Inspection on 17/11/05 for 22 De Parys Avenue

This inspection was carried out on 17th November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

22 De Parys Avenue 08/01/07

22 De Parys Avenue 15/07/05

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 22 De Parys Avenue Bedford MK40 2TW Lead Inspector Katrina Derbyshire Unannounced Inspection 17th November 2005 15:45 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 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 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 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. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 22 De Parys Avenue Address Bedford MK40 2TW 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) 01234 355133 01234 355133 THF Care Estates Limited Mr Ian Tarr Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The maximum number of service users accommodated at the home is 6. The home may admit service users aged between 18 and 65 years. The home shall only admit service users in the category of LD Learning Disability. The home may admit service users who have mental health needs in addition to their learning disability. The home shall not admit service users whose primary assessed need is in the category of MD - Mental Disorder. 15th July 2005 Date of last inspection Brief Description of the Service: Number 22 De Parys Avenue is a semi-detached property located close to the town centre of Bedford. The property provides long term residential care for a maximum of six adults. The house is a large building and provides accommodation on three floors. There is one large and one small lounge together with a dinning room, kitchen and utility area located on the lower floor. The first floor has a small staff room/ office and bedrooms. The third floor contains the main office. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 11th November 2005. The Deputy manager Mrs. Pat Harris was present throughout the inspection. During the inspection many of the areas within the home were visited and the inspector spent time with many of the residents’ in the dining room. The care of two residents’ was examined in depth by looking at their records and interviewing the residents’ and staff who look after them. Observations of care practice and communication between the residents’ and staff was also made at the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home still needs to improve on the way it writes guidance to staff on how they should support the residents in meeting their needs; this is within a document called the care plan. They need to be specific on exactly how the staff should support the residents so that continuity of care is offered at all times. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 6 They also need to do something about the corridor carpet on the first floor, as there are a lot of stains in this area. The home had cleaned the carpet since the last inspection but this had not removed the stains and this does not look very nice for the residents who live at the home. 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. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 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 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 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): EVIDENCE: These standards were not assessed at this inspection. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 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 Opportunities for residents to make decisions about their lives are good and make residents feel in control of their own lives. EVIDENCE: Within the files of the individual residents documents that supplemented the plan of care was in place for example a ‘pen picture’ of the resident. A new format was now in place and this provided a structured system for staff to follow, however the entries within the care plans to guide and direct staff on how to support the residents was not sufficient. This requirement remains outstanding from the last inspection in July 2005, and a discussion was held with the Deputy Manager at the time of the inspection relating to this. Residents spoke of the opportunities that they had to make decisions in their daily lives. One resident said “ l pretty much decide what l want to do, what l want to eat and when l want to go out” another said “ yes we decide most things in the home like what’s for dinner or where we go when we go out”. Observations made during the inspection showed several instances when residents were offered choices and the carers respected the resident’s decisions. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 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): 13 & 14 Arrangements for activities for residents are good and provide a varied social life for the residents. EVIDENCE: Within the care records of residents, entries were seen to show that residents participated in a variety of activities and occupation. Residents attended varying day care services where they were able to participate in a curriculum of activity and development. In addition it was noted that one resident had also attended a local college to attend a course in assertiveness. Staff confirmed that residents supported by themselves attended events within the local community. Residents had a good knowledge of the local area and all facilities available to them, a park and leisure centre at one end of their road and the town centre at the other. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Personal support is offered in such a way as to promote and protect resident’s privacy dignity and independence. EVIDENCE: Observations of the interaction between residents and staff were made throughout the inspection. It was noted that on all occasions staff approached all residents in a very sensitive and supportive manner, providing constant encouragement. It was also noted that staff knocked on all resident’s doors and waited for permission before entering. One resident said of the staff “ they are very kind to me and yes l do feel that they respect my privacy”. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has a satisfactory complaints system with some evidence that resident’s feel that their views are listened to and acted upon. EVIDENCE: The home had a very clear complaints procedure, which detailed how a resident could complain, to whom and how long they would wait before they received a response. In addition information on how to complain was displayed over the fireplace in the dining area so that residents had easy access to this information. Staff when questioned were able to accurately describe the actions that they should take when receiving a complaint as detailed within the homes own policy. Residents confirmed that they were aware of their right to complain and had been made aware of the homes policy. Staff training records confirmed that staff had received training in protecting vulnerable adults. In addition the homes policy for the protection of vulnerable adults contained all required information, for example the types of abuse including physical and financial. Staff were able to describe to whom any allegation of abuse should be reported to and that the Commission for Social Care Inspection should be informed. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed at this inspection. However it was noted that one requirement made at the previous inspection relating to a stained carpet in the home remained outstanding, therefore the requirement remains with an extended date given for compliance. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed at this inspection. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 The manager has a clear development plan and vision for the home, which he has effectively communicated to the residents and staff. EVIDENCE: Both staff and residents reported how they felt supported by the manager at the home. Staff said that he was very clear in his vision for how residents should be cared for and that he gave full encouragement to them in their own personal development. Residents said that the manager was “alright” and their comments suggested that they felt confident in his abilities. Clear management systems are in place with clear reporting lines and accountabilities, this results in a very organised home. The health and safety policies in the home were detailed and gave clear guidance to staff on how they should manage this area. Staff had all received training in a variety of Health and Safety subjects and these included food hygiene, moving and handling and infection control. Certificates or copies of certificates of attendance are maintained within the training files at the home. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 16 Residents and their representatives had been asked their opinion on the services offered by the home as part of the quality assurance system. The results and how the home acted upon the views of the residents were available for inspection. 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 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 3 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 22 De Parys Avenue Score 3 X X X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000061363.V267179.R01.S.doc Version 5.0 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 YA6 Regulation Requirement Timescale for action 15/02/06 2. YA24 12(1)(a),15 Care plans must contain clear guidance to staff in the support they must provide to all residents to meet their needs. (previous requirement timescale 15/10/05 not met) 16 The first floor corridor carpet 15/02/06 must be cleaned to remove all stains. (previous requirement timescale of 30/10/05 not met) 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 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 19 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 © 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 22 De Parys Avenue DS0000061363.V267179.R01.S.doc Version 5.0 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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