 2LF     The quality rating for this care home is:   three star excellent 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: Sue McGrath     Date: 2 7 0 4 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 27 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 27 Information about the care home Name of care home: Address: Avalon Residential Home Sexburga Drive Minster On Sea Sheerness Kent ME12 2LF 01795877289 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) : Mrs Evelyn Iris Marchington,Mr Barrie Michael Marchington care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 3 The maximum number of service users to be accomodated 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 service are within the following category: Learning disability (LD) Date of last inspection Brief description of the care home Avalon is a Home for three adults with a learning disability. The Residents have their own room and live very much as part of the family in a large family home. The home itself is very near the coast in Minster on The Isle of Sheppy. The Residents are within easy reach of Sheerness, which affords access to local shops. Transport is by bus or taxi, there is a main line railway station in Sheerness. The home is located on an unmade road which local residents do their best to keep reasonable. The Home has a large well-maintained garden, which is enjoyed by all the Residents. The home has several cats. The Residents enjoy having them around and are involved in their care. Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home The fees range from £650 to £850 per week. Care Homes for Adults (18-65 years) Page 5 of 27 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: This was a Key Unannounced inspection that took place in accordance with the Inspecting for Better Lives (IBL) process. Key inspections are aimed at making sure that the individual services are meeting the standards and regulations and that the outcomes are promoting the best interests of the people living in the home. The actual site visit was carried out by 1 inspector over one day. We (the Commission) spent time touring the building and talking to people living in the home We also spoke to the manager and staff and reviewed a selection of assessments, care plans, medication records, menus, staff files and other relevant documents. Prior to our visit an Annual Quality Assurance Assessment (AQAA) had been sent to us. Care Homes for Adults (18-65 years) Page 6 of 27 The AQAA is a self-assessment, required by law. This assessment focuses on how the service considers they are meeting the outcomes of the people using the service and where it feels it can make improvements. It also provides statistical information about the service. Information from the AQAA has been used in this report where appropriate. Judgements have been made with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Care Quality Commission (CQC) to be able to make an informed decision about each outcome area. Overall this was a very positive inspection with generally excellent outcomes for service users. The inspector on leaving the home was satisfied that the people living in the home were both safe and well cared for and wishes to thank the manager and her staff for their assistance and hospitality. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. 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 27 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 27 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. The home has a robust admission policy and procedure in place should it be required. People who live in the home are protected by an individual written contract of terms and conditions. Evidence: Avalon specialises in providing non intrusive professional support for people who want to live in a more intimate family type home. All of the current people lived in the home for many years and regard it as their home. Should the need arise the home does have a comprehensive admission process which would involve obtaining assessments from Social Services to support their own assessments. Relevant care plans would have to be in place to support their own admission assessment documentation that emphasizes all elements of the prospective persons needs and wishes. Prospective clients and their families would be encouraged to visit the home informally to see the homes facilities, meet the staff and to chat to the other clients. The current Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: clients would be involved with the admission procedure where applicable. The AQAA confirmed all clients receive a contract describing Avalons services, facilities, policies and procedures. Care Homes for Adults (18-65 years) Page 11 of 27 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. People who live in the home have their changing needs assessed in their indiviual plan and are consulted and make decisions in their daily lives. People are supported to take risks as part of an independent lifestyle. Evidence: People living in the home were very familiar with their care plans and were clearly involved with reviews and in setting personal goals. It was also evident that they were encouraged to make decisions about their lives and were supported to carry these decisions out to the best of their ability. All of the peole who live in the home benefit from regular multi agency reviews of their needs, activities programmes, work placements and health and personal care. This enables a person centred approach in promoting and encouraging their needs and views. The people who live in the home confirmed they had regular meetings, mostly on Sunday mornings, to discuss their experiences of the previous week and plans for the coming week. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: People who live in the home were encouraged to be a independent as possible in all aspects of their daily lives. For example on the first trip to a haidressers, the person was escorted but after that they were encouraged to go on their own. The care plans did hold some risk assessment but they were completed to ensure people were able to take some level of risk as part of an independent lifestyle. Care Homes for Adults (18-65 years) Page 13 of 27 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 living in the home have the opportunity for personal development and are able to participate in appropriate activities. People living in the home are part of the local communituy and appropriate personal relationships are supported. People living in the home receive a wholesome and balanced diet. Evidence: People who live at Avalon have a varied and busy lifestyle. Two people attend a local day centre Mondays to Fridays and one attends on three days. The other two days she works at Boots plc in Sherrness. She said that she really enjoys her job and feels it helps to give her some independence. She went on to explain that last Christmas she went out on a staff meal and that really made her feel part of the team. At work she helps with stock control and gives some assistance to customers. She also completes Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: some domestic work. One of the other people works on a cafe project in Sheerness and helps with the washing up etc. He explained that sometimes he goes for a drink after work with a friend from the day centre. The day centre offers a wide range of activites including trips out. Woodwork, arts and crafts, jewelery making and cooking were a few examples. The centre has a cafe and the clients said how much they enjoyed doing the shopping for the cafe and helping out there. One person also helps out on the reception and enjoys asking visitors to sign in and answering the phone. Trips out have included visits to Leeds Castle to see dog trials, sailing in a lake near Ashford, swimming, bowling and flower shows. Regular evening activities include discos at Mencap every other week. People in the home who were spoken with confirmed they had a choice over these activities and could choose what they wanted to do and what not to do. People in the home have also enjoyed regular holidays, with many trips abroad. The home tries to arrange a foreign holiday every other year and are hoping to start planning for the next one soon. People who live in the home all confirmed they felt well supported and that they