Inspection on 26/07/05 for 31 Carter Avenue

This inspection was carried out on 26th July 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

31 Carter Avenue 25/06/08

31 Carter Avenue 03/01/07

31 Carter Avenue 12/01/06

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 Carter Avenue Shanklin Isle of Wight PO37 7LG Lead Inspector Neil Kingman Unannounced 26th July 2005 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. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Carter Avenue Address 31 Carter Avenue, Shanklin, Isle of Wight, PO37 7LG 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) 01983 867845 01983 867845 Islecare 97 Limited Mr Christopher Hyland Care Home 6 Category(ies) of Learning Disability (6), Learning Disability over registration, with number 65 years of age (1 - Female) of places Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1st March 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 H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of 31 Carter Avenue took place unannounced over 2¾ hrs. Three residents were in the home at the time while two were at day services. The inspector toured the building with the manager, inspected a sample of the home’s records and spoke with two members of staff on duty. Two residents were spoken with. Due to cognitive impairments it was difficult for them to focus on questions relating to life in the home but both were able to confirm satisfaction with their present situation. The atmosphere in the home was friendly and good humoured with the three residents looking forward to lunch out with staff. One positive comment card was received from a relative. The home was found to be meeting all standards assessed. 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 H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 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 H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 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 standard(s) 2 There have been no new admissions to 31 Carter Avenue since the home was first registered in 2000. Those who live in the home have had their needs assessed and regularly reviewed during that time. EVIDENCE: All residents were relocated to Carter Avenue following the closure of another Islecare home in the locality where they had previously lived. All have been referred through Social Services care management. Islecare has a comprehensive admissions tool for use in the future. In discussions with the manager, although he had no experience of introducing a new resident to this home he recognised the importance of a thorough pre-admission assessment. Crucially, he showed an understanding of the need for prospective residents to feel comfortable in the home and be able to integrate with others who live there. An assessment was available with each of the care plans seen by the inspector. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 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 and 9 The home develops a comprehensive plan for each resident, which describes how individual health, social and personal needs will be met. Staff enable residents to take responsible risks, details of which are included in their individual plans. Risk assessments contain guidelines for staff on how risks are to be managed. EVIDENCE: An individual care plan was available for each resident and the inspector looked at a sample of three. They were seen to be comprehensive in content, with individuals’ physical, emotional, social and medical needs identified. Instructions are provided for staff on how those needs should be met. The home operates a key worker system for staff that provides, wherever possible, for one to one interaction with the residents. Staff confirmed that they update the plans with information on their key residents and carry out their monthly reviews. The inspector noted reviews to be up to date on the plans inspected. While two of the five residents have verbal communication they were not able to confirm an understanding of the care planning process. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 10 Care plans contain risk assessments and clear instructions for staff around daily routines, which are geared to minimising risk. Separate risk assessments were seen to be in place for identifiable risks around the home. Staff support residents to do whatever they want and assess the various activities where risks are identified. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 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 standard(s) 14, 15 and 17 Staff support residents to enjoy a range of leisure activities and the home’s transport enables individual and group excursions. The home encourages and helps residents to maintain links with family and friends. Residents are given freedom of choice and movement within the scope of their abilities and identified risks. Food served is varied and appealing to the residents. Although offered three times daily, there is flexibility to allow for residents who attend day services and other outside activities. EVIDENCE: The inspector noted a weekly activities programme for residents. All but one attend day services variously through the week. Staff take opportunities to accompany residents either together or individually to the shops, for drinks and meals out, and to the cinema, swimming and bowling. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 12 On the day of the inspection two residents were at day centres and the other three went out with staff to lunch. This year they had joined up with another similar sized home for a holiday in the New Forest. One resident described the experience to the inspector. The manager confirmed and records showed that residents’ families regularly visit the home. One regularly attends church with a friend. The manager had contacted the advocacy service for one resident and a visit was expected later in the week. Residents have opportunities to mix with people who do not have their disabilities, at venues to which the general public have access. Staff take turns in preparing meals in what is essentially a domestic setting. Menus follow a four-week cycle. They showed that food served to residents was wholesome, nutritious and varied. The manager said that they try to give residents what they like at the same time introducing vegetables and fresh fruit wherever possible. Experience has provided staff with an understanding of residents likes, dislikes and dietary requirements. Dinner is normally served in the evening as residents are provided with a packed lunch for day services. The two residents spoken with confirmed that they liked the food in the home. