CARE HOME ADULTS 18-65
18 Franklin Avenue Barton-le-clay Bedfordshire MK45 4LN Lead Inspector
Carol Mitchell Unannounced Inspection 8th February 2006 09:30 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 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 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 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. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 18 Franklin Avenue Address Barton-le-clay Bedfordshire MK45 4LN 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) 01582 883465 www.aldwyck.co.uk Aldwyck Housing Association Mrs N Parrott Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Physical disability (6) of places 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: 18 Franklin Avenue is a purpose built bungalow, which was registered in 1996 to provide residential care to six adults with learning disabilities. The home currently provides care for adults with profound learning disabilities. Aldwyck Housing association through contractual arrangements with the Bedfordshire Joint Commissioning Agency manages the home. The bungalow has six single bedrooms that were built to a wheelchair accessible specification. There is an adapted spa bath and additional level access shower close to the bedrooms. Communal space includes a large kitchen/diner and lounge with views over an attractive patio and garden. The home also has a sensory room. There is parking to the front of the building. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning of 8th February 2006 over a period of just under three hours. The inspector spent the time meeting residents and staff, checking some records, looking around the premises, and talking to the manager. One resident’s money, and the way the medicines are organised were checked. Staff files were not checked during this inspection. What the service does well:
This is a well-run, clean home with good facilities. The staff know the people living at the home and their needs well, and they are very friendly and kind. Staff know how to understand the residents even though they cannot speak, and they help the residents to stay as independent as possible. A detailed care plan is written for each resident, and the home is good at looking after people’s health needs and administering medicines. The manager and staff make sure that people at the home and their families are involved in running it. A staff member said “we always discuss things with parents, and they give their input.” Staff like working at the home. A staff member said, “The team is brilliant, everyone works together. Training is good and kept up to date, and there is a fantastic new filing system for everything.” The manager and staff make sure that they train and look after any new members of staff so that they feel well supported. A new staff member said, “I always get support, I can ask anything.” Staff feel very well supported by the manager, “She is excellent at supporting me and has increased my confidence.” The home tries hard to keep up links with families and friends. Staff make sure that they find out what people like doing or would enjoy doing, and then they try to organise the activities. Residents have busy lives, and staff take them out a lot. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 6 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. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 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 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 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 The manager makes sure that the right checks are made before someone is admitted to the home, so that people living there can be sure that their needs will be met. EVIDENCE: Care is taken to make sure that only people who can be well supported are admitted to the home. People are visited before they are admitted, and also visit the home prior to admission. Detailed assessment information was included in the files checked. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 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, 8, 9 The manager and staff know how to support the residents well, and each person living at the home can be sure that his or her changing needs will be written down in a detailed care plan. EVIDENCE: Staff know the residents well and are able to describe the detail of how they are supported, and the approach taken to the management of risks. The information in the care plans is very meaningful, individual, and specific. Detailed advice is included on such matters as how residents feed themselves, and attend to personal hygiene needs, so that an optimal level of independence is described and aspired to. Care plans detail how residents communicate and make their feelings known, (for example through interpretation of facial expression) so that their decisions and choices can be understood and respected. Residents and their families participate in reviews, meetings, and surveys, and the informal atmosphere at the home means that information can be shared in an easy and relaxed manner. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 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, 15, 16, 17 The manager and staff make sure that people living at the home keep doing everything they want to, they do things that help them, and eat food that they enjoy too. Residents at the home can therefore be sure that staff will try to make their time at the home as happy and fulfilled as possible. EVIDENCE: On the day of inspection, two of the residents were out at day centres. The residents are encouraged to continue with any established interests. Activities are tried so that the resident can decide if these are enjoyed or not. Two of the male residents like to attend football matches. A female resident enjoys having her nails done, and hand massages. At Christmas a party was held at the local village hall, and efforts are made to make optimum use of any local facilities. Residents enjoy going to the pub for a drink and meal. Key workers are actively encouraged to help residents to continue positive relationships with family and friends, and a structured approach to this was clearly recorded in care plans.
