Inspection on 12/01/06 for 31 Carter Avenue

This inspection was carried out on 12th 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 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

31 Carter Avenue 25/06/08

31 Carter Avenue 03/01/07

31 Carter Avenue 26/07/05

31 Carter Avenue 01/03/05

31 Carter Avenue 15/07/04

31 Carter Avenue 10/02/04

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

CARE HOME ADULTS 18-65 Carter Avenue (31) 31 Carter Avenue Shankin Isle Of Wight PO37 7LG Lead Inspector Neil Kingman Unannounced Inspection 12th January 2006 09:40 Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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 Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Carter Avenue (31) Address 31 Carter Avenue Shankin Isle Of Wight PO37 7LG 01983 867845 01983 867845 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) Islecare `97 Limited Mr Christopher Geoffrey Stewart Hyland Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26 July 2005 Brief Description of the Service: 31 Carter Avenue is a home that provides personal care and accommodation for 6 younger adults with a learning disability. The registered providers are Islecare 97 Ltd. The home is a detached 2 storey property situated in a residential area of Shanklin within walking distance of local shops, and town centre with its amenities and leisure facilities. There is a good sized garden to the rear, which is available for residents’ use. Parking is limited to the road in Carter Avenue and level access is via the front of the premises. There is no lift to the first floor and residents on that level are fully ambulant. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two inspections for the year at 31 Carter Avenue and took place unannounced over 3 hrs. Core standards not assessed on this occasion had been assessed at the last inspection. The inspector viewed a selection of records, toured the building with the manager and spoke with staff on duty. Two residents were at day services and two were in the home during the inspection. One resident was sleeping in and the other was convalescing, following her return from hospital. A third resident returned from a shopping trip with staff and was able to give views on life in the home, which were very positive. There were no concerns raised or identified. What the service does well: What has improved since the last inspection? What they could do better: There were no identified requirements or recommendations and based on the outcomes from this inspection the home is providing a good service in line with its aims and objectives. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 6 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. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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 Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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): 3 The home ensures that residents’ needs are met with the skills and experience of the staff, effective communication and access to specialist services. EVIDENCE: Residents at 31 Carter Avenue are long term and there have been no new admissions for several years. The home has a stable well-trained staff group with 78 having achieved the NVQ at level 2 or above. One support worker has achieved the NVQ at level 4 in care. Islecare provides a good training package for staff, which covers all statutory and service related subjects. Records show that the home will access specialist health care professionals as and when required, the most recent example being the assistance provided for one resident to enable her to regain her health following an accident. The manager confirmed that all other residents were in good health. Two of the five residents do not have family to support them. The manager said that the advocacy service was due to spend time with them over a six-week period commencing March 2006. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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): 7 Residents are enabled to take control of their own lives within the limits of their cognitive ability. Management and staff support those with intellectual impairment and/or limited communication skills to make decisions. EVIDENCE: Residents are assessed as being unable to manage their own finances. The home provides a system for administration and safekeeping of their monies and valuables. The integrity of the system provided was checked and found to be satisfactory. Due to cognitive impairments residents would be unable to contribute to a group discussion about the service, e.g., residents’ meetings. This emphasises the importance of staff being able to understand and recognise residents’ needs and wishes where verbal communication is not possible. The inspector spoke with the three support workers on duty who confirmed that experience helped them to recognise the signs exhibited by those with limited speech. Any restrictions placed on residents are made in their best interests for safety reasons, and are covered by risk assessments in their personal plans. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 10 Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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): 12 and 13 Residents at Carter Avenue lack the capacity to take up employment opportunities or education training. However, all but one lead active lives and maintain regular links with the community. EVIDENCE: The situation regarding this standard has not altered over successive inspections, in that the assessed needs of the residents are such that career and employment opportunities would not be a practical option due to the level of support required to facilitate this. Additionally, residents lack the capacity to engage in the civic process. They are assessed as individuals and therefore their preferences vary widely, from those who maximise opportunities outside of the home to one who prefers her own company in the privacy of her room. The home has a people carrier, which provides the residents with transport for day services, excursions to cafes, cinema, shopping, restaurants, and places of interest away from the home. Residents occasionally use public transport when Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 12 accompanied by a member of staff. There is a weekly programme of activities that is tailored to the needs of individual residents. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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): 18 All residents are independently mobile and require minimal physical support from staff. Guidance and support regarding personal hygiene is limited to encouragement and reassurance. EVIDENCE: The home operates a key worker system that provides for one to one support and monitoring of residents’ daily needs. Residents at Carter Avenue are ambulant, although staff use a wheelchair to assist one when he is away from the home. There is a mix of male and female staff to ensure flexibility for personal or intimate care where possible. The manager confirmed, and records showed that residents receive checks from their GP, dentist, optician and specialist health care professionals. They are registered with local health clinics and dental practices. All health care needs of residents are identified in their personal plans and all visits from medical/health care practitioners take place in the privacy of their own rooms. Residents’ rooms were seen to be personalised and there was evidence of service users exercising choice in the clothes they wear, fashion preferences and room decorations. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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): 23 The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: The home has in place appropriate guidance for responding to suspicion or evidence of abuse or neglect, to ensure the safety and protection of residents. The inspector also noted a copy of the local authority adult protection policy guidance. Staff spoken with during the inspection were very clear about the need to report all issues of concern without delay. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 15 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): 30 All areas of the home are generally clean, hygienic and free from unpleasant odours. EVIDENCE: The inspector toured the building with the manager. It was seen generally to be clean and hygienic with no unpleasant odours. Some areas have been freshly decorated. The home has a utility room where laundry is carried out. Direct access is via the dining room. The manager confirmed that laundry is only undertaken at times when the dining area is not used for eating. The utility room is domestic in character and has an impermeable floor. The washing machine enables washing to be carried out at appropriate temperatures. The home has appropriate policies and procedures are in place for the control of infection and safe handling and disposal of clinical waste. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 16 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 and 34 Staff at Carter Avenue have the necessary skills and experience to meet the needs of the people who live there. Staff turnover is low and a robust recruitment procedure ensures residents are protected. EVIDENCE: There are nine support workers at Carter Avenue, all but two (78 ) having achieved the NVQ at level 2 or above. One support worker has achieved the NVQ at level 4 in care. Records showed that staff undertake a range of training including statutory and service specific subjects, Learning Disability Award Framework (LDAF) induction and foundation training. Islecare ensures that staff receive additional external training, e.g., B/Tech infection control and advanced medication. All staff on duty were spoken with and confirmed that Islecare training is ongoing. Islecare has a sound recruitment policy and procedure in place for the home, which includes an application form, job description and disclosure of criminal background declaration. A minimum of two written references are taken and the required security checks are carried out by the company on all newly appointed staff. New support workers are subject to a six-month probationary Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 17 period before a full term contract is issued. The manager confirmed that no new staff had been recruited to the home since the last inspection. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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): 37 and 39 The registered manager has the experience and qualifications to run the home and meet its stated purpose, aims and objectives. Islecare has an annual development plan and a process of establishing residents/representatives’ views about the service. EVIDENCE: The manager Mr Hyland manages this and another nearby Islecare home of similar size and category of service user. He has at least ten years experience of working with people with learning disabilities and has achieved the NVQ at level 4 in care. He has only one further unit to complete for the Registered Managers Award. The Company has achieved the Investors in People Award and has recently published its annual review. There was evidence of some quality monitoring systems, e.g., monthly visits by a representative of the Company to monitor the conduct of the home, yearly resident reviews carried out by care managers Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 19 and Company visits to the home from the mainland to carry out quality audits. Staff and the manager were clear about picking up on any concerns that relatives may have with the service. In terms of residents’ views, in practice staff are well versed in gauging the extent of their satisfaction through experience. Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Carter Avenue (31) Score 3 x x x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x DS0000012472.V249080.R01.S.doc Version 5.0 Page 21 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. Refer to Standard Good Practice Recommendations Carter Avenue (31) DS0000012472.V249080.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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. 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