CARE HOME ADULTS 18-65
Parkstone Avenue (1) 1 Parkstone Ave Benfleet Essex SS7 1SP Lead Inspector
Sarah Hannington Key Unannounced Inspection 27th November 2006 11:00 Parkstone Avenue (1) DS0000018102.V313094.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 Parkstone Avenue (1) DS0000018102.V313094.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. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Parkstone Avenue (1) Address 1 Parkstone Ave Benfleet Essex SS7 1SP 01702 558571 01702 558571 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.rchl.org.uk Redbridge Community Housing Limited [RCHL] Carroll Bailey Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (1), Physical disability (7) of places Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The registered manager to complete NVQ level 4 in care and management by 2005. The registered manager to complete 2 courses approved in consultation with the CSCI local area office, one relevant to the best practice in the management of staff. The second course to be relevant to reflective care practice within 8 months of registration. Both courses to be identified within two months. 30th December 2005 Date of last inspection Brief Description of the Service: 1 Parkstone Avenue is a single storey purpose built care home built in a residential area of Thundersley. Care and accommodation is provided in two units. Each unit has a lounge, dining area, kitchen and four bedrooms. The home has a medium sized garden area, which is accessible to wheelchair users. Each resident living at the home has a learning and/or physical disability. The home is close to local shops, parks, libraries and other facilities. A local bus route runs by the home regularly. There is some parking to the side of the home; pathways leading from the home to the local amenities are accessible for wheelchair users. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. During the Inspection the senior team leader on duty and the manager of the home were present throughout the inspection process. A tour of the home took place and Staff, relatives and residents were spoken with during this inspection. The Key inspection site visit took place over a period of 5 hours. The visit mainly focused on the all Key standards and all of the requirements from the last inspection report. In addition, Information was also taken from the regulation 26 submitted by the Registered Provider. What the service does well: What has improved since the last inspection?
The manager of Parkstone has implemented a new policy and procedure for administration and recording of individual’s medication, whilst out in the community and there is a new monthly medication audit in place. New activities in house have been put into place such as a musician, masseur and physio coming in once a week. One of the service users families has donated a large television for the West wing and the lounge has had new carpets laid. The East Wing shower room is almost complete, this had be an on going issue since the last inspection in December 2005.The shower room tiles, floor, shower, cubicle and shower chair have all been replaced, all that remains to be completed is the outside wall which is to be re-painted once the new plaster has dried. Occupational Health has been involved as part of this assessment process of and as a result two specialised shower chairs have been purchased. There are a number of maintenance issues around re-decoration and renewal
Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 6 within the home, however it remains odour free and still provides a homely feel adequate for the service users at Parkstone. 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. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 7 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 Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. Parkstone Avenue demonstrated that it has procedures and meets the needs of individuals prior to admission. EVIDENCE: All of the residents have been at Parkstone Avenue for a number of years. Preadmission and initial assessments were evidenced in resident’s files. Yearly reviews of most service users have gone ahead and a relative spoken with confirmed this to be the case. Policies and procedures are in place regarding pre admission activity such as a prospective service user visiting the home and assessments to be carried out prior to them moving in. There have been no new service users admitted recently. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. Care plans for all service users and a good system of risk assessing is in place. There has been some involvement of residents, professionals and most families. EVIDENCE: Due to the nature of the service users complex disabilities the home has not been able to fully identify aspirations from the service users themselves but has attempted this by involving families, professionals or anyone else that may support this process. Care plans have been based as much as possible on person centred planning and have been recently reviewed and were evidenced as being written and recorded from the services users needs, likes and dislikes. Care plans highlighted Individual health needs and evidenced that service users are professionally assessed and offered services that catered for their ‘specific’ needs. Parkstone Avenue (1) DS0000018102.V313094.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 16 & 17 Quality in this area is excellent. This Judgement has been made using available evidence including a visit to this service. The home has an excellent standard of service users having choice of activities and involvement within the community. Family involvement is encouraged and relationships with resident’s families in general are good. Overall interaction and involvement in the service users lives is to a good standard. EVIDENCE: The home provides 4 activity co-ordinators during the week and this allows service users to have a wide and varied choice to be part of the local community and to have opportunities regarding educational, leisure and socially based pursuits. Although activities are currently to a high standard there are two vacant posts for activity co-ordinator’s role and this needs to be put into place as soon as possible, as this will maintain consistency if annual leave or sickness occurs. The manager is partly addressing this issue by having interviewed for these posts and is hoping to appoint one of the interviewee’s. The home evidences through Care plans and service users views recorded that personal autonomy and choices are promoted as much as possible and that staff are proactive within this area. During inspection staff interaction with service users was observed to be caring, appropriate and supportive.
Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. Service users personal and healthcare support is well managed and written information was evidenced. Paperwork within the home is being maintained to a good standard. EVIDENCE: Care plans address individuals needs in terms of personal, physical and emotional health for all service users within the home. No serviced users retain their own medication due to their level of disability. The home administers and monitors the service users medication. A policy and procedure is in place for the correct receipt, recording, storage and handling, administration and disposal of medications. The manager has recently written a new policy and procedure on administering and recording of medication whilst out in the community. Relatives spoken with confirmed medication was discussed and is reviewed. As part of this inspection medication administration records were looked at and no omissions in the recording was noted. If able, service users would be supported by the home to administer their own medication, however this is presently not the case at Parkstone Avenue. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. The manager and staff of the home work closely with families. Staff are having regular supervision and regular staff meetings. EVIDENCE: A relative spoken with knew about the complaints procedure and how to complain. One complaint has been received since the last inspection; this was being dealt with satisfactory. Training in the protection of vulnerable adults from abuse is in place. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,29 & 30 Quality in this area is adequate. This Judgement has been made using available evidence including a visit to this service. The home generally provides a homely comfortable environment for the service users. The home has good procedures in place for hygiene and infection control within the home. There are specific areas of the home, individual’s bedrooms and the garden that need redecoration and general maintenance. EVIDENCE: There are a number of maintenance issues that need addressing within the home. The West wing needs Repair work and repainting of the lounge and dining rooms walls. Both bathroom floors need replacing, as does the staff shower room. The East wing needs repair and repainting of the lounge walls. Woodwork and communal areas needs repainting. In general the sensory room needs completing. Hallway carpets in both communal areas need replacing and the Garden in general needs maintaining and tidying. M.O.A.T. who own the building are in negotiations with RCHL about the repairs needed, along with the bath that needs replacing. After consultation with service users and families the home has created a visitors room, this has been created by swapping over the office and sensory room. Policies and procedures for infection control are in place. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33,34, 35 & 36 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. Staff spoken with felt that they are supported through the management structure and support from supervision and staff meetings. Training opportunities are good including POVA. EVIDENCE: The manager is developing a system where as staff-training certificates is kept in one place so all certificates are available for inspection. All permanent and ‘relief’ staff files were sampled. The recruitment process in place is of a high standard. Staff files all had CRB and POVA 1st checks completed before staff are given start dates. Two references were present and gaps in employment history were checked. Staff spoken with confirmed that regular supervision and staff meetings go ahead. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this area is good. This Judgement has been made using available evidence including a visit to this service. The Organisation has a good Quality Assurance Package in place. EVIDENCE: Service users are benefiting from a strong management team and the level of service is good. The organisation has been proactive in having a good quality assurance process is in place. Recording of minutes, regular meetings, addressing issues raised in the different services and an action plan were present. The home has developed a quality assurance survey that will allow individuals or their representatives to give appraisal of the service, staff and environment provided. However this work still needs further development and when information is collated sent to CSCI and a report available to all interested parties made available within the home. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 16 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 1 28 X 29 1 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 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 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 4 X 3 X 3 X X 3 X Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 17 Are there any outstanding requirements from the last inspection? NO 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 YA27 YA28 YA29 YA30 2. YA24 23 (2) (b) The registered person must 28/02/07 ensure that all door frame and skirting board woodwork, hallway carpets, redecoration of communal walls in the West Wing and East Wing areas are maintained and made good. The registered person must 28/02/07 ensure that the premises are fit for purpose and in accordance with the national minimum care standards and the homes statement of purpose. This is in relation to one of the two baths being out of use and needs replacement. The registered person must ensure that the service users have access to appropriate communal areas including the Garden. This is in relation to general maintenance and accessibility.
DS0000018102.V313094.R01.S.doc Regulation Requirement The registered person must ensure that the East and West Wing bathroom floor, staff shower room floor is replaced. Timescale for action 28/02/07 23 (2) (b) 3. YA27 YA29 23 (2) (c) (j) 4. YA24 YA28 23 (2) (o) 28/02/07 Parkstone Avenue (1) Version 5.2 Page 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA39 Good Practice Recommendations The home needs to develop an action plan arising from the quality assurance surveys and send a copy of this to CSCI and all other relevant parties. Parkstone Avenue (1) DS0000018102.V313094.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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