Inspection on 20/07/05 for 2 Central Avenue

This inspection was carried out on 20th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

2 Central Avenue 02/12/08

2 Central Avenue 18/12/07

2 Central Avenue 04/07/07

2 Central Avenue 01/08/06

2 Central Avenue 05/12/05

2 Central Avenue 01/02/05

2 Central Avenue 20/07/04

2 Central Avenue 12/01/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Central Avenue (2) 2 Central Avenue Billericay Essex CM12 0QZ Lead Inspector Bernadette Little Unannounced 20 July 2005 14:30 th 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 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 Stationary 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. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Central Avenue (2) Address 2 Central Avenue Billericay Essex CM12 0QZ 01277 655394 01277 655394 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Estuary Housing Association Limited Mr Russell Neil Groves CRH Care Home 4 Category(ies) of LD Learning disabilities (4) registration, with number LD (E) Learning disabilities (4) of places Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2005 Brief Description of the Service: Central Avenue is a Care Home for four service users with Learning Disabilities. It is situated between Billericay and Stock. The home is registered for service users up to and over 65 years of age. The premises comprise of a bungalow with four single bedrooms, a bathroom, a lounge, kitchen/dining room and a small conservatory area with access to a large garden to the rear of the premises. There is also a garage for the home’s minibus. The laundry area is situated in a room behind the garage. The premises are in keeping with the local community. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection that took place between 2.40pm and 7.10pm on a Wednesday. Time was spent looking at records and documents and at the premises. Time was also spent talking with staff and residents and looking at and listening to the everyday things that went on at 2 Central Avenue. The residents and staff are thanked for their help with the inspection. What the service does well: What has improved since the last inspection? What they could do better: There needs to be a plan put into place for when work is to be done in the home, and whether it would be best if residents were not at home during this time. The laundry room needs to have a proper floor and wall coverings and a sink so that people can wash their hands, to help stop germs spreading. Some records, for example about staff training, need to be there for all staff and they need to have the right information. Staff also need to be given fire training. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 6 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. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4, 5 The information about the home, and the processes prior to admission, provided appropriate detail to help people make an informed choice about a placement at 2 Central Avenue. EVIDENCE: The Statement of Purpose and Service User Guide are clear and relevant. They need some minor updates, for example the managers registration status, details of the flooring in the premises and that there are four male residents. There had been no new admissions for some time. Staff described experience of appropriate procedures for pre-admission assessment, trial visits and a trial period, which were confirmed in the homes policies, procedures and Service User Guide. Staff were aware of the service uses needs and personalities. Files sampled indicated additional specialist training. Residents were provided with the pictorial format Statement of Terms and Conditions, as well as a formal Licence to Occupy. The Statement of Terms and Conditions also refers to other documents for additional information, for example to the service user guide for information on fees and what they include. There was no specific information regarding the additional charges to be paid by residents. This could be maintained as a separate record. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 8, 9, 10 Care management documents provided staff with clear detail on the residents’ needs and how these are to be met. Considered risks had been assessed, to support resident safety and well-being. EVIDENCE: The care plan sampled had two specific aims for current development. In addition there were numerous “ working practice” instructions that covered all aspects of the residents needs and wishes and how they were to be met. Care notes were regular and relevant. Care plans showed regular review. Reviews demonstrated resident and relative involvement. Records were safely stored and staff were aware of appropriate confidentiality of residents’ information. All areas of the care plan were supported by a corresponding risk assessment. A risk assessment for bed rails positively included a history of falls but did not identify an assessment of the type of rails for the individual resident. Taking into account residence abilities, observation of daily routines and inspection of the records indicated that residents were offered choices on routines in the home. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 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 standard(s) 13, 14, 15, 17 The home assisted residents to maintain a fulfilling lifestyle appropriate to their age and abilities. Relationships with relatives were encouraged. Residents were provided with a varied menu and specific dietary requirements were met. EVIDENCE: Three residents attended day resource facilities and earn some wages from the centre. Each resident had a recorded weekly activity plan, these included pub lunches or personal shopping. Staff said that some activities were less frequent as community access support worker hours had been withdrawn. Records showed that the staff continued to try to improve the quality and range of activities for residents, based on their interests. This included planned taster sessions on football and one to one gardening sessions. Minutes of the residents and relatives meetings and care reviews showed that relationships were supported. The home assisted where possible with transport. Staff planned the menu based on their knowledge of residents’ likes and dislikes. The nutrition record confirmed that alternatives were offered. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 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 standard(s) 18, 19, 21 Personal support was offered in such a way as to promote and protect residents’ privacy and dignity. Residents’ health care needs were effectively identified and met. EVIDENCE: A carer was aware and reminded a resident to close the bathroom door. They held the door closed for the resident while the workmen waited to finish laying the new flooring. Records showed regular monitoring of resident health care, for example weight charts, bowel charts and seizure monitoring charts. Each resident’s file also contained a record of healthcare appointments. In some cases these did not contain all the information on the reason, outcome and follow up. A protocol was in place for the administration of rectal diazepam for a specific resident. It did not include reference to a plan of care or management of the resident’s privacy and dignity during this procedure. It did include a requirement for annual training for staff. Staff confirmed that because they had not had training in the past year, they would not undertake the procedure, and would instead call the GP. Records showed the familys wishes for the resident’s end of life care and practices. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 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 standard(s) 22, 23 The homes complaints procedure had been written in pictorial format to support resident understanding. Staff had been provided with training and had an understanding of adult protection issues that safeguarded residents. EVIDENCE: The complaints procedure was readily available. Staff advised that no complaints had been received by the home since the last inspection. Staff spoken with confirmed that they had been provided with annual training of protection of vulnerable adults. Certificates in the staff files sampled, with the exception of that of the registered manager, supported this. Staff were aware of the whistleblowing policy but did not find the language easy to understand. The staff member in charge of home was clear on what action to take to report any suspicions and felt confident to do so. The staff member in charge the home advised that staff had had training on positive responses/management of challenging behaviour that week. This included six permanent staff and three regular agency staff. The recommendation of the last inspection had been actioned and a copy of the adult protection procedure from the funding authorities was available. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 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 standard(s) 24, 25, 26, 27, 28, 30 The home generally provided residents with a comfortable living environment. Better planning of, and more timely, maintenance would enhance this further for residents. EVIDENCE: Communal rooms were homely. Two of the residents bedrooms were well presented and individual. One residents bedroom had had a new floor laid on the day of the inspection, and the furniture was not back in place by the end of this inspection. The decoration of this room has been ongoing from many months and the hand-washing basin had not yet been replaced. One residents bedroom had no furniture in it and was having a wet concrete type floor laid on the evening of the inspection. The furniture was stacked in different areas, including the lounge, around the home. There was no clear plan in place for where the resident was to sleep that night. This was discussed with staff to ensure adequate arrangements were put in place. A new bathroom had been installed since the last inspection. Repairs to the flooring in this area were being undertaken on the day of this inspection. This restricted residents’ access to the toilet. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 14 A new floor was to be laid in the hallway of the bungalow, (off which all rooms lead), the following day. Again no clear plan had been put in place to manage this and ensure residents were not on the premises. A new washing machine, with the sluice facility, had been installed which is positive. No hand washing facilities were available in the laundry. The laundry outbuilding also is used for food storage. The surfaces used for walls and flooring did not support good infection control measures. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 35, The staffing levels, and the training provided to permanent staff enabled them to meet the needs of the residents. The availability of accurate training records for all staff would further confirm this. EVIDENCE: Staff advised that the current staffing level of two staff all day was appropriate. The roster did not have the full name of all staff. There were two permanent staff on duty at this inspection. The roster indicated that the home has staff vacancies and that there is use of regular agency staff. Staff advised however, that the use of regular agency staff has been a better situation for residents and staff, and provided consistency. The senior in charge to shift advised that four staff were undertaking NVQ level 3. At local training plan was available. The staff training matrix did not always clearly record when the training was actually completed. Individual training files were sampled for three permanent staff. Certificates were available to show that staff had attended mandatory training, with the exception of fire training, as well as training specific to the needs of residents. Training records were not available in relation to agency staff. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38, 40, 41, 42 The home generally presented as efficiently managed and well-organised to ensure an effective service for residents. EVIDENCE: Staff spoken with said they found the manager supportive and approachable. Minutes were available of staff meetings and of resident/relatives meetings. This recorded that relatives stated they were happy with the care provided. Residents do not have individual accounts within the home and a rolling float is maintained. Receipts were sent to Estuary each week and so not available. Records were not available of residents bank/savings accounts. It was positive to note that residents are no longer being charged for inappropriate items. Policies and procedures sampled were available and appropriate. Health and safety issues sampled were satisfactory with the exception that a risk assessment relating to Legionella was not available. All staff needed to be included in fire drills on a regular basis. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 3 3 x 2 Standard No 11 12 13 14 15 16 17 x x 2 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Central Avenue (2) Score 3 2 x 3 Standard No 37 38 39 40 41 42 43 Score x 3 x 3 3 2 x I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 5 Regulation 5& Schedule 4 (8) Requirement A record must be kept of the charges made to residents, including any additional charges made, and identified in the contract and the service user guide. (Previous timescale of 01/02/05 not met). The person registered must ensure that the home is safe and well maintained for residents at all times. This includes appropriate planning to ensure resident safety and comfort while maintenance is being undertaken to the premises. The person registered must ensure that appropriate facilities are available in the laundry to reduce the risk of infection. This refers to hand washing facilities, appropriate floor and wall coverings. (Previous timescale of 20/07/04 relating to the hand washing facilities and cleanliness of the laundry not met). The person registered must ensure that Criminal Records Bureau checks have been carried out by the agency for staff working in the home. (This is a requirement from the last Timescale for action 1 October 2005 2. 24 & 26 23 (2) 13(4) 20 July 2005 3. 30 23(2)(d)& 13(3) 1 October 2005 4. 34 18,19 & Schedule 2 20 July 2005 Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 19 5. 35 18 (1) & Schedule 2 6. 39 24 7. 42 23(4) inspection not assessed on this occasion. It is carried forward to the next inspection). The person registered must ensure that all staff working at the care home are appropriately trained. This refers to the accuracy of training records and includes agency staff. A person registered must implement and maintain an effective system for gathering the views of service users and interested parties as to the conduct of the home and the services provided. (This is a requirement from the last inspection not assessed on this occasion. It is carried forward to the next inspection). The person registered must ensure that staff were provided with suitable training in fire prevention and are involved in fire drills and practices at regular intervals. 1 October 2005 20 July 2005 20 July 2005 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. 2. 3. Refer to Standard 1 9 13 Good Practice Recommendations Statement of purpose and service user guide should be updated to reflect accurate information and copy sent to the Commission. Risk assessments relating to bedrails should contain more detail relevant to the individual resident. The registered person should reassess the staffing hours following the withdrawal of the community access worker hours, and ensure that additional staffing hours are available to provide residents with adequate opportunities for leisure and social activities. Records relating to residents health care and appointments should contain all relevant detail and be kept up-to-date. I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 20 4. 19 Central Avenue (2) 5. 6. 7. 8. 9. 10. 23 24 32 35 37 42 The whistleblowing policy should be written in clearer language. And effective planned programme of maintenance and renewal to be available and adhered to. At least 50 of care staff should achieve NVQ 2 by the end of 2005. The induction format to be detailed, comprehensive and to follow the TOPSS guidelines. Not inspected. The registered manager to achieve NVQ4 in care and management by the end of 2005. A risk assessment should be undertaken in relation to legionella and be available for inspection. Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Central Avenue (2) I56-I06 S18072 Central Avenue (2) V240362 200705 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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