Inspection on 18/08/05 for 21a & 21b Johnson Avenue

This inspection was carried out on 18th August 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 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

21a & 21b Johnson Avenue 26/09/07

21a & 21b Johnson Avenue 09/06/06

21a & 21b Johnson Avenue 08/12/05

21a & 21b Johnson Avenue 27/10/04

21a & 21b Johnson Avenue 23/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 21a Johnson Avenue 21a Johnson Avenue Spalding Lincolnshire PE11 2QE Lead Inspector Toby Payne Unannounced 18 August 2005 2:30pm 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. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 21a Johnson Avenue Address 21a Johnson Avenue Spalding Lincolnshire PE11 2QE 01775 767472 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) pat.morris@sense.org.uk Sense East Mrs P Morris PC Care Home Only 4 Category(ies) of SI Sensory Impairment (4) registration, with number of places LD Learning disability (0) 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 27th October 2004 Brief Description of the Service: 21a Johnson avenue is one of a pair of detached houses owned by Sense East. The property is domestic in design and in keeping with other houses in the road. The home is situated in a residential area of the market town of Spalding and is within walking distance of the town centre. The home is registered to provide personal care for up to 4 people with dual sensory impairments. The home is part of a group of homes in the area, managed by Sense. There is a small garden/patio area to the back of the home and all of the residents live in single bedrooms. . 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 2.30 p.m. It took place over 3 hours. The inspector spoke to 3 members of staff and the deputy manager. In view of the communication needs of the one resident living in the home at this inspection, the inspector relied on observations between staff and the person, information provided by staff members and records as evidence as to whether standards were being met. The main method of inspection was called “case tracking”. This involved tracking the care for the one resident. This was done by the checking of records, discussion with the care staff and observation of how their care was delivered. A pre-inspection questionnaire was completed by the home prior to this inspection. The CSCI also received comment cards from one of the 4 people living in the home and a relative. There were no adverse comments The other 3 residents were on holiday with their family. What the service does well: What has improved since the last inspection? The garden has been made more accessible for people living in the home with new chairs and tables. One resident’s bedroom has been repainted to improve the person’s quality of life. A new fridge/freezer has been purchased to keep food cooler and enable each resident to store their individual food. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 6 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. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.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 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.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) 3 and 5 Residents living at 21a Johnson Avenue receive clear information to enable them or their relatives/advocates to make an informed choice as to whether or not they wish to live in this home. Staff are prepared for working in the home and each resident has terms and conditions. EVIDENCE: Sense East has produced a statement of purpose and a service user’s guide. There is information that there is one bedroom marginally below the national minimum standards and one bedroom without a wash basin. The residents have been living in the home for many years. The last person admitted to the home was in 1993. There is therefore an established community. All staff receives a detailed induction programme in order to prepare them to support the people living in the home. Two new members of staff commented “I received a warm welcome and the induction programme prepared me for the work in the home” and “I have felt supported throughout this time”. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.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 There is detailed care planning which includes risk assessments. The health, personal and social care needs of people living in this home are fully met. EVIDENCE: Each resident has a detailed care plan. This is developed wherever possible with the involvement of the resident, their family/advocate and other relevant people. Care plans included a pen picture, which outlined their background, skills and abilities, emotional needs, hobbies and interests, food preferences, their daily routine and a daily record. There are also comprehensive risk assessments covering all aspects of daily living activities. There are also 6 monthly detailed reviews which again include wherever possible the resident and their family/advocate, representatives from the Glenside Resource Centre, the resident’s key worker and manager for the home. Before this there is a meeting to obtain all information concerning the resident. Residents were given choice concerning their interests and activities. Staff receive training in order to assist them. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 10 Care records were seen to be very individual and person focussed. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.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) 11, 13, 14, 15 and 16 Residents are involved in meaningful, appropriate activities, which include educational and recreational activities. There is regular family contact. EVIDENCE: All residents attend the purpose built Glenside Resource Centre which is run by Sense East. Activities available include cookery, pottery, horticulture, creative art, office skills, personal and social development, music, numeracy and literacy as part of their practical skills, local history and citizenship. They are taken there by a mini-bus and attend between 9.30 a. m. and 4 p.m. The Resource Centre is open Monday to Friday. Each resident has an “at home” day at which they can choose what they wish to do with the assistance/support of their key worker. These activities can include visits to the town, gymnasium, swimming and horse riding. Residents are also given the opportunity of going on holidays. There is a future holiday planned in Skegness. Staff are considering how for future holidays they can be made more individual to suit each resident. Three of the residents were on holiday with their family. