Inspection on 09/11/06 for 22 Prices Avenue

This inspection was carried out on 9th November 2006.

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

22 Prices Avenue 27/10/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 22 Prices Avenue Cliftonville Margate Kent CT9 2NT Lead Inspector Tina Thomas Key Unannounced Inspection 9th November 2006 10:00 22 Prices Avenue DS0000065351.V307413.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 Prices Avenue DS0000065351.V307413.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 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 22 Prices Avenue Address Cliftonville Margate Kent CT9 2NT 01843 293927 01843 293927 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) CareTech Community Services (No.2) Ltd Mrs Patricia Wolstenhulme Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th October 2005 Brief Description of the Service: 22 Prices Avenue is a semi detached house with six single bedrooms, the bedrooms are situated on the first and second floor of the property. There is no lift facility within the home. The home is registered for six adults with learning disabilities aged between 18-65 years. The home promotes person centred living. Service users are actively encouraged to maintain and develop personal independence and choice. The home is located in the residential area of Cliftonville, within short walking distance of local shops and amenities. Fees range from £830-£1,702.31 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a number of evidence gathering exercises including a site visit to the home conducted over two days. This was an unannounced key inspection and therefore all key standards of the national minimum standards for younger adults were reviewed. A pre inspection questionnaire was completed by the manager and submitted to the Commission. The Inspector met with and spoke to staff, the manager, and service users during the visit to the home. The inspector made observations, sampled records and had a look around the home. One service users said ‘I like the staff and other people who live here. Its nice’ Service users indicated that they are happy living at 22,Prices Avenue. Service users appeared relaxed and very happy with the pace of life at this home. Staff said that they enjoy working at the home and that feel staff work well as a team. The manager said that the home works with families and supports service users to maintain regular contact with families and friends. This was evidenced in service user plans. What the service does well: Assessments are based on the principles of person centred planning. This is recognised as good practice. Key workers review service user plans in detail every month. Risks are managed and supported in a positive way as part of an independent lifestyle. Behaviours are supported in a positive effective way. This has lead to a decrease in one persons challenging behaviours, which in turn has lead to increased independence and increased community participation and presence. Service users have opportunity to access a range of community leisure and educational facilities and services. Relationships are supported. The environment is homelike and clean. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 6 Staff are longstanding and competent in supporting service users needs. Staff communicate effectively with service users enabling choice. The home is well run by a competent effective manager. The manager and Provider are committed to constantly improving the service. The staff team is stable and longstanding. 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 Prices Avenue DS0000065351.V307413.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 Prices Avenue DS0000065351.V307413.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. Suitable care is taken to ensure that the needs of people considering moving to the home can be met. EVIDENCE: Staff at the home discussed how well service users got along together. They discussed that the atmosphere was calm and happy. some of the behaviours that service users exhibited prior to the being in the home had abated. The staff believed that this was because the service users were happy at the home. The Registered Manager said that it was to the credit of the Company, that they had allowed her time to select service users who could live together happily. She hadn’t felt pressured into making the wrong choice for financial reasons. For individuals referred through Care Management, the registered manager obtains a summary of the single Care Management (health and social services) assessment. The home also seeks information from other health care professionals, family supporters and the service users themselves. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 9 The home then develops with each prospective service user an individual service user plan based on the Care Management Assessment and care plan and the home’s own needs assessment. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 10 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 excellent. This judgement has been made using available evidence including a visit to this service. Service users know their changing needs and goals will be supported. Service users are supported to make choices and decisions. Service users are supported to take risks as part of an independant lifestyle. EVIDENCE: The inspector sampled service user plans. Records are organised and easy to follow. A person’s needs are assessed and a plan developed stating how staff are to support these needs. Plans are detailed and reviewed each month by a key worker. The monthly reviews are detailed and include an evaluation of individual goals. A person centred assessment is being introduced and the manager agreed to continue developing this to ensure that when aspirations and dreams are identified they are supported and reviewed by staff. Communication guidelines are included in plans detailing any special communication needs. This is important as some service users use alternative 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 11 forms of communication. These guidelines for staff ensure that service users are supported to make choices and decisions. Behaviour management guidelines are developed and are based on positive approaches. These too are kept under monthly review. Staff acknowledged and could evidence that certain challenging behaviours have decreased since one service users had moved to the home. Service users that spoke with the inspector were aware of the content of their care plan and it was drawn up with their involvement. Each service user has an allocated key worker, service users that spoke with inspector