Inspection on 07/07/05 for 2 Windsor Avenue

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

2 Windsor Avenue 08/12/05

2 Windsor Avenue 17/09/04

2 Windsor Avenue 16/04/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 HR Care Homes Limited 2 Windsor Avenue Desborough Northants NN14 2SS Lead Inspector Sharon Treadwell Unannounced Thursday, 7 July 2005 at 11.00 am 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. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service HR Care Homes Limited Address 2 Windsor Avenue Desborough Northants nn14 2SS 01536 760418 01536 764157 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) HR Care Homes Limited Mr Richard Charles Heap CRH 5 Category(ies) of LD Learning Disability registration, with number PD Physical Disability of places HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No person falling within the category of a Physical Disability (PD) may be admitted to the home unless that person also falls within the category of Learning Disability (LD) ie dual disability Date of last inspection 17th September 2004 Brief Description of the Service: Number two Windsor Avenue is one of two care homes situated in the small town of Desborough, which are owned and operated by Richard and Heather Mullin trading as HR Care Homes Limited. The home accommodates five young people with learning disability as their primary diagnosis and all the young people are additionally wheelchair users. The home offers personal care but does not provide nursing care and will not accommodate young people who are known to be physically aggressive to other service users or staff. The home is a converted dormer bungalow on the outskirts of the town which has been extensively and tastefully adapted to fully meet the needs of the client group. A wide range of moving and handling aids, including hoist tracking systems in bedrooms and bathrooms and specialist bathing and showering , have been installed. The home also has an attractive, enclosed garden with a lawn and large pond, which is fully accessible to all the young people accommodated at the home. The staff at the home facilitate access to a good range of education, leisure and entertainment opportunities for young people and the home has its own adapted mini bus to provide appropriate transport. All bedrooms at the home are large and have en suite facilities (one facility is shared by two young people) and shared areas consist of a large lounge, dining area and conservatory. The home is exceptionally clean and well appointed and provides a comfortable, homely environment for the young people. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out at 11am on a weekday morning. Prior to this inspection the providers submitted a pre-inspection questionnaire with supporting information to the Commission for Social Care Inspection office at Northampton and additionally two GP comment cards, a Care Manager comment card and a relative’s comment card, were received by that office. None of this information was available to the inspector prior to the completion of this inspection or the writing of this report and the information contained in these documents will be referenced within the second inspection of the home later this year. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users. The primary method used during this inspection was that of case tracking, which involved selecting two of the young people currently accommodated at the home and tracking the care they received through looking at their records and observation and discussion with young people and staff at the home. This inspection took four and a half hours, during which the inspector spoke with three of the young people, one of the providers, the Area Manager for HR Care Homes Limited and a member of the staff team. The inspector additionally had lunch with the young people and staff. This was a positive inspection with no requirements identified. What the service does well: Care Plans, comprehensive guidelines detailing individual support needs and detailed individual risk assessments evidence that the staff at the home strive to enhance the quality of life of the young people accommodated at the home. Young people are well supported and facilitated to access a wide range of education, leisure and social opportunities. The home provides an exceptionally clean, homely and well equipped environment for the client group for which it caters. The providers and staff have established strong working relationships with associated professionals and can evidence a focus on ‘working together’ to enable young people to reach their full potential. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 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. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.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 HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.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 and 2. All five young people currently accommodated are appropriately placed. The home has clearly stated admission criteria and procedures, which detail appropriate consideration of compatibility with current residents. EVIDENCE: The five young people currently residing at the home were admitted in 2003 when this home was initially registered. All were subject to appropriate assessment prior to admission. All are in long term placement. No admissions have recently been made and none are proposed. The home includes clear details of its admission criteria and of the admission procedure, which incorporates appropriate opportunities for prospective service users to visit, in its Statement of Purpose. The Statement of Purpose and Service User Guide are fully reflective of the services provided and of the philosophy and aims and objectives of the home. The home has a very wide range of moving and handling aids and specialist bathing equipment, which fully meets service users needs. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.