Inspection on 17/07/06 for 36A Birling Avenue

This inspection was carried out on 17th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

36A Birling Avenue 10/02/06

36A Birling Avenue 21/09/05

36A Birling Avenue 29/03/05

36A Birling Avenue 08/06/04

36A Birling Avenue 10/01/04

Similar services:

Dovedale Court

Lyncol House

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

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

CARE HOME ADULTS 18-65 36A Birling Avenue Rainham Gillingham Kent ME8 7EY Lead Inspector Andrea Leverett Unannounced Inspection 17th July 2006 10:00 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 36A Birling Avenue Address Rainham Gillingham Kent ME8 7EY 01634 234423 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) Medway Council Mrs Paula Anne Robbins Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th February 2006 Brief Description of the Service: Birling Avenue is a local authority (Medway Council) respite unit, providing planned, short stay respite for Adults with Learning Disabilities. The Home is used by 70 service users annually, with up to 7 service users staying at any one time. The Home is situated in a residential area, within walking distance of shops and local amenities. Public transport (rail and bus) is nearby. The Home also has its own vehicle. The property is large and spacious, providing accommodation on two floors. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. The site visit was spent talking to service users, support staff and one relative. Some judgements about quality of life and choices were taken from direct discussion with service users, their relatives, observation and discussion with support staff and evidencing records held at the home. CSCI feedback cards were also taken into consideration and a tour of the premises was undertaken. The service continues to provide a high standard of care and support in a very well maintained environment and progress has been made towards meeting requirements set at the last inspection. Service users do not pay the full cost of the service and any charges made are subject to individual financial assessments. What the service does well: 36a Birling Avenue provides a welcoming and homely environment, and is clean, bright and airy. Service users benefit from staying in an environment that is decorated and furnished to a good standard Service users’ needs are being met and the support staff respects their right to make informed choices about the service and personal lifestyle. Service users benefit from the opportunity to take part in a range of community activities. Including maintaining activities that they would have undertaken if not using the respite service. The service benefits from a well-trained stable support staff team and a motivated manager. The service has its own transport for the benefit of service users, which is unmarked and domestic in character. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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 The quality of service in this outcome area is judged as excellent. Service users benefit from a comprehensive assessment of their needs and prospective service users can be confident that the respite home would meet their needs and aspirations. EVIDENCE: Information seen on care plans confirmed that the service continues to ensure that service users aspirations and needs have been assessed and documented. Records viewed contained Care Manager assessments and assessments from health professionals were appropriate. Staff were seen to communicate appropriately with service users and discussion with staff on duty at the time of the inspection and observation of their practice demonstrated that they had the skills and experience to care for service users at that home. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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): 6,7,8,9 The quality of service in this outcome is judged as excellent. Service users benefit from having their assessed and changing needs reflected in their individual plan and acted upon. Service users are consulted on and participate in all aspects of life in the Home and are supported to make decisions and take risks as part of an independent life style. EVIDENCE: A sample of care plans viewed was found to be comprehensive and demonstrated how the identified needs including risks would be met. Records showed that care plans and assessments are reviewed appropriately. Written agreements were also in place. The Home attends multidisciplinary service user reviews, which are mainly held at the local day service. Records seen and discussion with service users and staff evidenced that service users continue to participated in the life of the home and undertook activities such as shopping and cooking. Service users spoken to confirmed that they were consulted about menu’s and activities and now have service user meetings with records kept. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 10 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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): 12,13,15,16,17 The Quality of service in this outcome area is judged as excellent. Service users benefit from having the opportunity for personal development with their daily living skills and enjoy leisure activities in their local community. Service users are supported to maintain continuity with activities and emotional support with family and friends whilst using the respite service. On the whole service users rights are respected but more needs to be done to develop awareness in the area of sexuality. Service users benefit from being offered a choice of suitable menus, which meet their dietary needs and which respect their individual preferences. EVIDENCE: It was evident throughout the inspection that service users were supported to maintain their individual living skills, and their social and emotional skills. Records and discussion with service users and staff evidenced that service 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 12 users were encouraged to be as independent as possible in the Home and undertook tasks such as cooking, shopping and cleaning with their agreement. Service users told the inspector that they go out to evening clubs, the cinema, bowling, swimming and the local day centre. All 4 service users and staff confirmed that service users have a choice of maintaining their usual activities are engaging in activities offered by the respite service. The Home also has its own transport for the benefit of service users. This is domestic in character and unmarked. A relative confirmed that she was welcome to visit the Home any time and gave good examples of staff working and communicating with her in the best interests of her adult child. The service now has a sexuality policy, which is in draft form but are still waiting for sexuality training. The manager confirmed that this is still being pursued and several information packs and books have been ordered from the FPA. An inspection of the home’s kitchen, food storage areas and the home’s menus was undertaken. It was evident that a balanced diet was offered and service users confirmed that their wishes regarding food are sort and respected. On the day of the inspection service users were observed having unrestricted access to the homes kitchen and were able to make drinks and snacks as they wished. Service users also confirmed that they took part in food shopping and cooking if that was their wish. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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): 18,19,20 The quality of service in this outcome area was judged as excellent. Staff provide sensitive and flexible personal support, which maximises service users, privacy, dignity, independence and control over their lives. Service users benefit from having their healthcare needs properly assessed and acted upon, ensuring a good quality of care in this area. Service users benefit from having their medication appropriately stored and recorded. On the whole medication is administered appropriately but some improvements are needed. EVIDENCE: Staff were observed offering appropriate support and encouragement to service users. Care plans indicated individual preferences regarding how service users are to be supported with their personal care. Service users spoken to happy with the way staff supported them, comments such as “ I like it here, staff are kind to me” “ I can get up when I like no one tells me to get up”. Was typical. Several service users also explained that they could have the room of their choice when they stayed for respite. Records viewed and discussion with staff evidenced that full assistance with all medical and healthcare needs are provided. Records showed that the health 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 14 needs of service users are comprehensively assessed before commencing respite stays and that these needs are reflected in care plans and acted upon. Medication was inspected and found to be stored appropriately and records maintained. On the whole medication was administered appropriately and records showed that medication administration training is provided. However there is an outstanding requirement regarding one service user who selfadministers insulin via the PEN method and although there is an expectation that staff supervise and monitor this, they have not received any formal training in this area. The manager explained that she has consulted with the community nurse, who has agreed to provide this awareness training for staff and the inspector is confident that this will now happen. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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 the following standard(s): 22,23 The quality of service in this outcome area is judged as good. Service users feel their views are listened to and acted on and are protected from abuse neglect and self-harm. EVIDENCE: Discussion with staff and records seen demonstrated that staff receive Adult Protection training and have an understanding of the principals and procedures needed to be followed in order to promote the protection of service users. The manager has given good examples at previous inspections of action she had taken in the past to ensure the protection of service users from abuse. The service has a complaints procedure, which is in an accessible format and is displayed in a prominent position in the Home. Service users spoken to felt confident about raising any concerns and had a good understanding of whom to complaint to and what they would expect to happen. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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 The quality of service in this outcome group is judged as excellent. Service users benefit from living in a homely, comfortable and clean environment and have access to indoor and outdoor communal areas, which are maintained appropriately. EVIDENCE: A tour of the home was undertaken and all areas were clean, safe and free from offensive odours. Procedures and equipment for ensuring appropriate infection control was evident throughout the home. The Home is decorated and furnished to a high standard throughout and service users told the inspector that they liked the Home. Bedrooms are colour themed for easy identification and reference. Most rooms are single occupancy, but there is one double room, which is used as a double in emergencies. Service users who occupy this double room have consented to share if the need arises. The Home has ample toilet and bathing facilities that are maintained to a good standard. There is a large garden and patio area, which are well-maintained and accessible to service users. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 17 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 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 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): 32,34,35 The quality of service in this outcome area is judged as good. On the whole service users benefit from being supported by a sufficient number of qualified, supervised and competent staff that meet their needs, although more could be done to enhance staff knowledge and skills in some key areas. EVIDENCE: Activity and daily records viewed and discussion with staff evidenced that sufficient staff are provided to consistently support service users with a wide range of activities including in the evenings and at weekends. Service users and Staff also confirmed that they had sufficient staff to meet service users personal care needs at all times. Two staff on duty at the time of the inspection gave detailed accounts of training undertaken and provided evidence of knowledge and skills relevant to their role. Feedback from staff and records seen also confirmed that the manager provided regular 1:1 supervision and regular staff meetings took place. Observation of staff and service user interaction evidenced that staff had appropriate skills to carry out their role. There is an outstanding requirement for staff to have awareness training regarding service users sexuality and relationships in order that service users 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 19 rights and needs are not undermined in this area. As stated previously medication training regarding the use of insulin PEN is also outstanding. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 20 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): 37,39,42 The quality of care in this outcome area is judged as excellent. The care of service users is enhanced by a staff team that is led by a competent and experienced manager, who ensures that the home is run well. Service users can be confident that their views underpin self-monitoring, review and development of the service. EVIDENCE: The manager is currently undertaking the NVQ 4 Management and Care Award and has several years experience of working with this client group as a support worker and later in a management capacity. Observation on the day, records viewed and discussion with staff evidenced that on the whole the manager delivered an effective service user led service. Service users, relatives and staff spoke highly of her and felt that she was approachable and inclusive in her management style. It was clear from information given by service users that they were consulted regarding meals and activities and regular individual 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 21 reviews were undertaken, the Home also carries out regular service user meetings with records kept to ascertain their views regarding the general running of the home. Information taken from the homes pre-inspection questionnaire, records seen at the Home and a tour of the premises showed that the Home was maintained appropriately. 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 22 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 4 3 4 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 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 4 X 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 23 Yes 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 YA15 Regulation 13.6 Requirement The registered person must ensure that staff has the training and knowledge to support service users in the area of sexuality and relationships. Outstanding from the last inspection. New action plan required. The registered person must ensure that staff receives Diabetic PEN training from a suitably qualified person. Outstanding from the last inspection. New action plan required. Timescale for action 01/09/06 5. YA20 13.2 01/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 36A Birling Avenue DS0000038517.V291682.R01.S.doc Version 5.2 Page 25 - 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!