Inspection on 10/08/05 for 25-27 Teewell Avenue

This inspection was carried out on 10th 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

25-27 Teewell Avenue 03/07/07

25-27 Teewell Avenue 14/08/06

25-27 Teewell Avenue 23/01/06

25-27 Teewell Avenue 22/02/05

25-27 Teewell Avenue 06/09/04

25-27 Teewell Avenue 18/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

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

CARE HOME ADULTS 18-65 27 Teewell Avenue Staple Hill South Glos BS16 2NF Lead Inspector Melanie Edwards Announced 10 August 2005 09:30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 27 Teewell Avenue Address Staple Hill South Gloucestershire BS16 2NF 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) 0117 9701573 0117 9699000 admin@aspectsandmilestones.org.uk Aspects & Milestones Trust Mr Michael Thurgar Care Home for Younger Adults 7 Category(ies) of MD Mental Disorder registration, with number OP Old age of places (7) 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 5 persons aged 19 years and over with Mental Disorder. May accommodate up to 5 persons aged 65 years and over with Mental Disorder. Date of last inspection 22 February 2005 Unannounced Brief Description of the Service: Aspects and Milestones, a charitable Trust own 26 and 27 Teewell Avenue, Staple Hill. It provides a home for seven adults with a mental disorder who require personal care services only with no nursing. It currently has six residents. The houses are semi detached and are interconnecting on the ground floor. There are seven single bedrooms, three in one house and four in the other. The two houses operate as one care home with one manager and a single staff group. The home is situated in the residential area of Staple Hill and nearby there are small local shops, pubs and a church. Further afield, in Downend, there is a library, health centre and more shops. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four of the residents currently living at the Home were consulted, as well as the manager, and a trainee manager currently working at the Home. Both staff were asked about their roles and responsibilities, their training needs, and how they assist and support residents and carry out their duties. A range of records relating to the day-to-day running and management of the Home were inspected. A selection of resident’s care records and care plans were also reviewed. The internal and external environment was also viewed. What the service does well: 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. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 6 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 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 Resident’s mental health needs are met, however the statement of purpose and service users guide does not provide prospective residents and their representatives with all of the information needed to make an informed choice about the Home. EVIDENCE: To find out how residents’ mental health needs are assessed two residents assessment records were inspected. There was an informative assessment carried out for each resident’s physical, social and psychological needs. The assessments had been regularly reviewed and updated; demonstrating staff monitor residents changing needs. Mr Thurgar encourages residents to be involved in the assessment process, and residents had signed care documentation in agreement with care to be provided. All the residents were positive in their views of the staff and the care they provide. Examples of comments by different residents included, ‘I think it’s a first class home, the staff are very nice ’, `I think the staff are doing a good job ’ and, `it’s not too bad here’. These comments reflected the views of all the residents the inspector met. A copy of the statement of purpose and service users guide was also reviewed to see what information is available for residents, and prospective residents 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 8 about the Home. The service users guide about the Home, was detailed and informative, and included colour photos of the Home and surrounding area, to help prospective residents find out about the Home. However the statement of purpose is still in a draft from, and contains some information that is not up to date about the Home and the service. This means that this document does not accurately inform the reader about the care and service provided. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 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) 6,7,9 Residents changing mental health needs are met, monitored and reviewed, and residents are consulted and encouraged to participate in the day-to-day running of the Home and to lead a fulfilling life both in and out of the Home. EVIDENCE: To find out about what care is provided two resident’s care plans were inspected. The care plans contained a range of information written by Mr Thurgar and demonstrated how to support residents sensitively with their care needs. Care plans included detailed and helpful information about the psychological needs of residents and how to help and support the person if they were feeling distressed or unwell. The care plans had been regularly reviewed and updated by Mr Thurgar, demonstrating staff monitor residents changing needs. Residents were observed approaching Mr Thurgar and the trainee manager to talk with them in a relaxed, confident way. Two residents were particularly willing to talk to the inspector, and explained why they feel the Home is so good, they also said Mr Thurgar regularly asks them for their views, and he also asks them what food they would like to buy, when out shopping with him at the supermarket. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 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 standard(s) 12,13,14,17 Residents are provided with a varied, well balanced diet, and are supported and encouraged to live a fulfilling life. EVIDENCE: Residents are encouraged and supported by staff to go on trips to areas of interest on a regular basis and residents clearly gain much satisfaction and enjoyment from these opportunities. One resident said they had been to the American Museum at Bath recently, and two other residents said they had very much enjoyed a recent boat trip to a pub for lunch. Two residents were observed leaving the Home to visit a nearby ‘coffee morning’, at a local church and both residents said they very much enjoyed attending the coffee mornings regularly. The menu record was inspected to see if residents are provided with a varied and well balanced diet. There were choices of dishes recorded for each day and the menu was nutritionally well balanced, and varied. Two residents said the meals provided were ‘very good’, and one resident said they were ‘not too bad.’ 