Inspection on 07/05/09 for Denewell Avenue (17)

This is the latest available inspection report for this service, carried out on 7th May 2009.

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

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

Denewell Avenue (17) 17/11/05

Denewell Avenue (17) 09/02/05

Denewell Avenue (17) 02/08/04

Similar services:

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Dilston College Of Further Education

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Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Denewell Avenue (17) Denewell Avenue (17) Low Fell Gateshead Tyne & Wear NE9 5HD two star good service The quality rating for this care home is: 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: Carole McKay Date: 0 7 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. They reflect the things that people have said are important to them: 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. 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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Denewell Avenue (17) Denewell Avenue (17) Low Fell Gateshead Tyne & Wear NE9 5HD 01914875068 OUTOFORDER ntawnt.denewell@nhs.net 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) : Northumberland, Tyne & Wear NHS Trust care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: Date of last inspection 3 0 0 5 2 0 0 7 A bit about the care home 17 Denewell Avenue is owned and managed by Northumberland, Tyne and Wear NHS Trust, The Trust. It provides ordinary housing for 3 people who have a learning disability. The gross weekly cost of the service is £1051.68. The weekly fee payable by service users is £62.35. 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 How we did our inspection: This is what the inspector did when they were at the care home Before the visit we looked at information we have received since the last visit on 30 May 2007. We visited the home on 7 May 2009 and looked at records… talked to service users and the staff. What the care home does well Keeping the needs of the service users regularly re assessed. The service has good service user plans. Health care and personal care are good. Keep staff up to date through training to protect service users from harm. What has got better from the last inspection The staffing arrangements are better now... so service users know the staff. The fire safety risk assessment has been updated, so people know what to do to stay safe. Some parts of the home have been redecorated to improve the personal space for service users. What the care home could do better Redecorate the shared rooms so that these are more pleasant. Make sure there are enough staff for one to one support. Improve the storage and records for medication. Improve the food budget. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Carole McKay CQC Newcastle St Nicholas Building St Nicholas St. Newcastle upon Tyne NE1 1NB 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 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 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People living at the service have their needs comprehensively assessed and are given information they need to make choices. Evidence: The home has had no new people admitted for several years. However the service is to be taken on by a new provider in the future. Planning for this has been underway for some time and is scheduled to be completed later in 2009. This process has involved re assessing the needs, wishes and aspirations of the people who live at the home. To progress this the home has, with the involvement of family representatives and advocates, produced up to date support plans, for each individual. These were examined and were found to be comprehensive, detailed and very affirming about peoples needs, preferences and strengths. The registered manager, Heather, said that they had attempted to represent the knowledge and understanding of each service user that the staff, families and other representatives hold, to support service users who are unable to voice there wishes for themselves. Service users and their representatives have been involved as far as possible in the decision making process to do with finding a new provider for the service. 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 . The service will support people in a planned way so that their needs are met and their choices and decisions are safely respected. Evidence: Each person living at the home has a service user plan, called a support plan. These are being re- drafted to provide a very comprehensive picture of each persons needs and preferences in anticipation of a new provider taking over the running of the home. Support plans are written with involvement of staff and representatives of service users. They are comprehensive and reflect the needs of the individual in detail, as well as their abilities and how they prefer to be supported. Limitations, risks and managing communication well are all documented so that harm to service users is avoided. This also supports service users to make decisions for themselves that are in their best interests. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who live at the service are supported to take part in a range of activities. Some restrictions are experienced due to lack of resources. Evidence: Usually, during the week, service users attend day centres. Regular social activities include a weekly disco, which everyone likes to attend, shopping at the Metro Centre, going to concerts, and attending a local Church. All of the service users will experience a holiday this year. These have been arranged based upon the staff knowledge of each service users personal preferences. None of the relatives were visiting on the day of the inspection, but the manager said that family involvement is encouraged and that the relatives of service users had been fully involved in recent meetings to do with the possible take over of the service by another provider. Service users are able to spend time on their own or with others and there is plenty of space available in the house to facilitate this. Each individuals preferred daily routine is recorded in their service user plan. Menus are planned and decided based upon the service users likes and dislikes, which are