knew who their care worker was, and also had some understanding of their role. Service users are encouraged to make their own decisions. Staff support them with information, assistance and communication support. Decision making processes are recorded and service users sign their agreement. Throughout the inspection there were many examples of decision making by service users, including time spent alone, phoning friends, activities, and mealtimes. There was information in the home and in care plans regarding advocacy. Service users spoken to were aware that there were people outside of the home they could speak with if they chose. Risks are assessed and strategies devised to support these risks. This means service users are not restricted but supported to take risks as part of an independent lifestyle. Service users attend reviews when family and care manages are invited. The manager and staff spoke with knowledge and understanding of service users needs and strategies to support those needs. Service users indicated by their relaxed behaviours, and told the inspector, that they are happy at the home. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 12 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): 12,12,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users take part in a range of activities and are supported to access the community. Service users relationships with friends and family are supported. Service users rights and responsibilities are respected by staff. Service users are offered a balanced diet. EVIDENCE: Each service user has an individual activity planner within their care plan. This includes evenings and weekends. Staff help service users find out about and take up opportunities for paid, supported or volunteer jobs/therapeutic work placements or work-related training schemes. One service user undertakes charity work. Service users have the opportunity to take part in a range of 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 13 activities. Hobbies are supported. One service user discussed with the inspector how he would like the home to have sky TV, so that service users could enjoy watching films, sport and music channels as a communal event. The manager agreed to discuss with the other service users, so as to give it more consideration. Service users access local amenities and facilities, including shops, leisure centres, colleges and clubs. The manager spoke with knowledge about the importance of service users being part of their local community. Evidence of this was supported in documentation relating to client team meetings and 1-1’s with key workers. On the day of the visit some service users were attending various college courses including further education and independent living skills. The support needed to support identified goals for the future were recorded in the care plan. Family and friends details are recorded in service user plans. Records are kept of contact with family and friends. Some service users visit friends and family who live both locally and further a field, The manager said that service users are encouraged to take part in household tasks. Some service users take part by doing a part of the task. This leads to more independence and control. During the inspection service users cleaned their own rooms, with help and prepared a light lunch and hot and cold drinks. Staff were observed interacting with service users in an appropriate respectful manner. The atmosphere was relaxed with service users indicating verbally and by their behaviours that they are happy with the pace of life. The kitchen is spacious and was clean on the day of the visit. The kitchen is suitable for service users to take part in cooking tasks. The home keeps a record of meals taken, which the manager said is usually planned on a weekly basis. Each service users communication profile shows how each service user can make independent choices regarding meal planning. Flash cards and cookery books provide pictorial aids are provided for some service users to indicate their preference. Service users said they are happy with the food provided at the home. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 14 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. Service users personal care needs and health needs are met. Medication practices are safe and encourage involvement of service users. EVIDENCE: Personal care needs are recorded in individual plans, which are kept under review. This ensures that service users are supported in the way they prefer. Service users indicated that their personal care needs are met. Each service user is registered with a GP. The inspector noted that detailed records are kept of health appointments and outcomes. This included chiropody and dieticians. It was evident that service users are assisted to access a range of health advice and support. Health needs are monitored by staff and advice sought when necessary. Health needs are assessed and where necessary a care plan or risk assessment developed. The home has a suitable medication policy and procedures. Medication practices were audited and found to be sound. Service users complete with the 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 15 help of their key worker a workbook called ‘my medicine’ this is very good practice. Staff support service users with their medication as no service user has elected to maintain their own medication. There are systems in place for ordering and receiving medication into the home. A record is kept of medication entering the home. The inspector examined the medication administration records (MAR). There were no gaps and initials are used as required. Guidelines are in place for the use of ‘when required’ medication. Staff are appropriately trained in the administration of medication. The manager conducts competency appraisals with staff to ensure they maintain their competency. The manager agreed to develop a system to check staff competency regularly. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 16 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. Service users views are listened to and acted on. Service users are protected from abuse. Quality in this outcome area for service users is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure. This procedure is included in the service user guide. The manager said that individual meetings with key workers enable service users to air their views. Service user meetings are also held, which staff facilitate. Opportunity is also given at review meetings to make complaints or raise issues. The home and the Commission have received a complaint about the service (not specific to the care of service users), since the last inspection. The home has investigated in accordance with their own complaints procedure and responded appropriately. The home has an adult protection policy as well as the local authority multi agency protection policy. Staff attend training in recognising and responding to abuse. There have no adult protection alerts since the last inspection. When interviewed the manager was able to show knowledge and understanding of adult protection procedures as were staff. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 17 No one at the home or the organisation is appointee for any service user. Service users are supported to control their personal allowance. Individual records are kept of expenditure, which is receipted. One record was audited and found to be sound. Aggression and self-harm is understood and supported. Guidelines are clear and based on positive approaches, which is good practice. As mentioned it has been recorded that service users aggression and challenging behaviours have reduced since moving to the home. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 18 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 home is safe, clean and homely. EVIDENCE: Service users appeared relaxed and happy in their home. Service users moved out of the home in September, and lived in a caravan park for 3 weeks whilst the home was completely rewired, redecorated and re- carpeted. Service users discussed how they had been involved in packing up the house and how it had felt when they returned home. Furniture and fittings are of good quality and domestic in nature. There is a lounge, kitchen/ diner with separate laundry on the ground floor. The house has a homelike feel. Service users told the inspector how they chose the colour of their rooms. One said ‘im going to chose the blinds for my room tomorrow’ Service users also 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 19 discussed other new furnishings they were going to choose for communal areas. The home has an ongoing maintenance plan. One service user discussed the new window that had been put in his room earlier in the year. The home has a good size garden and service users discussed enjoying it in the summer. The home has a current fire risk assessment on the premises. The home was clean on the day of the visit. It was observed that service users are supported to carry out the cleaning and laundry etc. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are trained to do their job. Recruitment checks are robust which protects service users. EVIDENCE: The inspector spoke with staff and found that they were interested, motivated and committed. Staff generally had a good understanding of the service users they supported. The inspector sampled some staff files. Staff complete an induction and foundation training, which is in line with skills for care and linked to the Learning disability award framework. More than 50 of staff are trained to NVQ Level 2 or above The inspector noted that staff complete a range of training, as certificates were present in staff files. Each staff member has a training profile. There was evidence that thorough checks are carried out to ensure that staff are suitable to work with vulnerable people. The required information in relation to each staff member was available to the inspector and in order. Staff 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 21 were observed supporting service users in a positive consistent manner. Service users were at ease joking and interacting with staff and the manager, however staff are aware of maintaining the boundaries necessary for effective support. Staff take on roles of key workers to certain service users. Key workers complete monthly reviews of service user plans, which are detailed, and comprehensive. The staff team is longstanding with good retention rates. This leads to consistency in care and support, which benefits service users. Whilst the company does provide some service specific training, it was agreed that not all key workers have an in-depth knowledge of the conditions of the service users they support. Further specific training has been recommended. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 22 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. This is a well run home. Service users know their health and safety will be protected. Quality assurance systems are in place and service users views underpin the development of the service. EVIDENCE: The manager spoke with knowledge and understanding of service users needs and has a good understanding of the day-to-day operation of the home. The manager has years of experience in working with people with a learning disability and has completed the required qualification of the National Minimum Standards. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 23 The manager said that regular staff meetings and regular supervision sessions with staff enable her to monitor practice and ensure effective communication. The manager also works alongside staff to coach and mentor. It was evident that the manager is approachable to staff and service users and has a caring and supportive style. There are monitoring and audit systems in place to ensure good practice is maintained. There is a quality assurance system in place. Questionnaires are sent out to relatives and social care and health professionals for feedback. Views of service users are also sought. A summary statement has been produced. This will ensure that the service develops and improves underpinned by these views. Records are well organised, up to date and held securely. Policies have been reviewed. The home is safe, well maintained and free from hazards. The inspector noted that staff attend various health and safety related training courses regularly. Cleaning products are stored appropriately. Accidents and incidents are recorded and included in formal reviews. These are also audited and reported to the health and safety officer for monitoring. 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 24 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 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 3 x 3 x x 3 x 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? no 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. 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 2 Refer to Standard YA12 YA35 Good Practice Recommendations Consideration should be given to the service users request for sky TV Key workers have training specific to the conditions of those service users they support 22 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Prices Avenue DS0000065351.V307413.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!