18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 11 In conversation staff demonstrated detailed knowledge of how they try to boost individual residents’ self esteem, how residents make choices, and about likes and dislikes and how these are communicated. The menus were being reviewed at the time of inspection because the manager and staff want to increase the variety of meals on offer. Residents are involved as much as possible in any changes, and staff assess how residents respond to different foods and alternatives are provided when needed. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The manager makes sure that all the staff know how the people living at the home like to be supported, and about their health and other needs. The manager also makes sure that staff are trained when they need to be. Therefore residents at the home can be sure that they will receive personal support in the right way for them. EVIDENCE: Staff are very able to describe the individual emotional and physical needs of specific residents in detail. Staff could speak with confidence about such matters as how individual residents like help with personal hygiene and eating. Training in specific areas is arranged so that staff are confident when dealing with any relevant clinical matters. Close attention is given to health appointments, and ongoing health problems and an efficient recording system means that all staff are kept fully aware of any issues or impending appointments. Staff like the well-organised approach to recording information, and they keep the records up to date. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 13 The medicines are also well organised, and the home’s pharmacist inspects the systems every year and writes a report. Specific health information, such as the home’s clear guidelines for the administration of any as needed medicines is easy to access within the home’s very efficient filing system. The safe administration of a medicine was observed during the inspection. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 14 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 The manager and staff know that it is important that people living at the home are heard and protected from harm. They therefore make sure that they do everything they can so that residents know that they are listened to and safe. EVIDENCE: At the time of the inspection the complaints policy was being worked on by the head office to make it easier for residents to understand. The manager detailed how any complaint would be investigated and dealt with. Information about how individual residents express dissatisfaction is recorded in the care plans. Staff described how residents make themselves understood when they are unhappy with something. A residents’ satisfaction survey is sent out every year for residents or their families to complete if they wish, and meetings are held periodically. Staff receive training about the possible abuse of vulnerable adults, and when questioned, staff were able to discuss the action they will take should they witness, or have knowledge of abuse of any kind. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 15 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, 25, 30 The manager and staff make sure that decoration is done when needed, and that the home is kept clean. Therefore people there are living in a homely and comfortable environment. EVIDENCE: The home is a friendly and welcoming place, and all areas seen were clean at the time of inspection. Two bedrooms have been decorated, and the residents were involved in the choosing of colours and curtains/blinds. The shower room has been redecorated, and a new shower was to be fitted around the time of inspection. Some further redecoration, especially in the hallway to include new flooring, was being planned at the time of inspection. Bedrooms have the right equipment to meet the needs of specific residents (electric beds, overhead hoists). Care has been taken to make sure that the bathroom is a relaxing and enjoyable place to take a bath. Music can be played in the bathroom, and there is a spa bath and special lighting including a disco ball. Good use is made of the garden, which has a useful hard area.
18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 16 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): 31, 32, 33, 34, 35, 36 The manager is very good at making sure that all the staff are well supported and trained. Therefore people living at the home can be sure that they will be supported by a good team. EVIDENCE: Staff know the residents well, and residents are confident and relaxed in their presence. Staff are knowledgeable, friendly and professional in their manner. Great emphasis is placed on the well-organised training and support of staff. Staff spoken to had received training, and confirmed that they are supervised and have annual appraisals. Staff feel well supported and prepared for their roles. There is always a senior person on call should such assistance be required. Staff are managed in a very organised way and know exactly what is expected of them on a shift-by-shift basis. Staff meetings and supervision sessions are held every month. Staff files were not seen during this inspection. However, solid recruitment procedures were described in detail by the manager. Support for new staff members is given excellent attention. New staff are directly supervised until such time that they feel comfortable with their role, and have completed comprehensive induction training. The importance of
18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 17 support for new staff members is emphasised to the whole team. The new member of staff on duty during the inspection described proper recruitment procedures, thorough induction training, and excellent support from the manager and staff. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 18 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, 38, 39, 42 The manager knows the residents and what they need, and she is good at supporting and organising the home and the staff. Therefore, people living there do benefit because the home is very well run. EVIDENCE: The manager was present for the inspection. She has recently been promoted, and is not yet the Registered Manager. The manager is friendly, approachable and very aware of the residents’ needs and how to organise the home and staff to ensure that all needs are met professionally and efficiently. The manager has detailed knowledge of residents, and how they may express their views. She has a close rapport with them and their family members, and obtains feedback about the service through informal and formal methods such as surveys and meetings. Staff feel well supported by the manager who has increased the knowledge and confidence of individual staff members.
18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 19 The filing systems at the home are noticeably well ordered, and easy for staff to access and use. Staff training is being tracked carefully so that no staff member misses training they require, and new staff are intensely supported during the first crucial weeks. One resident’s money was checked and found to be correct during the inspection. Health and safety procedures are in place so that for example fire extinguishers are checked every year. 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 20 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 2 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 3 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 3 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 3 x 3 3 3 x x 3 x 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 21 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. Standard Regulation Requirement Timescale for action 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 18 Franklin Avenue DS0000014902.V282511.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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