Inspection on 01/09/05 for 5 Ashley Avenue

This inspection was carried out on 1st September 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

5 Ashley Avenue 09/01/07

5 Ashley Avenue 02/03/06

5 Ashley Avenue 15/02/05

5 Ashley Avenue 27/07/04

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Insight - Eastchurch

Southfields

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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 5 Ashley Avenue 5 Ashley Avenue Folkestone Kent CT20 2RL Lead Inspector Lisbeth Scoones Announced 1 September 2005 9:30 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. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 5 Ashley Avenue Address 5 Ashley Avenue, Folkestone, Kent, CT20 2RL 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) 01303 252787 Blythson Limited Richard Emrys Jones Care home only 3 Category(ies) of Learning Disability x 3 registration, with number of places 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15.02.05 Brief Description of the Service: 5 Ashley Avenue is one of 4 Proactive Development care homes in Folkestone, owned by Blythson Ltd. It provides personal care and support for three service users with severe learning difficulties. It is a semi-detached house comprising three floors with a small front and larger back garden with car parking space. Service users’ single room accommodation is situated on the first and the second floor. The home is adjacent to no 3 Ashley Avenue, which is owned and managed by the company. The registered manager for both homes is Mr Richard Jones. All areas of the house are well furnished, peaceful and welcoming. During the day on weekdays, staff is provided on a one to one basis, being managed by a team leader. At night there is a sleeping and waking staff member on duty. A senior member of staff is always on call. Staff receive comprehensive training. As part of the programme of care, the home provides daily structured meaningful individualised activities. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over 7 hours and comprised a meeting with all three residents, discussions with the manager Mr Richard Jones and all members of staff, a tour of the premises and the garden, a shared lunch and the examination of records. Prior to the inspection, a resident’ relative completed a comment card indicating satisfaction with the service provided. The manager completed a self-assessment of the home’s compliance with the national minimum standards. Information thus received contributed to and informed the inspection process. What the service does well: What has improved since the last inspection? The following changes were identified: The computer equipment mentioned above has been introduced. The garden has improved with special attention to the lawn and a herb garden designed for residents’ enjoyment. The registered manager has nearly completed a NVQ 4 in management. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 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. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 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 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 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, 3 2 No new resident is admitted until a full and comprehensive assessment of need has been undertaken. 3 Residents know that the home will meet their needs and aspirations EVIDENCE: 2 No new residents have been admitted since the previous inspection. It is ascertained that the preadmission process is comprehensive and includes visits to the home to allow the resident to get to know the staff and other service users living in the home. All referrals have an up to date care plan, which is taken into account before a referral. 3 It is evident from discussions with the manager, day care coordinator and other members of staff that they have the skills and experience to deliver the care, which the home offers to provide. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 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, 7, 8, 9, 10 6 and 10 Residents know that their personal goals are reflected in their individual plans and that their views are listened to and their records kept securely. 7 and 8 Residents make decisions about their lives with assistance as needed and they are consulted about all aspects of their life in the home. 9 Staff enable the residents to take risks as part of an independent lifestyle. EVIDENCE: 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 10 6 Every resident has a care plan, which covers all aspects of personal and social support, health care needs, behavioural guidelines and charts. It includes development objectives, which are reviewed monthly by the team and the manager. The manager said that care plans are constantly monitored to improve development and that the residents and their relatives are involved in all aspects of planning. Staff are trained in Makaton sign language. The manager said that it is very important that staff follow the residents’ preferred routines. Laminated records of such routines were noted. Formal care reviews with care managers, residents and relatives are carried out 3 to 6 monthly or as needed. Care plan reviews occur every other day during handover of a shift. Handover files contain detailed daily records, incidents reports, the daily task planner, risk assessments, completed nutrition charts and weekly review. Detailed computer generated daily records are maintained. Regulation 26 reports comment on the quality and currency of the care plans. 7, 8 and 9 From observations and conversations with the staff, it is evident that they respect the residents’ rights to make decisions about every aspect of their lives within a risk assessment framework. Every new activity introduced is covered with a risk assessment. The manager said that the home is run around the residents’ needs and choices. It was observed that staff assist the residents in an enabling and empowering manner. 10 All staff sign the confidentiality agreement. Residents’ records are kept maintained and stored securely. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 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) 11, 12, 13, 14, 15, 16, 17 11, 12, 13, 14 Residents are provided with many opportunities for personal development. They are able to take part in suitable appropriate activities and leisure activities. 