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 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 standard(s) 19 and 20 Residents’ healthcare needs are regularly addressed. Residents are assessed as being unable to retain, administer and control their own medication. Medication for residents is held under secure conditions and appropriate records maintained. EVIDENCE: Staff confirmed, and care 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 healthcare needs of residents are identified in their care plans and the inspector noted the particular attention paid to one individual’s care where outside interventions were especially important. While visits from medical/healthcare practitioners take place in the privacy of residents’ rooms the norm is for staff to take them to the local clinic. Plans contain a health action plan, which is set out in a person centred way. In circumstances where a resident requires a hospital visit the action plan goes with them to provide hospital staff with the information they need about someone with communication difficulties. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 14 Medication is dispensed from blister packs by staff deemed competent by the manager. Staff undertake both in-house medication training and the B/Tech advanced medication course. At the time of the inspection medication for residents was held in appropriate, secure conditions. Records relating to the safekeeping and administration of medicines were checked and found to be in order. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 15 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 The home has a clear complaints policy and procedure in place. EVIDENCE: The manager and staff confirmed there had been no complaints from residents or representatives in the last year, but in the event of a complaint being made staff would make a record of the issue together with details of the outcome. One positive comment card was received from the relative of one of the residents. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 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 standard(s) 24 and 26 31 Carter Avenue provides a domestic style of environment, which in general terms meets the needs of those who live there. Bedrooms are decorated and equipped to meet the needs and wishes of the residents. EVIDENCE: The inspector toured the building with the manager. There was evidence of work having been carried out in accordance with the home’s decoration and maintenance programme. Areas that had been improved since the last inspection were; new porch windows to the front, one resident’s bedroom redecorated and rotting joists in dining room floor replaced. The manager confirmed that work planned to be carried out in the near future included the dining room redecorated, a new carpet and furniture in the lounge, the stairs and first floor landing areas redecorated, new flooring in one resident’s room and a new radiator cover in the ground floor bathroom. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 17 Residents’ rooms were noted to be comfortably furnished and well personalised. They are equipped with furniture and fittings suitable to their assessed needs. Two residents spoken with confirmed their satisfaction with their rooms. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 18 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) 35 Staff at 31 Carter Avenue have appropriate skills and experience to meet the needs of the people who live there. EVIDENCE: Records showed that staff undertake a range of training including statutory and service specific subjects. Of the nine support staff working in the home five have achieved the NVQ at level 2, one at level 3, eight have undertaken the Learning Disability Award Framework (LDAF) induction programme and two the foundation programme. Islecare has introduced a new ‘fire safety for the carer’ training programme, which all staff are involved with. Both staff on duty during the inspection were spoken with. They confirmed the training they had achieved since working with Islecare. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 19 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) 41 and 42 Corporate Islecare ’97 Ltd policies and records cover all aspects of the running of the business and the protection of residents. They are maintained under secure conditions. Policies, procedures and staff training are in place to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: Service users lack the cognitive ability to help maintain their care plans but are consulted in the process. The inspector had viewed the home’s policies and procedures several times at previous inspections. They are maintained under secure conditions. Islecare ensures that a good health and safety package is provided for staff. Mandatory in-house first aid, health and safety and moving and handling training is provided, and there is a written policy and procedure in place for maintaining safe working practices. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 20 A selection of records was seen and found to be in order. Two staff members spoken with confirmed that all their statutory training was up to date; one had achieved the NVQ at level 2 and the other was scheduled to undertake the NVQ at level 3. Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 21 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x x Standard No 11 12 13 14 15 16 17 x x x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Carter Avenue Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x 3 3 x H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 22 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Carter Avenue H55-H04 S12472 Carter Ave V218063 270605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Mill Court Furrlongs Newport, Isle of Wight 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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