Inspection on 23/01/06 for 25-27 Teewell Avenue

This inspection was carried out on 23rd January 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 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

25-27 Teewell Avenue 03/07/07

25-27 Teewell Avenue 14/08/06

25-27 Teewell Avenue 10/08/05

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 Unannounced Inspection 23rd January 2006 10:00 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 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 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 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. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 27 Teewell Avenue Address Staple Hill South Glos BS16 2NF 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) 0117 9701573 0117 9699000 admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Mr Michael Thurgur Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Old age, not falling within any of places other category (7) 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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 10th August 2005 Date of last inspection 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. 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 DS0000003357.V276169.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four residents were consulted to find out their views of the Home. The registered manager was also consulted about their role and responsibility’s, training needs, and how they support residents. One member of staff was observed assisting residents with their needs during the inspection. A selection of records relating to the running and management of the Home were inspected. Also a range of residents’ care records and care plans were reviewed. The whole of the environment was 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. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 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 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 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): 2,3 Residents assessed needs are met by the Home. EVIDENCE: Two recently admitted residents assessment records were inspected to monitor how Mr Thurger and the team are assessing residents’ needs including their mental health needs There was detailed information recorded about residents care needs. The assessments had been regularly reviewed and updated helping to demonstrate staff monitor residents changing needs. Included with the assessments of residents needs were detailed risk assessments to support residents to maintain safety and minimise risks both in and out of the Home. However residents’ best interests would be better protected if the Home were to expand the risk assessment in place for one resident. This is to ensure there are clear guidelines for staff to follow when the person becomes verbally angry to other residents. All residents, expressed generally positive views of the care they receive. Examples of comments made by residents included, `the staff are very good,’ `they give us bacon sandwiches, and `the home is run very well and Mike’s a very good manager.’ 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 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 Residents changing needs are being met, monitored and reviewed by staff. EVIDENCE: To review the care how care is provided two residents care plans were inspected. The care plans contained a range of information, and detailed how to support the residents with their health care needs. Care plans also addressed the psychological needs of the residents and detailed how to respond to the person if they were distressed or angry in mood. Care plans had been regularly reviewed and updated by Mr Thurger, demonstrating that staff monitor the persons changing needs. There was information that demonstrated residents had been involved in deciding how their care was planned and implemented. As already referred to in the report, Mr Thurger and a member of staff were observed carrying out their duties through the morning and during lunchtime. Both staff conveyed that they were understanding and sensitive when assisting residents. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 10 Three residents were away from the Home during the morning attending community based facilities, and going shopping. This helps to demonstrate that residents are encouraged to live an independent lifestyle. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,17 Residents are offered a varied well balanced diet, and are supported and encouraged to live a fulfilling life in the Home and the community. EVIDENCE: Mr Thurger has introduced a new format for residents’ menus, which has been put in place to encourage and assist residents to make an active choice of what meals they would like on a daily basis. The new menu record was inspected to see if residents are being provided with a well balanced diet. There was evidence that residents are offered choices of dishes and menu choices were nutritionally well balanced, and varied. Residents said that they regularly went to the shops with the support of staff to purchase the weekly food shopping. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 12 There was information written in residents care records that demonstrated residents regularly go to different community activities, including the shops, the pub or different day care support groups. As has already been referred to, three residents went out to the local community to attend social activities. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents are supported to meet their needs in the way preferred by them. EVIDENCE: As has already been referred to in the report residents were all generally positive about the home, and how their needs are met. The inspector also observed residents rising during the morning at their preferred time. The care plans included detailed information that showed how to support residents with their physical and emotional needs. (See also standard 6). Mr Thurger and the care assistant on duty were observed supporting residents in a good humoured and sensitive manner, and residents evidently have built up warm and trusting relationships with them. All of the residents the inspector met said they were satisfied with how staff help them. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): There are procedures in place to ensure complaints are investigated promptly and thoroughly, and to protect residents from harm or abuse. EVIDENCE: There is a copy of the complaints procedure kept with the service users guide on a table in the entrance hall which includes the contact details of the of the Commission for Social Care Inspection, for anyone who wishes to contact the Commission directly and make a complaint. The contact details of the registered provider of the Home are included in the service users guide, if residents or representatives wish to contact them to make a complaint. The record of complaints received was also looked at to see how the Home responds when complaints are made. There had been no written complaint received since the last inspection. All of the residents the inspector met said that they felt able to speak to Mr Thurger at any time if they had any concerns. There is a procedure in place relating to the issue of `protection of vulnerable adults from abuse’ that includes up to date `protection of vulnerable adults from abuse’ guidance. This information is needed to help guide staff in the event of an allegation of abuse being made. All staff also attend externally run training sessions to help them in understanding the principle of the `protection of vulnerable adults from abuse.’ There are risk assessments in place that support and guide staff in their care practises. However as has already been referred to in the report one residents risk assessment should be expanded to included detailed information about what actions staff should follow if the person is verbally angry to other 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 15 residents, as this information has not been included in the current risk assessment. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 16 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): 24-30 Residents live in a homely and generally suitable environment. EVIDENCE: The Home is two properties converted into one house built over two floors, which can be accessed by stairs only. The building is a converted residential property. Bedrooms are all for single occupancy and were generally satisfactorily decorated and maintained. Bedrooms do not have en suite facilities, however there are bathrooms and toilets located within close proximity, and a washbasin in each bedroom. There is an assisted shower room for residents who requires additional assistance with personal care. There is a dining room situated on the ground floor, as well as a television lounge and a designated ‘smoking’ lounge, this is a popular room as a number of residents are smokers. Residents were observed sitting in communal areas looking very relaxed and comfortable in the environment. Facilities were clean and tidy when viewed. The Home was generally satisfactorily maintained however the stairs carpet is starting to become worn and consideration must be given to when this is to be replaced. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 32,33,36 A well-trained, well-supervised staff team support residents with their needs. EVIDENCE: The training records of two care staff were reviewed, and these demonstrated staff had attended training relevant to the needs of the residents over the last twelve months. Mr Thurger has also recently led a staff training day, which was around the topic of ‘mental health awareness’ to encourage staff to further reflect on the needs of the residents. The supervision records of two care staff were also inspected and demonstrated that staff are being provided with regular structured one to one support and supervision from Mr Thurger. This should assist them in their work and practice. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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): 39,42 There are systems in place to monitor the quality of care. However the health and safety of residents and staff is only partly protected. EVIDENCE: The fire logbook record showed that the range of required fire safety checks were being carried out and were up to date, helping to ensure the safety of people who are in the building. The kitchen was also inspected to check what systems are in place to ensure safe food handling, storage, preparation, and serving. The kitchen environment was clean and reasonably well maintained. There were records kept to demonstrate that staff were temperature probing `high risk’ foods prior to being served to residents. There were also up to date records to demonstrate staff monitor the temperatures of the fridge and freezer. The Home has its own laundry room with washing machine and a tumble dryer. However due to the changing physical care needs of residents there is now a need for a washing machine that includes a sluicing programme to wash laundry safely and minimise the risk of cross infection. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 19 An external trust employee with experience in quality monitoring work has recently carried out a quality-monitoring audit of the service. Residents have been fully consulted about the Home. Their views are part of an action plan that has been devised to address suggestions made to enhance the service. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 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 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X 3 X X 2 X 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2 Standard YA42 YA24 Regulation 13.3 23.2(b) Requirement Suitable arrangements must be made to minimise the risk of cross infection in the Home. Put in place an action plan for the replacement of the carpet on the stairs. Timescale for action 23/03/06 23/03/06 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 YA23 Good Practice Recommendations Expand the risk assessment for one resident to ensure there are clear guidelines for staff to follow if the person becomes verbally abusive to residents. 27 Teewell Avenue DS0000003357.V276169.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Bristol North LO 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 DS0000003357.V276169.R01.S.doc Version 5.1 Page 23 - 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. 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