15 and 16 Residents are encouraged to have close links with their relatives. Residents’ rights are respected and responsibilities recognised. 17 Residents are offered a healthy diet and take part in the preparation of a choice of meals. EVIDENCE: 11 Providing residents with opportunities to learn is part of the company ethos. Residents have a structured week. The inspector spent some time with the day care coordinator who devises individual structured learning and leisure activities for the residents recorded on weekly activity schedules. Staff support residents’ community participation and the residents go out every day. The company provides a vehicle but residents would also travel by bus and train. Two of the residents have their own computer with touch screen, 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 12 symbol pack and specially designed programmes for their enjoyment. Sensory equipment has been bought for one of the residents. Residents are offered a range of entertainment and leisure facilities including 14 days holiday a year. Residents would soon be going on holiday on a farm in Rye. Such holidays provide opportunities for independent living skills. 15 and 16 Visits from relatives are encouraged. It is the home’s intention to produce a regular illustrated newsletter to keep residents’ relatives informed of their relative’s progress and participation in activities. It the residents were assessed as requiring therapy, this would be provided by outside agencies. Staff actively encourage the residents to be involved in with housekeeping tasks and work in the garden. Proactive homes have recently competed for the “best kept garden”. Although “number 5” did not win, the garden looked very attractive. 17 Residents are provided with a healthy choice of meals. Nutritional assessments are carried out. Staff and residents eat together in a pleasant dining area. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 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) 18, 19, 20 18 Residents receive personal support in a manner that they choose and require. 19 Residents’ physical and emotional health care needs are met. 20 Good medication administration systems ensure that residents’ medication needs are met. EVIDENCE: 18 Staff encourage residents, with due regard for privacy, to be as independent as possible. It is evident that staff know the residents, their likes, dislikes and preferences very well. 19 Residents’ health checks are carried out when required. Prompt referrals are made to appropriate specialists when required. Residents are registered with a GP and have access to dentists and chiropodists. 20 The home has a policy on the administration of medication and staff have received medication training. MAR charts and other records pertaining to medication were examined and had been well maintained. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 22 23 Residents know that their views are listened to and acted upon. Residents are protected from abuse. EVIDENCE: 22 Residents, through their relatives, are aware of and encouraged to use the home’s complaint procedure. 23 Staff said that they are trained in adult protection issues as evidenced on the home’s training matrix and supported by an adult protection policy. Staff are trained in CPI to be used as a last resort. The home has robust recruitment procedures, which include CRB and POVA checks and the obtaining of 4 references. See also standard 34. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28, 29, 30 24 and 26 Residents live in a homely, comfortable and safe environment, maintained to a good standard. 27 Residents are provided with a good standard of bathroom and toilet facilities. 28 Residents are provided with a good standard and choice of shared rooms. 30 The home is clean and hygienic. EVIDENCE: 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 16 24 The home provides a welcoming, safe, well-decorated and furnished environment for the residents with safe, pleasant well-tended front and back gardens. In the garden, a shed containing a resident’ coloured bricks and a raised herb garden tended by one of the residents were noted. While the residents are on holiday, a major decorating programme is to be undertaken. This includes the kitchen and some of the residents’ bedrooms. One of the bedrooms contained new furniture. All bedrooms reflected the residents’ personalities and interests. 26 The quality of a resident’s bedding was discussed and it was agreed that this would be addressed. 28 The home has four day areas, including the kitchen, which are well furnished, comfortable, colourful and homely. There is a quiet lounge for residents to be alone according to their wish. 27 and 30 All areas, including a bathroom and toilet visited were clean and odour free. Soap and towels for hand washing are stored with due regard for residents’ safety following risk assessment. A comprehensive COSHH folder was seen. The kitchen was clean and tidy. There is a daily cleaning planner and residents are encouraged to participate. It was noted in the Section 26 reports, that the directors keep a close eye on cleanliness, hygiene and tidiness in the home. As reported before, the laundry facility is outside, which is less than ideal. The manager said that there are long-term plans for a possible extension and upgrade of the laundry facility. As confirmed on the training calendar, formal infection control training is scheduled twice a year. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 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) 31, 32, 33, 34, 35, 36 31 and 33 Residents know that they are supported by staff who are aware of their role and responsibilities. 32, 35 and 36 Residents are supported by competent, qualified, well-trained and supervised staff. 34 Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: 31 Richard Jones is the manager for 3 and 5 Ashley Avenue, registered with the CSCI. Care is provided in teams, consisting of a team leader and residential social worker. Staff have recently been provide with new job descriptions clearly setting out their roles and responsibilities. Staff are first introduced to the home’s aims and values at induction. This is further reinforced at house meetings and during supervision. The day care coordinator and newly appointed team leader and support worker said they enjoyed the work and think highly of the company’s ethos. 