Inspection on 15/05/08 for 43, Florence Avenue

This inspection was carried out on 15th May 2008.

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

43, Florence Avenue 11/09/07

43, Florence Avenue 26/06/06

43, Florence Avenue 28/11/05

43, Florence Avenue 24/05/05

43, Florence Avenue 22/11/04

43, Florence Avenue 27/04/04

43, Florence Avenue 21/10/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOME ADULTS 18-65 43, Florence Avenue Morden Surrey SM4 6EX Lead Inspector Jean Stuart Key Unannounced Inspection 15th May 2008 13:50 43, Florence Avenue DS0000027216.V364058.R02.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 43, Florence Avenue DS0000027216.V364058.R02.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. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 43, Florence Avenue Address Morden Surrey SM4 6EX 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) Category(ies) of registration, with number of places 0208 646 5921 www.caremanagementgroup.com Care Management Group Ltd Beverley Knapp Care Home 8 Learning disability (8) 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 8 11th September 2007 Date of last inspection Brief Description of the Service: 43 Florence Avenue is a registered care home for eight adults with learning disabilities. The home is owned and managed by Care Management Group (CMG) and is situated in a quiet residential road in Morden. Public transport, churches, leisure facilities, local shops and the shopping centres of Morden, Sutton and Mitcham are close by. The home is set over two floors with a self-contained flat for one resident within the grounds. The home is staffed twenty-four hours a day. Information about the home is provided to residents and their representatives in a written guide. The current range of fees is £1200 to £1600 per week. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means people who use this service experience Good quality outcomes. Florence Avenue provides a respite care service for people with a learning disability living in the community. We spent five hours and forty minutes from 1.50pm to 7.30pm at Florence Avenue. We spoke with six people who were able to tell us about their experiences at the home, the manager and three staff members. We saw records and documents, including care plans, risk assessments, medication and food records, and the complaint log. Eight survey forms were sent to people using the service, four to parents and three professionals. Completed surveys were received from seven people six of whom were assisted by staff, and one survey from parents /carers. What the service does well: What has improved since the last inspection? When assessing peoples needs prior to moving to the home an opportunity will be given to meet other people who live in the home. Person Centred Planning 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 6 (P.C.P.) is being developed for each person, promoting very individualised care. The environment has improved rooms been painted, and the kitchen refurbished. 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. The summary of this inspection report can be made available in other formats on request. 43, Florence Avenue DS0000027216.V364058.R02.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 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. Before agreeing admission the service carefully considers the assessment for each person and the capacity of the home to meet their needs. The home currently has one vacancy. Admissions only take place when the service is confident that staff have the necessary skills, abilities and qualifications to provide good quality care. EVIDENCE: Assessments of need are carried out with individuals and their family. A detailed assessment is drawn up looking at all aspects of a person’s life. Social, physical and emotional needs are noted. The assessment/care planning focuses on achieving positive outcomes for people and that the diverse needs of people are met as seen in the different day time activities. 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People are involved in the daily and longer term planning of their care. Satisfactory risk assessments are in place to make sure individuals are independent but remain as safe as possible. Consultation promotes the delivery of appropriate care. People direct the planning of the service. EVIDENCE: People reported on the things they enjoy and the decisions they make about their lives. People reported they enjoyed “bowling, swimming and cycling” and a planned holiday abroad. It is evident that the preferred communication style of each individual is known by staff, and is demonstrated in the care plan. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 10 People have a choice about how they use their time. Some people go to the day centre or college. Other people spend their day at home and make use of community resources. Staff understand the importance of people being supported in decision making on a daily basis. The service involves individuals in the planning of care that affects their lifestyles and quality of life. A relative reported “they always keep me informed and try very hard to make an individual’s life fulfilled”. People responded very positively to the question can you do what you want to do. One individual stated “I make up my own decisions about what to do everyday”. The care planning format has changed. Old information has been archieved. Plans and their reviews are kept in a separate folder. With the move to Person Centred Planning, care plans are now very focused on the individual and their preferences. Visual aids could also help people understand the process. Four care plans were sampled. These had details on physical, emotional and social needs. The key worker system allows staff to work on a one to one basis with people, and to introduce time scales for tasks to be achieved. The care plan is a working document and consistently reflect the care being delivered. This is supported by entries made in each person’s daily diary and ongoing good practice, seen on the day. A person spoke of meetings about what is happening in the house views of the service are given in their regular meetings (minutes of these were seen). The service sends out a company survey. This is not particular to Florence Avenue, but does seek the view of people who live in the home, relatives and other stake holders. Each support plan has a satisfactory risk assessment, which indicates the area of risk and how it is managed. 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People are able to enjoy a good range of activities, both at home and in the community, meeting with friends and family, visiting pubs and restaurants, and activities of their own choosing. Meal times are viewed very positively and are seen as an enjoyable time. EVIDENCE: People spoke of activities they enjoy. Daytime activities of their own choosing are followed. At the end of the day people are free to spend their time as they wish. The dining room is a popular place for people to sort out laundry, chatting and being with staff, the kitchen was a hive of activity with people coming through with their empty plates, and getting themselves a drink. These activities are carried out with the assistance of staff as required. An individual spoke of their regular visits to their family. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 12 The meal for the day is decided on in the weekly “residents” meeting. Each person selects a meal they would enjoy. None of the people require a special diet. A record of the food served is also maintained, this shows that people sometimes chose alternative food. People are encouraged to help with the cooking. A person reported they “enjoy being in the kitchen”. As reported in the AQAA the kitchen has been refurbished and the layout provided adequate work areas and cooking facilities. Individual’s rights to live an ordinary and meaningful life both at home and in the community are maintained. The routine for individuals is demonstrated on an activity board. The manager plans to develop this by using Makaton symbols and pictures to make everyone aware of the range of possible activities. People have said that they would like to meet more people and have the opportunity to develop relationships. The manager is widening the range of activities with the intention of providing more opportunities for friendships to develop. 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People receive effective personal and health care support based on individual needs and preferences. Knowledgeable staff deliver good care recognising physical and emotional needs. The home’s medication policies and procedures protect from harm. EVIDENCE: We found the delivery of personal support to be individual and flexible, consistent and reliable. A person centred approach reflects the individuals right to dignity. Individual support was given depending on the activity, and the individual’s needs. Staff respect users preferences. People’s health care needs were documented in their health care plan. One person was happy to share this with us. Regular medical treatment is dealt with the local surgery. Personal support is responsive to the preferences of the individual. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 14 Staff are trained in health care matters, and arrangements are made on specialist areas as required. A request for training in the needs of people autism has been made to the Company by the manager. We saw medication being was given to two people. This was dealt with in an appropriate manner. The medication record showed that all medication is signed for when given. The files reflect medication training and staff confirmed this. Training promotes the safe giving of medication and that the well being of service users is protected. 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. People feel safe and secure in the service provided are aware of how to use the complaint procedure. People are protected from harm by appropriate training for staff. EVIDENCE: The complaint procedure is in the Statement of Purpose/service users guide, in alternative formats. These help people with different levels of understanding to comprehend the procedure. Staff know the importance of taking view seriously and of listening and responding to issues raised. Three complaints have been raised since the previous inspection. All three complaints were found to be unsubstantiated. One person informed us that they know how to make a complaint. A relative reported they had used the complaint procedure. Another person said when they raised concerns the manager “responded to them appropriately”. Staff records indicate they have received training in abuse and neglect, to minimise the risk to people. People expressed no concerns. 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. People who use the service experience adequate quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. The environment is clean, safe and comfortable. The accommodation is not maintained to a good standard. EVIDENCE: People were positive about the environment provided. One person said they are “very comfortable”. Overall the home provides a pleasant environment. The Kitchen has been refurbished and the bathroom has been redecorated. However certain parts of the building require attention to reach a good standard. The shower room still needs attention. The shower tray is 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 17 discoloured, wall fittings are old and marked, and flooring should be replaced. The area immediately outside the shower room is an unsightly, old washing machine pipe, which is no longer in use, should be removed. The carpet from the lounge to the kitchen is worn and shiny, replacement should be considered. The home was well lit, clean and tidy and smelt fresh; survey forms from people living in the home and relatives supported this. 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. All recruitment checks are complete before a person starts work. Staff have benefited from mandatory training, and are NVQ level two trained. Staff are appropriately trained to support people. EVIDENCE: During the inspection staff were consistently available to meet the needs of people. Staff demonstrated a good knowledge and understanding of people. We saw staff that got on well with people and the atmosphere was light hearted and relaxed. Staff have the skills to communicate effectively with people. In response to the survey forms people reported staff “always” or “usually” treat them well and listen to what they have to say. Staff reported that they have National vocation qualifications (N.V.Q.) level two and have taken courses in moving and handling, medication, and food hygiene. Individual training certificates supported this. Many people have autism and the manager has asked the company to provide training on this. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 19 The manager demonstrated that the service has an understanding of equality and diversity throughout their recruitment process employing staff of different genders and from different cultures. Staff reported that their references were collected and CRB check carried out before they were employed. The staff files supported this. 43, Florence Avenue DS0000027216.V364058.R02.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. People who use the service experience good quality in these outcome areas. This judgement has been made using available evidence including a visit to this service. The manager has the necessary skills and qualifications to discharge their duties. The manager has a clear vision and is searching for continuous improvement to the service in the best interests of the people. The view of people, families and other stakeholders are sought in an annual review. Florence Avenue follows safe working practices. EVIDENCE: The manager has the required qualifications and experience to run the home. She has a clear understanding of the key principles and focus of the service. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 21 There is an increased quality of live for individuals, people are to be provided with additional information in a pictorial form. There is a strong focus on equality and diversity and promoting human rights, an aspect of this is the opportunity to develop friendships. The manager ensures that all staff are trained in health and safety matters. Individual training records reflect this and regular updates are planned ahead. Policies and procedures are regularly reviewed. The AQAA was returned in time and contained good information with evidence to support this. 43, Florence Avenue DS0000027216.V364058.R02.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 x 3 3 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 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 23 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. 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 2 2 Refer to Standard YA7 YA24 YA32 Good Practice Recommendations Visual aids would be a helpful way of documenting any aspect of life and the manager is asked to consider this. The home should be well maintained, to promote peoples’ safety and dignity. Many people have autism and training on autism should be provided. 43, Florence Avenue DS0000027216.V364058.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 43, Florence Avenue DS0000027216.V364058.R02.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. 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