recorded in their care plans. Mealtimes are very flexible and times of meals depend on the routines and activities that service users are attending. Service users are Evidence: encouraged and supported by staff to prepare their own meals. The Inspector sat and chatted with service users and staff over the evening meal, which was a relaxed social occasion. The meal provided was freshly cooked and wholesome, but there were no trimmings. In surveys received after the visit staff said that the food budget is very poor and choice of food is limited due to lack of money. The manager said that the food budget was adequate, but that it had not increased for the past three years. Therefore the budget had not kept pace with recent inflation. This meant that staff had to be frugal with resources when shopping for food. Where service users have special needs to do with diet or eating these have been addressed by referral to specialists, use of aids to independence and fortifying food intake. 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 . Service users personal and health care needs are addressed. Medication is stored and managed safely though there is some shortfall in best practice to do with resources and recording. Evidence: The people who live at the service each have a support plan that includes an assessment of their health and personal care needs. These assessments are updated on a monthly basis. The service user plans take account of the preferences and the abilities of service users. This helps maintain as much independence with personal care as possible. On the day of the visit a community nurse was attending to update a health action plan for one person. The appointment logs show that service users are supported to attend routine health appointments, podiatry for example, and there is good evidence of referral and follow up appointments for specific individual needs. Also the records show a good level of recording of health observations by staff and accounting for visits to specialists. For example there was a very detailed account of one persons visit to a physiotherapist. Where necessary food and fluid intakes are monitored and recorded to help support good health. For example one person had required additional support to get back to a full diet following a period in hospital. The medication needs of service users are described in their service user plans. Reasons for taking the medication are described along with information about side effects to look out for. Permissions to give a limited and named number of over the Evidence: counter medication have been sought from GPs. Guidelines are available to staff in the service user plans to do with consent to treatment. The arrangements for storing medications are secure but not very practical, as the door to the cupboard swings open when unlocked and is at head height, and could prove to be a hazard. A risk assessment for using the cupboard has been devised. The cupboard is made of wood and the paint on the exterior is worn and no longer easy to keep clean. The medication administration records (mar) are fully completed and up to date. But where instructions have been entered by hand, these have not been signed and countersigned as correct. Staff have received training in the safe handling of medication and there are written policies and procedures available in the home for staff to follow. The manager has in place a questionnaire for assessing the competence of the staff to continue to administer medications. There is a process for daily and weekly checking of medication stocks and records. These processes ensure the well being of the service users. 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 . Arrangements are in place for people to raise concerns and to have these investigated. Procedures and staff training protect people from harm. Evidence: The home has a working procedures file. This contains a corporate policy and procedure regarding complaints and the home has developed an easy read version of the first stage procedure. This is issued to service users and their representatives. In surveys the staff confirmed that they know what to do if someone reports concerns to them. The manager said that they had not received any complaints in the last twelve months. A record has been made of a previous complaint. None have been received by CQC. There are copies at the home of the local Gateshead policies and procedures for safeguarding vulnerable adults. These are the multi agency procedures. Staff have received these during recent training events. Staff confirmed that they are to undertake further training later in the month. This training is to bring them up to date with recent developments in safeguarding the liberty of vulnerable people. No safeguarding referrals have been raised by the service, or about the service, since the last inspection. The Trust also issues policies and procedures for staff in dealing with violence and aggression. And for handling service users bank accounts and property. The manager said that staff routinely receive training in control and restraint and that this is regularly updated by the Trust as mandatory. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The environment is homely, comfortable and clean, providing service users with a safe place to live. However some of the bedrooms and communal areas need to be redecorated to provide a more pleasing and well maintained environment for the service users. Evidence: The home has three bedrooms on the first floor, so no-one needs to share a room. These rooms are comfortably furnished and pleasant, though one is in need of having the decor refreshed. The bathroom is on the first floor and contains a WC. The building throughout was found to be clean with no unpleasant odours. There is a communal lounge and separate dining room that leads onto an enclosed garden area. These are bright, airy comfortable places in which the service users can engage in activities of their choice. A bird feeding station and a garden swing have been purchased for the garden. One of the service users particularly enjoys sitting in the garden, and on the day of the visit this person spent some time watching the birds. Although there is a maintenance programme, which involves the manager submitting an annual