32 and 35 The home provides one to one staff during the day Monday to Friday, two to three at other times including the night shift when one member of staff is on waking duties. The manager works in a supernumerary capacity. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 18 The home employs a day care coordinator for the planning, delivery and coordination of activities. A senior member of staff is always on call. Through induction, on going training, monthly staff and residents’ meetings, the manager ensures that the staff have the necessary knowledge of the disabilities and conditions of the residents. It is evident that the home is committed to staff training, including NVQ. The inspector spoke with a recently employed team leader who is soon to start NVQ3. The company employs an Operations Manager who is Proactive’s training coordinator. The Operations Manager is the LDAF Coordinator who ensures that all new staff receive LDAF induction and foundation training. The company’s managers are LDAF mentors. As confirmed on the Proactive training calendar, all statutory training is scheduled twice a year. Additional resident specific training includes adult protection, delegation/supervision & teamwork and crisis prevention & intervention. 34 A support worker discussed the process of his recent recruitment. A sample of staff files confirmed the home’s robust recruitment procedures. It is the home’s policy to obtain 4 references. It was recommended that the detail of information thus obtained be scrutinised in respect of the “status” of the referee. The induction training includes equal opportunities and knowledge of disability legislation. 36 There are daily handovers whereby the manager is always present. The manager said that there is an open door policy. A recent development is the setting of objectives for each member of staff. Such objectives would be discussed at supervision. All staff have monthly, formal supervision as agreed in the contract. A supervision matrix is in place. Appraisals are undertaken annually. Staff said they feel supported by management. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 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) 37, 38, 39, 40, 42 37 and 38 The manager provides clear leadership with all the staff who demonstrate an awareness of their roles and responsibilities. Residents benefit form the ethos of the company and the open and inclusive management approach. 39 The home regularly and consistently reviews its performance through a series of systems of self-review and consultation which include the views of the residents and relatives. 40 and 42 Residents’ and staff’ rights, best interests, health and safety are promoted and protected. EVIDENCE: 37 and 38 Richard Jones is the registered manager and has nearly completed NVQ level 4 in management. Mr Jones continues to demonstrate a commitment and enthusiasm to provide a quality service for the residents and a good working environment for the staff. It is evident that the manager 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 20 promotes an open culture and communicates a clear sense of direction and leadership. It is evident that residents and their relatives are always included and their views sought and acted upon. Every two days, at the change of shift, there is a comprehensive handover. Even when not on official duty, the manager, directors and team leaders are on call to give advice in emergencies. There are regular staff meetings both formal and ad hoc as situations arise. Staff said they feel well supported by the manager and the manager said the director’s support him. Mr Jones said that the company provides him with training opportunities to support him in his role. Residents’ meetings take place every month and are minuted. Once a week individual care reviews are carried out with the service user, the manager and team leader. 39 An excellent review, monitoring and audit programme is in place. A scored Service Audit has been introduced. There is an annual development plan (seen on display) which states the home’s aims and objectives. There are care managers’ reviews and weekly care plan reviews and objcetives. The companay regularly reviews its policies and procedures. Following a recent incident, a new policy has been introduced. The Directors formally visit the home and produce detailed, monthly reports in accordance with Regulation 26. These demonstrate a clear health and safety audit of the premises and services provided and include interviews with staff who speak aon behalf of the residents. The reports include an action sheet which identifies the timescaled action to be taken when deficits are found and which member of staff is resposible for carrying this out. The home uses a daily task planner which incorporates the standard of cleanliness and safety and maintenance checks. These tasks are planned on a 4 weekly basis. 42 Staff attend regular statutory and refresher training. Daily health and safety checks are undertaken and recorded. Regulation 26 reports comment on regular fire drills, smoke detector maintenance and contents of first aid kits. Qualified people test appliances and there are on call arrangements for maintenance. Risk assessments to ensure safe working practices are carried out and signed by residents and staff. The manager is vigilant in reporting accidents and incidents to the CSCI in accordance with Regulation 37. Accident records are maintained. It was recommended that these be audited. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 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 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 4 4 3 4 3 3 4 Standard No 31 32 33 34 35 36 Score 3 3 3 3 4 4 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 5 Ashley Avenue Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 x 3 x H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 22 NA 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 42.7 Good Practice Recommendations That accident records be audited. 5 Ashley Avenue H56-H05 S23163 5 Ashley Avenue V238979 010905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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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