Inspection on 08/01/07 for 22 De Parys Avenue

This inspection was carried out on 8th January 2007.

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 no outstanding requirements from the previous inspection report, but 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 17/11/05

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 8th January 2007 12:45 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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.V326619.R01.S.doc Version 5.2 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.V326619.R01.S.doc Version 5.2 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.V326619.R01.S.doc Version 5.2 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. 17th November 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. The fees for this home are £750.00 per week. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this visit was to undertake a key inspection. This unannounced visit took place on 8th January 2007. The manager was present throughout the inspection. During the inspection all areas of the home were visited and the inspector spent time with many of the residents’ in the sitting area of the home and dinning room. The care of two residents’ was examined by looking at their records and interviewing the residents’ and staff who look after them. The views of residents have been used alongside information from the home through a pre inspection questionnaire to assess the outcomes within each standard. Observations of care practice and communication between the residents’ and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. This inspection report should be read alongside the National Minimum Standards for Younger Adults (18-65). What the service does well: The home continues to be very good at helping residents feel part of the local community. Local facilities including shops, pubs and places of worship are all within walking distance and residents are encouraged to use all the town facilities. In addition staff always make sure that local events are shared with the residents so that they can always be involved with the local community in Bedfordshire. The home keep a folder with information on local events and facilities, which is kept in the games room at the home. Residents therefore have this information readily available, helping them to choose what they wish to participate in. Staff also have a very good knowledge of the residents that live at the home so residents feel safe in the knowledge that the people who care for them are well trained and dedicated. The standard of cleanliness at this home is very good, all areas are nicely decorated and care and attention is paid to providing the residents with a homely environment to live in. One resident said about their own individual room “ l love it, l have everything l need in here, l even have my own couch”. They are also very good at making sure the home is a safe place for the residents to live in. Fire safety checks are carried out regularly and a specialist contractor comes and checks that the fire equipment is in good working order. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 6 The kitchen in the home is also very clean and hygiene and safety checks are carried out, the temperature of water is also tested to make sure that it is safe for the residents. 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. The summary of this inspection report can be made available in other formats on request. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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.V326619.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of pre admission assessment at this home is good so management have sufficient information to ascertain if they are able to meet the needs of the residents. EVIDENCE: Information seen within the care records of residents showed that a system was in place to assess the needs of prospective residents. The home was noted to use a standardised document to record their assessment of needs. In addition information from the referring agency was also seen providing a comprehensive background concerning the resident’s life. Residents are invited to visit before deciding to move in to the home, meals can be taken and there is a possibility of an overnight stay. One resident confirmed that they had been given a choice as to whether they moved into the home. They also recollected being asked to give their views about their own needs and how they felt staff could support them in meeting their needs. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of care planning at this home is good, providing staff with clear guidance on how they should support the residents to meet their individual needs. EVIDENCE: The home maintains care plans on each of the residents; each care plan is directly linked to the assessments undertaken so that there is a plan in place, for each assessed need. Care plans set out any rehabilitation plans or communication development for the resident, and were clear in any restrictions on choice or freedom in place following a detailed risk assessment. Residents were aware of the care plans and spoke of their involvement supported by staff in their development. The staff had reviewed the care detailed within the plans examined, entries to show that this had been undertaken were seen. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 10 Residents through discussion confirmed that they liked living in the home and felt their privacy was respected. Management had sought the services of an advocacy group for those residents who did not have any other representation. Documents that described varying activities undertaken by residents were seen. The activity had been described and it gave clear guidance on the required support needed for each resident, so that any risk associated with that activity would be reduced. Risk assessments were also in place on individual files relating to fire safety associated with smoking, and the physical support required by the resident if it was needed. Observation of the physical and emotional support offered to one resident during the inspection so that the risk to that resident was reduced was noted to be carried out appropriately, this support had been described in the residents records. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are required to ensure resident’s rights and responsibilities are met by following the homes policies and procedures at all times. EVIDENCE: A choice of meals was available; menus seen examined reflected a varied diet and staff informed the inspector that residents were involved in setting the menus in the home and on occasions assisted in the homes ‘ shopping’. The kitchen was seen to be clean and tidy and the documentation regarding kitchen cleaning, food labelling and temperature control were all noted to be satisfactory. Residents through discussion and through feedback from returned comment cards confirmed that they were satisfied with the food at the home. One resident spoke of the contact with their family, they were visited by their family members at the home on a regular basis or they could visit them at 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 12 their own home. Documents seen within the individual care record of this resident gave clear guidance to staff in how they should support the resident in maintaining these close relationships with the family members. Management advised that some resident’s were engaged in paid employment at this time. Residents through discussion spoke of their attendance at a local centre and described their programme of learning. Information examined supported this as records were maintained to show that one resident for example had received help with financial management. Entries made within the care records described the social and leisure activities the resident’s had received. Records viewed on the day of inspection indicated that activities that had been provided for example were shopping trips, walks and going out for a pub meal/drink. One resident who was able to access local facilities independently did so several times each week, they informed the inspector that they liked to go to the local cinema and held a season ticket for this. The care records seen also identified very different individual interests of the residents and they were specific in the identification of the residents preferred leisure interests, regular contact with family members and visits to their homes were also included. Residents spoke of their favourite things that they liked to do and these included for one resident an interest in music; which they had access to in their rooms with audio equipment in place. In addition a games room was seen containing for example a dartboard, computer and audio equipment. The rights and responsibilities of residents were written within several documents, including the policies in the home. However following an incident where a resident had physically injured a staff member, it was noted that staff had not followed the homes own policy. The policy stated that a review must be undertaken; staff and records confirmed that this had not been undertaken. The incident report showed that the staff member had received several injuries. A requirement has been made relating to this. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The way in which the medication at the home is managed continues to be satisfactory in promoting good health for the residents. EVIDENCE: Documents within the individual care records of residents demonstrate that healthcare for residents is supported and thoroughly overviewed with residents being enabled to access all relevant services. The staff support residents to receive the full spectrum of healthcare facilities and are conscientious in establishing liaison with all relevant professional bodies that may be able to advise and enhance residents physical health. Health screening is supported and there was evidence that residents are offered informed choice and enabled to refuse screening if they so wish. Although from the information available the health needs of the residents seems to be met the home still needs to seek initiating a Health Action Plan for all residents, with the appropriate healthcare professionals in accordance with the guidance from the Valuing People White paper 2001. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 14 The home had a medication policy. On inspection the storage and handling of medication were noted to be carried out appropriately, and the home utilised a monitored dosage system for the administration of medication. Training records submitted by the home showed staff responsible for the administration of medicines had received training in this area. Residents and staff said that times for getting up or going to bed were led by the residents, restrictions that were in place for example to rise at a certain time to attend another service during the day were documented in the care records seen on this inspection, and the reasons for these restrictions were made clear. It was observed that only once permission from a resident had been given, did staff enter service resident’s individual rooms. Also through discussion with residents they confirmed that they choose their own clothes and hairstyle. Guidance and support regarding personal hygiene and the level offered by staff was reflected in the care plans examined on this inspection. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Management at this home has a good understanding of the local protection of vulnerable adults protocols so residents are protected by the protection and support of a multi disciplinary approach. EVIDENCE: As assessed at the previous inspection the home continued to have 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. 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, all written feedback sent to the Commission for Social Care Inspection through returned comment cards indicated this. 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. The management at the home had recently made a referral under this scheme concerning a resident at the home. The management had acted swiftly following receipt of information, this related to an alleged incident outside of the home. Their actions followed the local 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 16 protocols for the protection of vulnerable adults, thus securing action and support from a multi disciplinary approach. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The domestic style furnishings and fittings in this home help to create a homely environment for the residents to live in. EVIDENCE: Accommodation is provided to residents across three floors with access via stairs. The home is situated just minutes walk from the town centre of Bedford. There is a small amount of outdoor space available to the residents and this is well kept. Up to six residents can share a lounge and dining room alongside a games room and snug room. Some areas had been redecorated since the homes last inspection. One resident showed the inspector their individual room. This contained numerous items that helped in creating a homely and personal space for the resident. The resident indicated that they were happy with their room, which contained photographs, pictures, television, music equipment and ornaments. All the areas seen at this visit were noted to be clean and tidy. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The approach and systems in place at this home for staff training are good, so residents receive support from staff with sufficient knowledge and understanding of their needs. EVIDENCE: As previously assessed staff files examined on this visit still contained the information listed in schedule 2 and 4. The home had obtained in all circumstances all matters in relation to this standard. Criminal Record Bureau checks had been received prior to the employment of an employee. Staff confirmed that they had been issued copies of the codes of conduct and practices set by the General Social Care Council. All further recruitment checks had also been undertaken. Induction checklists on the staff files seen on this inspection showed that the required areas of the staff’s roles and responsibilities had been covered and met all the Sector Skills Council specifications for induction or foundation 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 19 training. The use of the Learning Disability Award Framework-accredited training needs was being accessed to provide underpinning knowledge for new care staff. Training records and staff confirmed that alongside statutory training staff had undertaken further training in relation to their roles. The home had been active in commencing staff on a National Vocational Qualification programme and all staff had development and appraisal plans in place. Information supplied by the home to the Commission for Social Care Inspection showed 99 of staff with a national vocational qualification at level 2 or above. Certificates of attendance were maintained for all courses undertaken. Staffing rotas submitted by the home to the Commission for Social Care Inspection and staff confirmed that there was a period of time in the morning when only one staff member was on duty. In view of the incident described in the lifestyle section, staff informed the inspector that they felt “vulnerable”. The home needs to review its staffing arrangements to ensure the safety of all staff and residents at the home. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems in place at the home for gaining the views of residents are good so residents have an opportunity to influence the running of the home. EVIDENCE: Staff and residents spoke of how they felt supported by the manager at the home. Staff said that they found him “ so approachable”. Records supplied by the home and examined in the home show that the manger holds the Registered Managers Award. All residents spoken with at this visit spoke very favourably of the manager. Comments included “ he listens to me”, “ l always feel l can go to him” and “ l don’t know what l would have done without him, he helped me”. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 21 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. 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. Residents and staff at the home spoke of representatives of Social Services recently visiting them at the home. They informed the inspector that this was to consult them about the care that they receive and the possibility of changes in the way their support is paid for and provided. Discussion with the manager was held regarding this, the Commission for Social Care Inspection must be kept informed of any possible changes. 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 1 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 22 De Parys Avenue DS0000061363.V326619.R01.S.doc Version 5.2 Page 23 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 YA16 Regulation 12(1)(b) Requirement The homes procedure must be followed in reviewing the care of residents following an incident, to ensure all resident’s rights; responsibilities and changing needs are reviewed and met. Timescale for action 15/02/07 2. YA33 18 (1)(a) A review of staffing numbers 15/02/07 must be undertaken and changes must be made to ensure that there are sufficient staff on duty in the mornings, to maintain the safety of both residents and staff. 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 YA19 Good Practice Recommendations The home should initiate with the relevant medical professionals for all residents to have a Health Action Plan in accordance with the Valuing People White Paper 2001. DS0000061363.V326619.R01.S.doc Version 5.2 Page 24 22 De Parys Avenue Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V326619.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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