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 and 9. Care planning, written guidelines detailing individual support needs in all areas of personal care and comprehensive individual risk assessments facilitate the provision of very individualised care. EVIDENCE: The two files examined during this inspection evidenced detailed individual care plans. Each young person’s care plan is summarised at the front of the file to provide an ‘at a glance’ summary of primary care needs. The care plans of both young people tracked were dated February 2004 and each detailed a review date of August 2004 but neither file contained evidence of such a review. Both young people had since been subject to annual review of placement. The provider and staff confirmed that young people’s placement plans were reviewed internally at team meetings and that the minutes of these meetings evidenced which young person’s plan had been reviewed and detailed any amendments to be made. Both care plans had clearly been amended but these amendments were not dated. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 10 The home should clearly record dates of review of young people’s care plans and clarify why and when amendments are made. The home is commended on the provision of comprehensive guidelines, in relation to each service user, detailing how personal care should be provided. The guidelines cover a wide range of care provision: bathroom, mealtimes, bedtime routine, continence management, moving and handling, behaviour management and leisure preferences. These guidelines provide an excellent foundation for ensuring consistency of care. The case tracking of files evidenced that the service users’ rights to make decisions was well supported by the staff at Windsor Avenue. Symbols are currently being used with one young person who has no verbal communication skills to enable positive choices. The home is particularly praised for the inclusion in its Family and Social Contact Policy that, whilst fully encouraging retention of contact ‘this is the resident’s choice-not a right to be exercised by families’. Full individual risk assessments were evidenced on both the files tracked and these covered all potentially hazardous situations: wheelchair use, travelling in the mini bus, use of moving and handling equipment, use of bed sides and additionally involvement in various leisure or social activities. There was clear evidence of the home’s encouragement to young people to ‘live life to the full’ as safely as possible. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 11 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) 12, 13, 15, 16, 17. Staff at the home strive consistently to enhance the quality of life of the young people accommodated by facilitating access to a wide range of social, leisure and education opportunities. EVIDENCE: The files examined and discussions with young people and staff at the home indicate that young people are encouraged and assisted to access a very wide range of opportunities for socialising, enjoying leisure activities and pursuing educational development. All of the young people have access to day centres. Two young people attend the Henley Day Centre five days each week and one parent commented in an annual review ‘I feel that Windsor Avenue and Henley Day Centre have developed such a good working relationship that it provides total consistency in care’. Other young people attend local day centres and also have access to HR Care’s day centre, which is located at their other care home, also in Desborough, where they have the opportunity to try various arts and crafts activities, sewing literacy and to try their hand at horticulture. Two young people at Windsor Avenue have recently planted up some lovely tubs in HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 12 the garden from seed. One young person has recently commenced a florestry class at Tresham College. Other activities from the home include ‘sailability’ at a local sailing school, shopping, bowling, cinema visits and regular hydrotherapy sessions at Hinwick College. Two of the current residents at Windsor Avenue were previously resident at the college so this activity also enables them to see old friends. One of the providers and the manager of the home have been fully trained by the physiotherapist at Hinwick Hall to supervise young people accessing this facility. Young People’s files clearly identified family relationships. The young people’s files tracked and discussions with young people evidenced that staff at the home promote and facilitate family contact. Family members are welcome visitors at the home and the provider detailed that, because residential placement at Windsor Avenue resulted in families losing their mobility vehicle allocation, that the home almost always transported young people to and from home. Menus were examined during the inspection and were noted to provide a good variety and a nutritional balance. On the day of inspection two of the young people were out shopping with staff at a local supermarket and staff informed the inspector that this was done twice weekly. The inspector ate lunch with young people and staff. Young people requiring assistance were appropriately provided with it. At the time of this inspection the bedroom doors at the home are not fitted with any locking mechanism and young people are not provided with any lockable facility in which to store valuable, personal possessions. The home should certainly provide the latter and has been recommended to either fit suitable locking mechanisms or to clearly detail in individual risk assessments why this is not appropriate HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 13 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 Young people are provided with a very individual service, their specific and very individual personal support needs are clearly identified and well met. EVIDENCE: The compilation of comprehensive guidelines detailing each young person’s specific personal care requirements forms the basis of consistency of care provision. Examination of the guidelines prepared in relation to the two young people tracked evidenced that the home was flexible in the provision of personal support, tailoring it to young people’s individual capabilities and needs. Mealtime routines detailed the level of