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Inspection on 17/03/09 for 281 - 287 St Georges Road
Also see our care home review for 281 - 287 St Georges Road for more information
This inspection was carried out on 17th March 2009.
CSCI found this care home to be providing an Good service.
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.
What follows are excerpts from this inspection report. For more information read the full report on the next tab.
Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.
Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: 281 - 287 St Georges Road 281, 283, 285, & 287 St Georges Road Hull East Yorkshire HU3 3SW The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: George Skinn
Date: 1 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home
Name of care home: Address: 281 - 287 St Georges Road 281, 283, 285, & 287 St Georges Road Hull East Yorkshire HU3 3SW 01482618096 01482329337 stgeorgesroad@avocettrust.co,uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Avocet Trust care home 12 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 12 To retain one service user over 65 years of age. Date of last inspection Brief description of the care home The service at 281-287 St Georges Road is managed by Avocet Trust who rent the premises from Sanctuary Housing. It is one of a small number of similar services that Avocet provides. Avocet Trust is a registered charity. 281-287 St Georges Road consists of four separate units registered to provide care for twelve (12) with a learning disabilty. The home is situated just off the Hessle Road shopping area to the west of the city Hull. Two (2) of the units are for four (4) people and two (2) are for two (2) people, all accommodated in single rooms and each house has its own separate garden area. Three (3) houses have a relaxation room and the house without has an additional lounge. Each house also has a communal lounge/dining area, kitchen, laundry and bathroom. One (1) house has an additional bathroom. There are a variety of shops, pubs, GP surgeries and post office all within walking distance. Care Homes for Adults (18-65 years)
Page 4 of 26 Brief description of the care home Public transport to various parts of the city is easily accessible and in addition some of the people who live at the home have their own car arranged through their mobility benefits. There are parking facilities on-site. Additional charges are made for the following: newspapers/magazines, hairdressing, chiropody, transport for social activities and sweets. Information on the service is made available to people via the Statement of Purpose, Service User Guide and inspection report. Care Homes for Adults (18-65 years) Page 5 of 26 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home
peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence, these sources include: Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment AQAA. Comment cards returned from people who live at the home and staff. A visit to the home carried out by one inspector. Care Homes for Adults (18-65 years)
Page 6 of 26 A site visit was carried out which lasted four (4) hours we looked at records relating to the people who live at the home, staff and management activities. During the visit care practices were observed where appropriate and time was also spent watching the general activity within the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 10 January 2007 there has been an Annual Service Review (ASR) done in-between these inspections. The acting manager was available to assist throughout the day. Current weekly fees range from 984.53 GBP to 1148.99 GBP. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Adults (18-65 years) Page 8 of 26 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 26 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are appropriately assessed to ensure that the home is able to meet their ongoing and changing needs. Evidence: We looked at two (2) files which belonged to the people who live at the home. We saw that these contained an assessment of the persons needs done by both the home and the Placing Authority. We saw that there was a copy of the Local Authority Care plan that had been developed from the Local Authority Community Care Assessment and we saw an Individual Programme Plan (IPP) that had been developed by the home. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported through a care planning and risk assessment process to live the lives that they choose. Evidence: We looked at two (2) care files which belonged to the people who live at the home. We saw that these contained support plans that had been completed with the people who live at the home being at the centre of planning. The care files had lots of information regarding peoples needs including life histories, preference lists, risk assessments, moving and handling assessments, epilepsy management and treatment plans, reviews, various monitoring charts for behaviour, bowel care and nutritional intake. Some files contained guidance for staff on how to enable the person to maintain their independence. We saw that the care plans consisted of support plans and management plans. The
Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: management plans were added information for particular tasks and these were usually put in place when some element of risk has been identified. The support plans were written in a person centred way. We saw that care plans had been evaluated on a monthly basis and a summary written that detailed how effective the support plans were. We saw that reviews of care plans were held with family members and professionals present if appropriate. At the last inspection it was noted that a risk assessment had not been formulated for one person, this has now been done and all of the files we looked at contained comprehensive risk assessments. We saw that daily recording detailed the care provided to people. We saw that behaviour management plans were in place that gave staff clear instruction in how to deal with issues as they arose. We saw that the care files were signed by staff to evidence they had read and understood them. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to undertake activities that are on the whole their choice, are supported to maintain relationships and have their dietary needs met. Evidence: None of the people who live at the home are currently engaged in work placements; however, we saw that everyone participated in a wide range of activities to continue their opportunities for personal development. We saw that each person who lives at the home had a weekly activity plan which included staff support with activities of daily living around the home for some people. These included helping in the kitchen assisting with meal preparations or observing staff as they completed this and tidying their rooms. We saw that people who live at the home take part in an active social life in the
Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: community which included bowling, swimming, shopping, visits to the hairdresser, walks out, going for meals at the pub and visiting friends. One of the people who live at the home support Hull City and attends some of the home games. We saw that people who live at the home continue to have a holiday at least once a year and have in the past gone to Butlins or Avocets caravan at Skipsea. we saw that people who live at the home continue to be supported to visit their parents or relatives at home or were visited by them at their own home. We saw that the manager and staff continue to promote a healthy eating menu but tried to balance this with peoples likes and dislikes. Special treats are offered on occasions and on the day of the visit the staff had got fish and chips from a local fish shop for most of the people who live at the home.. We saw that any restrictions placed on people were clearly recorded in the persons care file and where possible agreed. Some of the people who live at the home have been assessed by the dietician and we saw that the home were following the recommendations made; we also saw robust monitoring of weight, food and fluid intake. We saw that some people who live at the homes continue to attend Avocets five senses day service. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to meet their personal care health and medication needs. Evidence: We saw that support plans had been developed that covered the persons health and personal care needs. We saw that these included preferences and likes and dislikes. We saw that charts for behaviour monitoring, epileptic seizure activity, bowel function, nutritional intake and weight records were in place. We saw that people accessed a range of health professionals for example hospital consultants, specialist nurses, speech and language therapists, dieticians and occupational therapists. We saw that people attended appointments with dentists chiropodists and opticians. We saw that people who live at the home have been involved with producing a document called Healthy Me. We saw that this detailed the health professionals involved in the persons care and the dates of any appointments or regular clinics the person had to attend. The Community Team for Learning Disability had been
Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: approached to assist in the preparation of Health Action plans; the manager told us that these were ready to go into the plans and this would be done a soon as possible. There continues to be no one who lives at the home who is able to self-medicate. We saw that there continues to be written policies and procedures in place for staff to adhere to regarding administration of medication. We saw that medication records were in good order and accurately recorded all medication given. We saw that the proper arrangements are still in place for the storage of medciation. The home had information leaflets with the medication files to ensure staff were aware of what the medication was and what side effects to look out for. We saw that all staff who are responsible for administering medication have received accredited training and this is updated as required. All accidents continue to be logged and the manager continues to undertake a monthly audit of these and takes action where required. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by policies and procedures to be protected from harm and to raise concerns. Evidence: We saw that the home continues to be a complaints policy. No complaints have been received by the CSCI since the last inspection and the home have not been the subject of any investigations undertaken by the Local Authority Safeguarding Adults team. The AQAA returned by the home indicated that one (1) complaint had been received by the home since the last inspection, this had been resolved satisfactorily. We saw that staff continue to have access to a copy of the Local Authority policy The Protection of Vulnerable Adults (POVA). Avocet ensure that all staff have received training about safeguarding adults and this refreshed when needed. Staff told us they understood about protecting people and they have a good knowledge of POVA and the actions that they would take should they suspect an incident of harm had occurred. People continue to be supported by the staff to manage their personal finances. Records and receipt of purchases continue to be kept. Care Homes for Adults (18-65 years) Page 18 of 26 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean warm and comfortable home. Evidence: 281-287 St Georges Road consists of four separate units registered to provide care for twelve (12) people. The home is situated just off the Hessle Road shopping area to the west of the city of Hull. Houses 285 and 287 are for four (4) people each and houses 281 and 283 are for two (2) people each; all the people who live at the home have single rooms that are nicely personalised. Each house has all the aids and adaptation which the staff need to be able to move the people safely and have assisted baths. Each house has its own separate garden area. One of the gardens has been upgraded to provide a patio and barbecue area. Currently the home are obtaining quote for redecoration and are looking at fitting protection to those areas of greatest wear and tear like door frames and corners of corridors. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported by a staff team that are trained and supervised in their roles. Evidence: Staff recruitment files are not available at the home as they are held centrally within the organisation, these have been looked at on previous inspections and no issues or concerns were found. Staff told us that when they had been recruited they only started working if they had a satisfactory Criminal records Bureau (CRB) check and all references had been taken. Sometimes staff have to start work before the CRB check is complete this is called working with a 1st POVA check. Avocet ensure these people are closely supervised at all times and records are used to demonstrate this. No one is working at the home currently under a 1st POVA. The company now employ a central coordinator for all of the staff training and they have ensured that all induction training now meets the guidelines and requirements of all of the recognised training bodies. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: At the last inspection it was noted that the staff were not receiving the required amount of supervision per year; this has now been addressed and we saw that staff have received supervision at least once every 2 months sometimes sooner if needed. More than 50 of the staff are trained to NVQ level 2. At the last inspection it was noted that there was not a clear plan for staff training; this has now been addressed and we saw that an effective plan is in place which identifies when the staff have undertaken training and when this needs up dating. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by an experienced manager who assists them to be involved in the development of the home and where systems are in place to maintain their health and safety. Evidence: The home is currently being managed by an acting manager who is submitting an application for registration to the CSCI now her probationary period is over. She has worked at the home for number of years and has lots of experience as a deputy manger. The home have fully implemented the company quality assurance system, however this still needs to be extended to include the opinions of other health care professionals who have an interest in the care of the people who live at the home. Senior managers continue to visit the home by virtue of regulation 26 on a regular basis; the company have recently introduced a new format for these visit and this now
Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: fully identifies areas for improvement and sets time scales for completion. Staff told us that meeting occur on a regular basis. The home continues to have a Health and Safety file that includes a copy of the Health and Safety policy and risk assessment and the company health and safety officer visits on a regular basis to up date these as the needs of the people who live at the home change and following changes in legislation. There are additional risk assessments relating to the use of the equipment around the home, risk of falls, hot water, fire and cleaning materials. Electrical wiring and gas safety certificates are available at the home to show that these areas are safe and do not pose a risk to the people living and working in the home. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 39 The home should expand the Qualty Assurance (QA) system to include the opinions of visiting health care professional like doctors and nurses. The company should submit and application for the registration of the manager as soon as possible. 2 39 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!