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 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 standard(s) 18,19,20,21 Residents are supported to meet their needs in the way preferred by them, and the systems in place for the handling, administration, storage and disposal of resident’s medication are safe. Staff respond with sensitivity and respect to the ageing and death of residents. EVIDENCE: The procedures and systems in place for administration, storage and disposal of medication were reviewed, to monitor if there were safe systems in place. The medication administration charts of three residents were inspected. There was a photograph of the resident maintained with each record, to ensure medication is dispensed to the correct person. The medication administration charts were legible, up to date, and contained the signature of the dispensing member of staff, demonstrating resident’s medication is administered safely, the reasons for any omissions had also been written on the charts. The trainee manager and Mr Thurgar talked to residents in a good humoured and friendly manner, and residents evidently have built up warm and trusting relationships with staff. Since the last inspection one resident has sadly died, one of the residents told the inspector about this, they said they were glad they had gone to the person’s funeral, they also said all residents who wished to, had been able to attend. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 12 From discussion with Mr Thurgar it is very clear the team supported the person who died with considerable care and respect. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 13 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) 22,23 There are procedures in place that help to ensure residents complaints are investigated thoroughly, and residents are protected from abuse. EVIDENCE: All residents are given a copy of the complaints procedure. The procedure includes the contact details for the Trust and the area office of the Commission for Social Care Inspection, if someone is not happy with the outcome of a complaint investigated by the Home. The complaints record book was viewed to find out how complaints are responded to by the Home. There had been no new complaints recorded since before the last inspection, the record did include the details of how the complaints were to be dealt with. There are procedures and a range of guidance information for the protection of vulnerable adults from abuse, which should help protect vulnerable adults who live at the Home. All staff attended recent training to help them better understand issues around the protection of vulnerable adults from abuse. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 14 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) 24-30 Residents live in a homely and suitable environment. EVIDENCE: Teewell Avenue consists of two converted modern residential properties, in a residential area close to local shops, amenities and a bus route into the centre of Bristol, making the Home accessible to community-based facilities. However the Home would not be currently suitable for someone who cannot manage to walk up stairs, as there is no lift. The style of decoration throughout was homely and domestic. The Home was clean and tidy, and residents looked relaxed, comfortable and settled in their surroundings. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 15 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) 32,33,34,36 Residents are supported to meet their care needs by competent wellsupervised staff. EVIDENCE: The staff duty record for shifts worked for August 2005 was inspected to review the number of staff on duty to support residents with their needs. There is a minimum of one member of staff on duty for a night shift, and between two and three staff on duty during core hours during the day between 10am and 5.30pm to work closely supporting residents both in and out of the Home. The training records demonstrated staff had attended training courses and study days relevant to the needs of the residents. Based on the positive comments made by all of the residents who were consulted staff evidently support residents sensitively. Three staff recruitment records were viewed, each of these records contained a completed Criminal Records Bureau check, as well as two detailed references and a completed job application form. This information should help to protect, residents who due to their dependency needs are a vulnerable resident group. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 16 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) 38,40,42, Resident’s views and wishes are at the centre of the management decisions made and generally the health and safety of residents, staff and visitors, is maintained. EVIDENCE: 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 17 The records that were inspected were satisfactorily maintained and in order. Other records have been referenced elsewhere in this report, demonstrating well organised management in the Home. Residents are consulted about their views of the Home, the care they received and how they feel about the overall service, and this information is reviewed by Mr Thurgar and team to ensure the Home is meeting residents’ needs, on a regular basis. All of the residents who spoke to the inspector said that Mr Thurgar was very kind, helpful and approachable, they also said they would be happy to speak with him if they had any concerns. The fire logbook record showed that the range of required fire safety checks were being carried out. However the loft of the building is being used to store old files and paperwork. The advice of a fire safety officer should be sought to check if this is an acceptable place to store paper documents that are clearly flammable in the event of a fire, and as such could be a fire safety risk. There are regular health and safety checks carried out of the environment, helping to ensure that the building is satisfactorily maintained. There are policies and procedures in place to support and guide staff in their care practises, health and safety matters, employment issues, and the general running of the Home. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 18 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 2 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 27 Teewell Avenue Score 3 3 3 4 Standard No 37 38 39 40 41 42 43 Score x 4 x 3 x 3 x Version 1.30 Page 19 D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc 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 1 Regulation 4 Requirement The statement of purpose must be completed and contain all of the required information about the Home,and a copy of the statement of purpose must be sent to the area office of the Commission for Socal Care Inspection . Timescale for action BY 1/10/05 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 42 Good Practice Recommendations The advice of a fire safety officer should be obtained, about whether it is safe to store paper documents in the loft. Any recommendations made should be implemented. 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 27 Teewell Avenue D56_D05 S3357_TeewellAvenue_V233662_100805_Stage 4.doc Version 1.30 Page 21 - 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!