felt involved with the running of the home and felt they had control over their own lives. They explained that most Sunday mornings they held a meeting to discuss the last week and to plan the next. This included the menus. All said the food was very good. Saturdays was normally spent shopping in the town, with lunch out. All of the client said how much they enjoyed this. Risk assessments were in place for accessing public areas. Family links and friendships were encouraged and regular meetings were well supported by Avalon. One person continues to require and receive support in arranging and transporting to family visits twenty miles away. Avalon assisted all cleints in acquiring ID bus passes and along with Avalons own vehicle, this enables clients to access the wider community for shopping, leisure and general social activities. The home has a computer with internet access for the peopel to use and one person had a laptop in her own room. The home reacts well to indiviaul lifestyle preferences. People living in the home are known and seen as part of the local community, they are recognised in the local pubs and shops and are often stopped in the town by people they know. The AQAA confirmed that staff always knock and wait to be greeted before entering a cleints room or bathroom. Mail is placed on the breakfast/dinner table for the correct Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: individuals attention. All clients have their own keys freely issued. Light household chores are by choice and preference and within personal risk assessments. This was confirmed by the clients during discussion with them. Care Homes for Adults (18-65 years) Page 16 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home receive the support they require in the manner they prefer and have their health care needs very well met. Evidence: The AQAA confirmed that clients requiring assistance with toiletry issues are supported by staff of the same gender unless they clearly indicate they have no preferences. People who lived in the home spoke about how they always chose their own clothing and said if they required help with personal care it was always available. All of the peole living at the home were registered with a local GP and a dentist and optician of their choice. Clear records were maintained of all visits.The owners of the home had a very good understanding of the health care needs of all the poeple who lived in the home. They were aware of their physical and medical history and of all their health issues. These were handled sensitivley and efficiently. Peoples health was seen to be monitored and potential complications or problems were identified at an early stage and refered to an approprriate specialist or GP. All of people in the home were able to communicate their needs and wishes regarding any support they felt they Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: needed. A full multi agency (NHS/Social Services) Individual Needs Portrayal had recently been completed for all of the clients. This review confirmed Avalon,s capability to continue to meet their clients wishes and needs. Clients are supported and encouraged to be as independent as possible over health care needs. One resident spoke of how well the staff had supported her through a recent bereavement and how much she had appreciated the support offered. Medication was managed in a safe manner and in accordance with the guidance from the Royal Pharmacuetical Society of Great Britain. One client chooses to self medicate and the home monitors this. It is recommeded that a risk assesment is completed on this subject. Care Homes for Adults (18-65 years) Page 18 of 27 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. People living in the home have their views listened to and they are protected from abuse. Evidence: The home has a robust and effective concerns, complaints and protection policy in place and client are encouraged to express any concerns at their regualr weekly meeting. Each client has their own personal copy of the complaints procedure. One person who lived in the home said the owners were great and easy to talk to. All clients said they were happy in the home and had no concerns. The home has not received any complaints since the last inspection. The Commission has also not received any complaints since the last inspection. Care Homes for Adults (18-65 years) Page 19 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from having large and spacious communal areas and comfortable bedrooms. The home is well maintained, safe and very clean. Evidence: The internal and external premisise at Avalon are excellent and exceed the requirements of regualtion. The property is situated in a private road near the seafront. The home is well presented and maintained to a high standard with spacious living areas. All of the bedrooms were viewed at the invitation of the people who lived there. They were clearly very proud of their rooms and were eager to show them. All were decorated to a high standard and were all individually presented. All of the fittings and fixtures required by regualtions were in place and the rooms had a homely feel to them. All were well personalised to the individuals tastes and preferences. Bathrooms were seen to be spacious and clean. The owners discussed plans to install a wet room on the lower floor with disabled access. They also stated in the AQAA that they were hoping to replace some of the rear windows this year. Care Homes for Adults (18-65 years) Page 20 of 27 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. People living in the home benefit from having a trained, competent, supportive and consistent staff approach. Evidence: The home currently only employs one member of staff but is in the process of employing another. Both are family members. The registered providers have supported the people living in the home for many years and were fully aware of all their needs and daily requirements. The one member of staff was clear on the responsibilities of her role. All of the information required by regulation for the extra members of staff were in place or had been applied for. All of staff in the home were seen to be good communicators and the people who lived in the home said they were all approachable and caring. The AQAA confirmed statutory training had been undertaken and records confirmed this. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: One staff member is currently undertaking NVQ level three in Health and Social Care and was hoping to progress to the management award. Care Homes for Adults (18-65 years) Page 22 of 27 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. People have confidence in the care home because it is run and managed appropriately. People 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. Evidence: The manager has been in post since the home opened and the current people have been living at the home for many years. Both the registered providers are totally involved with the day to day running of the home and although neither have an NVQ level 4 or RMA this does not distracted from the quality of care and support given to the people living in the home. All of the people living in the home said they felt well supported by the registered providers and that it was their home and they regarded the owners as part of their extended families. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The people who lived in the home also were clearly involved with the day to day running and decision making processes in the home and all spoke about their weekly Sunday morning meetings. Regular quality assurance questionnaires were in place and provided very positive feedback. The health, safety and welfare of the people living in the home was promoted and protected by the management of the home. The AQAA confirmed all the necessary maintenance and safety checks were in place. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 1 2 20 34 It is recommended that risk assessments be carried out for any service user who wishes to self medicate. It is recommended that a minimum of one staff completes the First Aid at Work course approved by the Health and Safety Executive. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 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. 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!