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 12 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.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 Resident’s health and emotional needs are met. Medication is safely and correctly administered. EVIDENCE: Care records clearly showed that any health or emotional needs were being met either by staff, specialist staff from Sense East or by the GP. Staff also showed knowledge of the particular needs of the residents. There are also detailed policies and procedures to enable staff to deliver their care and support. Staff who administer medication have received training in how to administer medication. Records were well maintained. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 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 standard(s) 22 and 23 Any complaints received are taken seriously and residents are protected from abuse. EVIDENCE: Sense East have produced a “Resolving Issues” policy, which gives written and pictorial guidance concerning how a resident can raise any issues. This can be provided in Braille, tape or other languages other than English. No complaints have been received by the CSCI and the home since the last inspection. The home has an adult protection policy and all staff as part of their induction receive abuse training. They also receive yearly refresher training programme in the form of a questionnaire at their appraisal. A new member of staff knew what abuse was and what they should do if abuse was suspected. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 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 standard(s) 24, 27, 29 and 30 People live in a safe, clean and well decorated comfortable home. EVIDENCE: Hot water temperatures are monitored and safety devices have been installed to prevent residents being harmed by being in contact with hot surfaces. Any maintenance required is attended to promptly. There is a loop system fitted in the lounge to enable residents to listen to the TV. In addition, 2 of the bedrooms have flashing light indicators, which shows the resident whether there was someone at their door or wishing to come in. There is also one in a bathroom on the first floor. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 16 All residents are required to be fully mobile as there is no stair or shaft lift installed. There is a disabled access toilet and shower on the ground floor. There is a seat and grab rails in the shower. There is a wheel chair ramp leading to the front door of the home. Tactile pictures have been provided. Where required, advice can be obtained from a Sense Rehabilitation Officer or Occupational Therapist The home was clean and odour free throughout. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 17 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) 32 and 36 There are safe levels of staff and staff know how to meet the resident’s needs by a comprehensive programme of education. Staff are supported in their work. EVIDENCE: All staff are responsible for care, catering, domestic and laundry duties. Sleep in cover is provided in the home, as there are no wakeful staff on duty at night. However, where required additional help can be provided. The staff felt they could meet the needs of the residents and felt they had sufficient time. This was observed during the inspection by staff taking particular time to communicate to a resident in a calm and kind manner. Staff also spoke of the support provided and how they all worked as one team. Staff also spoke of the training provided to enable them to care and support the people living in the home. This training also includes how to sign in order to communicate with the people living in the home. Staff also receive formal supervision to identify and training needs or support required. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 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 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) 37, 38 and 39 Staff are lead by an experienced, competent and committed manager who supports the staff and residents. Staff have confidence in the management. EVIDENCE: The manager has worked for Sense East since 1991 and has a wide experience in care and management. This has included learning disability, sensory impairment and mental disability. She has been the registered manager since the 25/4/2005 and has care, education and management qualifications. Monthly meetings are held with staff. Staff felt they were valued and supported. Staff commented, “I like working here”, “we have a stable workforce” and “the manager is very approachable and supportive”. There are detailed policies and procedures, which enable staff to deliver care and support. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 19 The home also receives monthly unannounced monitoring visits by Sense East management and detailed reports are sent to the CSCI. There have been no concerns. 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x 3 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 x x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 21a Johnson Avenue Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x x 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 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. 1. 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. 1. Refer to Standard Good Practice Recommendations 21a Johnson Avenue 20050818 21a Johnson Ave X00022 UN Stage 4 V244630 C53.doc Version 1.40 Page 22 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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. 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