Inspection on 02/03/06 for 5 Ashley Avenue

This inspection was carried out on 2nd March 2006.

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 01/09/05

5 Ashley Avenue 15/02/05

5 Ashley Avenue 27/07/04

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 5 Ashley Avenue 5 Ashley Avenue Folkestone Kent CT19 4PX Lead Inspector Lisbeth Scoones Unannounced Inspection 2 March 2006 10:00 nd 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 5 Ashley Avenue Address 5 Ashley Avenue Folkestone Kent CT19 4PX 01303 252787 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) Blythson Limited Mr Richard Emrys Jones Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st September 2005 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 residents 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. Residents 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 DS0000023163.V276801.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 5.5 hours and comprised a meeting with all three residents, discussions with the manager Mr Richard Jones, deputy manger and other members of staff, a partial tour of the premises and the garden, and examination of records. What the service does well: What has improved since the last inspection? The manager has achieved the NVQ 4 in care and management. (Registered Manager’s Award) The computer equipment is now fully operational. Medical records have been expanded allowing for more detail and a protocol for “as required” medication has been devised. While the residents were on holiday, the kitchen has been refurnished and other areas redecorated. Following a previous recommendation, accidents records are audited. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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 DS0000023163.V276801.R01.S.doc Version 5.1 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 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not inspected on this occasion. It was noted that the statement of purpose and service user guide on display were dated January 2006 evidencing recent review. The same three residents are living at the home. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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 Residents know that their personal goals are reflected in their individual plans and that their views are listened to. Residents make decisions about their lives with assistance as needed and they are consulted about all aspects of their life in the home. Staff enable the residents to take risks as part of an independent lifestyle. EVIDENCE: 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. Resident profiles are comprehensive and recently reviewed. 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 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 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 10 and weekly review. Detailed computer generated daily records are maintained. In respect of all records viewed during the inspection, a recommendation was made that the current documentation review ensures that all records are signed, dated and cross-referenced where required. See also standard 41. Regulation 26 reports comment on the quality and currency of the care plans and other records. 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 centred on the residents’ needs and choices. It was observed that staff assist the residents in an enabling and empowering manner. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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): 11, 12, 13, 14, 15, 16 Residents are provided with many opportunities for personal development. They are able to take part in suitable appropriate activities and leisure activities. Residents are encouraged to have close links with their relatives. Residents’ rights are respected and responsibilities recognised. Residents are offered a healthy diet and take part in the preparation of a choice of meals. EVIDENCE: The manager and deputy manager plan, co-ordinate and review residents’ activities. Providing residents with opportunities to learn is part of the company ethos. Residents have a structured week. The inspector spent some time with the deputy manager who discussed the short and long-term goals set for individual structured learning and leisure activities. He described a resident’s progress in social interaction and said,” he now participates really well.” Staff have excellent communication skills, which includes sign language. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 12 Staff support residents’ community participation and the residents usually go out for the day. The activities for one resident comprise trampolining, horse riding, light sensory, hydrotherapy, woodwork classes as well as indoor activities. At the time of the inspection, the vehicle was being repaired and activities were provided in-house. The acting team manager assisted a resident in an enabling manner and said that the plan for the afternoon was to play musical instruments. In the afternoon, a member of staff took a resident out for a walk. Two of the residents have their own computer with touch screen, 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 have recently enjoyed a holiday and another one is being planned for September. Such holidays provide opportunities for independent living skills. Visits from relatives are encouraged. A resident had just been home on a family visit for the weekend and a relative was due to visit a resident later that day. 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 will again this year compete for the “best kept garden”. Residents are provided with a healthy choice of meals. Nutritional assessments are carried out. Staff and residents eat together in a pleasant dining area. On the day of the inspection, a Chinese takeaway meal was enjoyed. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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 Residents receive personal support in a manner that they choose and require and their physical and emotional health care needs are met. Good medication administration systems ensure that residents’ medication needs are met but staff must ensure correct record keeping. EVIDENCE: 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. Residents’ health checks are carried out when required. Prompt referrals are made to appropriate specialists when required. A resident had recently been assessed by the speech and language therapist who had complimented the staff on the progress made. Residents are registered with a GP and have access to dentists and chiropodists. The Regulation 26 reports comment on residents’ health status The home has a policy on the administration of medication and staff are provided with medication training. Medication has recently been reviewed. A protocol for “as required” medication and an expanded “medical form” providing more detail have recently been introduced. These are good 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 14 initiatives. MAR charts and other records pertaining to medication were examined. Although these were in general well maintained, written instructions for a medication to be discontinued, while correctly carried out, had not been transferred onto the medication chart. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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 Residents know that their views are listened to and acted upon and are protected from abuse. EVIDENCE: Residents, through their relatives and staff, are aware of and encouraged to use the home’s complaint procedure. From discussions on the day and evidenced on the training programme, it is ascertained that staff are very aware of adult protection issues. The training is based on and supported by the 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. Residents’ finances were discussed and comprehensive, regularly audited records are maintained. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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 Residents live in a homely, clean, hygienic, comfortable and safe environment, maintained to a good standard. EVIDENCE: 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 shapes and a raised herb garden tended by one of the residents were noted. While the residents were on holiday, a major decorating programme has been undertaken. This included the kitchen and some of the residents’ bedrooms. All bedrooms seen reflected the residents’ personalities and interests. It was said that further refurbishment is to take place when the residents are on holiday in the autumn. The decorating and upgrading of the home’s exterior is incorporated in Proactive’s development plan. The quality of a resident’s bedding was again discussed and is now being addressed. 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’ 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 17 safety following risk assessment. 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. Staff are provided with infection control training. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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): 31, 32, 34, 35, 36 Residents know that they are supported by competent, qualified, well-trained and supervised staff who are aware of their role and responsibilities. Residents are supported and protected by the home’s recruitment procedures. EVIDENCE: Richard Jones is the manager for 3 and 5 Ashley Avenue, registered with the CSCI. He said that the staff are stable and work well as a team. Care is provided in teams, consisting of a team leader and residential social worker. All staff have 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 deputy manager, newly appointed acting team manager and support worker said they enjoyed the work and think highly of the company’s ethos. The deputy manager’s hours have changed recently and he now works Monday to Friday during the day. He currently has a dual role, which includes that of day care coordinator. The dual role involves both mentoring and monitoring. 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. A senior member of staff is always on call. Through induction, on going training, 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 19 monthly staff and residents’ meetings, the manager ensures that the staff have the necessary knowledge of the disabilities and conditions of the residents. Staff are provided with all statutory and specialist training as required. The commitment to training, including NVQ, is evident. The inspector spoke with a recently employed acting team manager and support worker on induction. Until recently, the company employed an Operations Manager who was Proactive’s training coordinator. The various roles are currently reviewed and incorporated in senior staff’s job description. A new induction-training package based on LDAF principles has recently been introduced. Induction involves a three-day shadowing process, completion of a workbook and questionnaire. A sample of staff files seen confirmed the home’s robust recruitment procedures. It is the home’s policy to obtain 4 references. The induction training includes equal opportunities and knowledge of disability legislation. All staff have monthly, formal supervision as agreed in the contract. supervision matrix is in place. Appraisals are undertaken annually. Staff said they feel supported by management. A 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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, 38, 39, 41, 42 The manager provides clear leadership to 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. 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. All records are currently reviewed but some of these need to be signed and dated. Residents’ health, safety and welfare are promoted and protected. EVIDENCE: 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 21 Richard Jones is the registered manager and has achieved 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. Staff spoken to confirmed that the manager 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. Recent training for all managers includes staff appraisal and retention and recruitment. A review, monitoring and audit programme is in place. There is an annual development plan which states the home’s aims and objectives. Residents’ meetings take place every month and are minuted. Once a week individual care reviews are carried out with the residents, the manager and team leader. There are care managers’ reviews and weekly care plan reviews and objcetives set. The company regularly reviews its policies and procedures. However, in respect of record keeping, a general recommendation was made that the documentation review currently taking place ensures that all records are signed, dated and cross-referenced when necessary. It was further suggested, to provide clarity and easy access, that some residents’ care information be filed away. 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 on 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 responsible 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. 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. The manager is vigilant in reporting accidents and incidents to the CSCI in accordance with Regulation 37. Accident records are maintained. Following a previous recommendation, these are now audited monthly. Risk assessments to ensure safe working practices are carried out and signed by staff. 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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 x 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 3 STAFFING Standard No Score 31 3 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 4 x LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 4 3 x 2 3 x 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 23 N/A 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 Refer to Standard YA20 YA41 Good Practice Recommendations That instructions for a change or discontinuation of medication be transferred onto the MAR chart That all records are signed, dated and cross-referenced where needed 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI 5 Ashley Avenue DS0000023163.V276801.R01.S.doc Version 5.1 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!