request to the maintenance department within the Trust, she does not have direct control of a budget to address issues as required. Since the last inspection some improvements have been made. There are a number of areas within the home that still require attention, for example: the paintwork in the corridor, landing and kitchen area all need attention, the bathroom suite does not match, the toilet and sink are beige in colour whilst the bath is white. These matters were raised following the last inspection of the home and the manager has prepared an annual plan to address these. Since then the home has had a small flood and there is water damage to the ceiling in the kitchen. The leak that caused the flood has been repaired and the manager said that it has been agreed that redecoration of this area will follow later in May 2009. Evidence: Detailed policies and procedures are available in relation to infection control and the manager and staff confirmed that they have all had training in this as part of their induction. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users benefit from a well trained staff team and staffing levels are adequate, though sometimes there may not be enough staff on duty to fully address the service users social and leisure needs. Staff records are not held within the home and as such it was not possible to confirm that the service users are supported and protected by the homes recruitment practices. Evidence: All staff surveys mention the impact that staffing levels are having on the social opportunities for service users. Two staff have left in the last twelve months. This is a lower staff turnover than at the last inspection. The home now employs six full time staff and one part time staff. Bank staff who are recruited internally by the Trust, are used two to three times per week. The manager said that she tries to use the same staff where possible and this was shown on the rota. The staff said that the uncertainty about their futures was to some extent disheartening but in surveys the comment was also made that most staff are willing to go the extra bit to make sure service users needs are met and support each other. The rota provides for a minimum of two staff on duty through the day when service users are at home. One waking night staff is on duty. Three staff cover periods of planned social outings for the service users. Though, as two people need the support of two staff at these times, this can still be restrictive. For example; during the visit two service users were able to go to the weekly disco with two staff. The manager covered the home while they were away. Staff explained that service users take turns to stay behind each week. The manager said that staffing levels are under review, as part of the preparation for a new provider taking over the service. Evidence: Staff records are held centrally and due to the timing of the inspection being arranged to coincide with staff being available and at home, the records were not accessed at this inspection. This was discussed with the manager and agreed that this can be done centrally for this and other services at a separate visit. The manager assured us that staff are fully recruited and background checks are carried out. Staff surveys confirmed that this is the case. Training is provided through the Trust and external courses are also used. The manager has a training schedule and this shows that staff mandatory training is kept up to date. Some staff have had, or are about to have training in the mental capacity act and associated procedures. Though staff surveys show that some staff do not feel that they are given training that keeps them up to date. All the staff now hold a national vocational qualification (NVQ), level 2 or above, in care. Staff said that they had been provided with induction training. 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 . Overall management systems are generally good and ensure that the health, safety and welfare of service users are promoted. Evidence: The service is owned and managed by Northumberland,Tyne and Wear NHS Trust. However the Trust is proposing to transfer the service to another, yet un-named provider. The manager said that extensive consultations have taken place about the proposal. These have included staff and service users and/or their representatives. CQC has not been informed yet of the Trusts intentions to do with transferring the service. Since the last inspection the management arrangements at the home have become more stable. There has been no change in manager since the last inspection. The current manager has a number of years experience and is competent to run the home. She works to improve the service and provide a good quality of life for the service users. This is within a period of change that has brought some staff turnover. But this has been well managed. The Trust has a comprehensive quality assurance process that includes a monthly audit of standards, including finance and complaints. A system is maintained for keeping the home safe. This makes sure that the electrical, gas and other appliances are regularly maintained. In line with a requirement the fire risk assessment has been revised since the last inspection, with assistance from the fire officer Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 33 18 The review of staffing levels must take account of the dependency needs of the service users. 31/07/2009 To ensure that the leisure and social needs of service users can be addressed at all times. 2 42 39 The registered person must 30/09/2009 give notice in writing to the Commission for Quality Care as soon as it is practicable to do so if a person other than the registered person carries on or manages the home. To ensure the continuity of care for the service users. 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 3 17 20 20 The food budget should be reviewed to take account of recent inflation in food prices. The medication cupboard should be replaced with one that is easier to clean and safer to use. Handwritten entries in the medication administration record should be checked for accuracy and countersigned as correct by a second person. 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). 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