staff assistance required as well as the trialling of various aids to support young people to feed themselves wherever possible. Care Plans examined clarified young people’s communication difficulties and detailed the appropriate involvement of professionals such as Speech and Language Therapists to enhance communication ability. The provider detailed that, where intimate care was provided, young people’s preferences in relation to staff providing this care were respected. Nursing care is not provided by the home. The home has an extensive range of moving and handling equipment, including a portable hoist, which is used when young people are taken on HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 14 holiday. The provider and staff told the inspector that a recent holiday with the three male residents in Tenby had necessitated a number of trips to transport both residents and all the necessary equipment. Standards 19 and 20 have not been inspected on this occasion and will be fully inspected during the second inspection of the home later this year. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 15 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) none N/A EVIDENCE: No standards were inspected under Concerns, Complaints and Protection. These standards will be fully inspected during the second inspection of the home later this year. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 16 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. Windsor Avenue provides a homely, clean and comfortable environment for the young people accommodated. EVIDENCE: A full tour of the premises was conducted during this inspection. All service users’ bedrooms are large, airy and well personalised. Every bedroom is fitted with a full range of equipment appropriate to the service user’s individual needs. All bedrooms have en suite facilities. Two of the service users share an en suite and the provider detailed to the inspector that a special dispensation had been obtained from the Commission for Social Care Inspection, at the time of initial registration, for this arrangement. The home additionally has a communal bathroom, which is also equipped with hoist and specialist bath. All service users’ bedrooms were noted to be well personalised. Observations during the inspection and discussions with service users indicated that they were comfortable and happy in their surroundings. The mother of one service user said during an annual review ‘We don’t think we could have found a more caring and happy home for … to live in. It really is home from home.’ HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 17 The home has an up to date Fire Risk assessment and undertakes appropriate fire safety checks. In line with a requirement identified during the previous inspection the home has incorporated full details of its fire safety procedures into its Statement of Purpose. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 18 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) 35 Staff at the home are supported to undertake appropriate professional training and training specifically relevant to the client group accommodated. EVIDENCE: The area Manager of HR Care Limited undertakes responsibility for organising and managing staff training in this home. A training matrix was supplied to the inspector during this inspection. All new staff at the home undergo induction and foundation training to Skills for Care (Formerly TOPSS) specification and recently the home has trialled the LDAF (Learning Disability Award Framework) induction/foundation package with two new staff. Several staff at the home are currently studying for NVQ (National Vocational Qualification) awards at various levels. The training matrix evidences that the home is progressively training its staff team in a range of areas specifically relevant to the client group accommodated. These include epilepsy awareness, manual handling, accredited medication training with Boots Chemists, Makaton, Speech and language, abdominal massage, abuse in the care home and first aid. HR Care Homes Limited is currently in the process of registering a third care home in the Desborough area. If successful, this will result in management changes at this home. The inspector was advised that an application is HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 19 currently with the Commission for Social Care Inspection for Mr. Richard Heap (currently manager of Windsor Avenue) to be registered as manager of the new home and also that an application had been submitted for the current assistant manager of Windsor Avenue to be registered as manager. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 20 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) None N/A EVIDENCE: No standards were inspected under Conduct and Management of the Home. These standards will be fully inspected during the second inspection of the home later this year. HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 21 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 HR Care Homes Limited Score 4 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 22 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. 1. Standard Regulation None 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. 1. Refer to Standard 6 Good Practice Recommendations Service users care plans should be subject to six monthly review and sevice users records should evidence that such a review has taken place. Any ammendments to the care plan should be clearly recorded and actioned. The home should provide service users with a lockable facility in which to store valuable, personal possessions and has been recommended to either fit suitable locking mechanisms to service users bedroom doors or to clearly detail in individual risk assessments why this is not appropriate 2. 16 HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 23 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB 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 HR Care Homes Limited C51 C08 S37377 HR Care Homes Ltd V228700 Stage 4 070705.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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