Inspection on 23/05/05 for 4 Burnham Avenue

This inspection was carried out on 23rd May 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

4 Burnham Avenue 07/10/05

4 Burnham Avenue 18/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 4 Burnham Avenue 4 Burnham Avenue Bognor Regis West Sussex PO21 2LB Lead Inspector Mrs K Allen Announced 23 May 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. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service burnham avenue Address 4 burnham avenue, bognor regis, west sussex, PO21 2lb 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) United Response Mr Robert lles Care Home (CRH) 5 Category(ies) of Learning Disability registration, with number of places 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2004 Brief Description of the Service: Burnham Avenue provides care and accommodation for up to five people with a learning difficulty between the ages of 18 and 65. It is a three storey end of terrace house in a residential area of Bognor Regis and close to shops and other facilities in the town including public transport. Residents are accommodated on the first and second floor. There is no lift. There is a lounge, dining room and conservatory for everyone to use. The home has a small rear garden which is easily accessible and well looked after. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection, which included an analysis of incident reports and those of other statutory bodies such as the fire service. This visit was an announced inspection and took place over four hours from 3pm on Monday 23rd May. During the inspection an interview was held in private with three residents living at the home and a more general discussion was held with the other two. One member of staff on duty was interviewed as well as the deputy manager. In addition a tour of the premises was made and the statutory records and those kept on two residents were seen. Comment cards were sent to the home for distribution to relatives and two had returned them with their comments. The inspector was informed that plans are in hand for the current registered manager to take on a different job within United Response and that the current deputy will apply to be registered. What the service does well: What has improved since the last inspection? Additional staff have been employed to provide more appropriate and meaningful activities for two residents. This partly meets a requirement from the last inspection. Monthly reports on the conduct of the home are being carried out. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 6 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. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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) None EVIDENCE: No new residents have been admitted to the home since the last inspection. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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, 7, 8 & 9 Residents know that their needs and goals are reflected in their individual plan so that their needs are met. Service users are enabled to make decisions about their lives. They are consulted and this empowers them in their day to day lives. EVIDENCE: All residents have a written plan for their care. This is supplemented by personal goal planning which sets out different areas for development for each resident. In one case this is focussed on the individuals wish to move to a more independent setting. All care plans are signed by the residents and reviewed approximately every two months. In addition, a review of the care provided is carried out each year and everyone involved in that person’s care is invited to attend such as parents or social worker. A pictorial ‘orientation’ board in the dining room informs all of the residents what they can expect to happen on any given day. This includes appointments as well as daily routines. All residents have their own post office account. Staff have liaised with the Department of Work and Pensions with regard to the administration of benefits and residents receive their money by cheque. Staff support residents in varying degrees to manage their money. For example, one person, who used 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 10 to throw his money away is now able to have a little spending money each week with a view to increasing this amount as he begins to value and understand money. Another person is fully in control of her money. Each week residents meet individually with a staff member to discuss how they are getting on and there are regular meetings with all of the service users. One resident said these “help you get on”. Residents are enabled to take risks. For example, one person travels to a job on her own and has a mobile telephone which she said was “only for emergencies”. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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) 12, 13, 14, 15, 16 & 17 Residents take part in appropriate activities, which enable them to learn new skills and maintain their self-esteem. They are part of the community, which helps them to lead a normal life. Residents engage in appropriate activities which give them a fulfilling life. Good support is given to residents so that they maintain contact with family and make friends. Residents rights are respected. Satisfactory meals are provided which residents enjoy. EVIDENCE: Two residents have jobs – one at a nursery and the other in a charity shop. They have kept these jobs for some time and both said that they enjoyed working and had friends at work. All residents have a weekly programme which includes attendance at college and vocational activities. They include gardening, art and DIY. Residents are part of the community in that they use local shops, transport, pubs, cafes and leisure centres. There are good relations with the immediate neighbour. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 12 Leisure activities are encouraged and include swimming, jigsaws, outings, watching videos and an annual holiday for everyone. There is time for staff to support service users outside of the home if it is planned. (see Staffing) All residents have contact with family members. Two stay with family frequently whilst others have less contact. One person has resumed contact with a close family member and is supported in her decision not to meet up with others. One person said she had recently had a boyfriend. Staff respect residents and are guided by their wishes whilst offering good support. For example, two gentlemen are prone to anxiety and staff reassured them in a quiet but effective manner. Some residents have a key to their bedroom and the front door provided after a risk assessment has been carried out. Residents are free to be alone if they wish and one person spent a long time in his room after returning from college. There are no restrictions on access to the home and grounds. However, female residents have their own accommodation, including a bathroom on the top floor and male residents do not use this area. Residents have a day set aside for household tasks including their laundry, cleaning their room and cooking the communal meal. They said they enjoyed their day back at the home and the person on ‘home day’ participated in the cooking willingly. The meals provided were satisfactory and one person said they especially liked “Bolognese”. Staff knew the likes and dislikes of residents although an alternative would be provided if necessary. The table is laid attractively and everyone eats together. Packed lunches are provided if residents are out during the day. Fresh fruit is available. One person was watching her weight and was helped to do so. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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) 18, 19 & 20 Personal support is given in the way residents prefer which helps maintain their independence. Residents health care needs are met and they benefit from routine checks. Residents are helped to manage their own medication although staffing needs to be reviewed to ensure there is sufficient time allowed to undertake all tasks satisfactorily. EVIDENCE: All of the residents are able to care for themselves but with support and prompting from staff. This is given in a positive and encouraging manner. Residents said they chose whether to have a bath or shower and staff supervised in a discreet manner. Getting up and going to bed times are flexible and one person said weekends were for “relaxing”. Residents choose their own clothes and toiletries. Hairstyles are appropriate and one gentleman said he went “to the town” for his haircut. Another resident had her hair dyed recently and said she was “pleased” with it Individual working records set out residents preferred routines. The staff team is stable which provides continuity although a key worker system is not operated. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 14 The health care of residents is met well. They said that “staff make appointments” and records confirmed this. The team were particularly vigilant in ensuring that residents benefited from routine health checks such as the dentist, optician and chiropodist. One person looks after her own medication and staff help other residents. Good records are kept including for non-prescribed medication. The doctor regularly reviews individual’s medication. There were two recorded incidents when medication was not given as prescribed although there were no adverse effects on the person concerned. (see Stafing) 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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 & 23 Residents views are listened to so that any concerns can be acted upon. Residents are protected and live in safety. EVIDENCE: When asked residents said that they would “speak to Ian or Bob” (manager & deputy manager), if they were not happy. They also said that staff “listen” and are “kind”. Residents had received a copy of the homes complaints procedure, which was in pictorial form. There was a record kept of complaints, which showed satisfactory outcomes. There are written procedures for staff to follow when responding to any suspicion or allegation of abuse. They have received training in this matter. Physical and verbal aggression is understood and following a recent episode the manager identified the need for further training and this has been provided. Residents money is managed well and those who look after their own have a safe place to keep it. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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, 27, 28 & 30 Residents live in a clean, homely and safe environment. Toilets and bathrooms provide good privacy. The shared space is satisfactory and spacious enough for the number of residents. EVIDENCE: The home is in a residential street and indistinguishable from its neighbours. It is close to the town and local amenities. It is accessible to all of the residents. The premises are brightly decorated, well furnished and a homely atmosphere has been created. The requirements from the last fire officer’s report have been acted upon. There are separate bathrooms for men and women on different floors shared by no more than three people. The men’s bathroom is due to be refurbished and the skirting sealed so that any overspill from the bath will not damage the floor. All bathrooms and toilets are fitted with locks. Shared space includes a lounge, dining room, conservatory, kitchen and rear garden. There is an office/sleeping in room for private conversation. The laundry room is separate from the kitchen and a wash-hand basin located nearby. There is a dishwasher in the kitchen. The home was clean throughout. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 & 36 Staffing numbers are not sufficient to meet the needs of residents. Staff receive satisfactory training in order to meet residents needs. Staff are supervised and receive support so that they work well with residents. EVIDENCE: One member of staff works the early or the late shift and another covers the daytime unless there are appointments or events in which case there will be two people on the early or late shift. At weekends staff work on their own. At night one person sleeps on the premises. No ancillary staff are employed. A member of staff is on call at all times in the case of emergencies. Since the last inspection additional hours have been provided to offer more support to two residents during the day however this has not changed the overall staffing at the home. The level of staffing does not provide for uninterrupted work with individuals. For example, residents need staff support when cooking the communal meal, supervising when showering, talking to when anxious as well as reminding to carry out tasks appropriately. In addition, residents had to go out as a group at weekends or not at all whilst the wishes of one person to go on a separate holiday could not be met, in part because staffing did not allow for this. There were two incidents recorded when medication was missed due to a “busy morning”. Staff turnover is low as is the use of agency staff. However, one resident said she did not like it if agency staff were used. Staff were able to understand and communicate well with residents. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 18 There is a training and development programme for staff which includes core training such as first aid, food hygiene, health and safety, medication and preventing harm. The deputy manager is doing National Vocational Training Qualifications (NVQ) Level 4 and two other members of staff are doing Level 3. A fourth person is due to register for Level 3. Staff meet together at the beginning of a shift to pass on information. They receive supervision every month. Procedures are in place for dealing with physical aggression towards staff and working alone was said to be “usually OK”. Staff liked working at the home and said the job was “never boring”. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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) 39 & 42 Residents views inform the development of the home. The health and safety of residents and staff is maintained so that they live and work in a safe environment. EVIDENCE: United Response do not have a formal quality assurance system. They do seek the opinion of residents through individual meetings each week and a resident said this was to “check if the staff were doing their job properly”. These sessions are recorded and action has recently been taken to ensure that any matters arising from these sessions are followed up. The opinions of family members are sought by distributing the comment cards provided by the CSCI prior to an announced inspection. On this occasion there was one written response when a parent stated that her son was “lucky to live in such a nice house with such caring people”. Management and the staff at the home are in contact with families through helping residents make arrangements for visits, enabling them to share in decision making with residents and involving them in reviews of residents care. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 20 Residents are made aware of inspections and were very willing to talk with the inspector. Monthly visits are made to the home by a representative of United Response to monitor the conduct of the home however reports are not sent to the CSCI. Policies and procedures are regularly reviewed and updated. There is a written health and safety policy at the home. Staff receive training in health and safety matters such as safe lifting, fire precautions, first aid and food hygiene. Hazardous chemicals are safely stored. Gas and electrical appliances are serviced and maintained. A record of accidents and incidents is kept and action taken as indicated by any incident. 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 4 Burnham Avenue Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 22 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. 2. 3. 4. Standard 33 39 39 20 Regulation 18 24 26 13 Requirement Sufficient staff must be employed to fully meet residents needs A quallity assurance system must be established A monthly report must be sent to the CSCI on visits made by the registered provider Medication must be given as required Timescale for action 30 Nov 2005 30 Nov 2005 23 May 2005 23 May 2005 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 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 4 Burnham Avenue H60-H11 S14309 Burnham Avenue V220602 Stage 4.doc Version 1.30 Page 24 - 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!