Inspection on 30/06/05 for 55a Beech Avenue

This inspection was carried out on 30th June 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

55a Beech Avenue 26/03/07

55a Beech Avenue 13/03/06

55a Beech Avenue 16/12/04

55a Beech Avenue 16/06/04

55a Beech Avenue 24/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 55a Beech Avenue 55a Beech Avenue Gatley Stockport SK8 4LS Lead Inspector Kathleen Mcall Unannounced 30 June 2005, 3:20pm th 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. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 55a Beech Avenue Address 55A Beech Avenue, Gatley, Stockport SK8 4LS 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) 0161 428 7413 Independent Options (Stockport Limited) Ms Elizabeth Siobhan Cunliffe Care Home 4 Category(ies) of Learning Disability - 4 registration, with number of places 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th December 2004 Brief Description of the Service: 55a Beech Avenue is a care home owned by Independent Options (Stockport) Limited and is one of two short stay homes that provide respite care to service users with a learning disability. 55a Beech Avenue is registered to accommodate up to four people between the ages of 18 and 65 years at any one time. Service users are referred to as ‘guests’ and are encouraged to see their break at the home as a holiday. The property is a detached dormer bungalow, accomodation consists of four single bedrooms, one of which is situated on the first floor. A combined lounge and dining room, kitched and two bathrooms. The kitchen has been designed with facilites that enable worktops to be lowered for those service users in wheelchairs to prepare their own meals and drinks. The downstairs bathroom has a Kingcraft bath with hoist facilities and a electrical sink that can be lowered to suit individual service users. There is car parking space to the front of the property and a large enclosed garden with ramp access to the rear. The home is suitable for wheelchair users. The home is located within the quiet residential area of Gatley, Stockport. Local shops, banks and public houses are approximately a 15 to 20 minute walk away. Stockport town centre and motorway network are easily accessible by car. Gatley train station is situated approximately a mile from the home. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a Thursday evening. One senior support worker and one support worker who were on duty at the time of the inspection accompanied the inspector throughout the inspection process. Care plans, assessment documentation and medication storage were examined. The inspector met and spoke with three residents who were visiting the home for a short stay break. All residents appeared well cared for and had good rapport with support staff who were on duty. Service users appeared relaxed and happy. What the service does well: What has improved since the last inspection? What they could do better: The registered providers needs to review the way in which information regarding complaints is recorded and stored at the home to ensure that it is held in accordance with the Data Protection Act 1998. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 6 The registered providers need to review the way in which medication is administered in the home. A number of fire safety issues remain unresolved and need a satisfactory conclusion. 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. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 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 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 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) 1, 2, 3 and 5. Sufficient information was available to service users and their relatives to enable them to make an informed choice about respite at the home. Assessments were undertaken and service users care needs were met, however contracts were out of date. EVIDENCE: Independent Options had put in place a Service User Guide and a Statement of Purpose. The Service User Guide was produced in a written and pictorial format for service users and their relatives. Service users care needs were fully assessed before a service was offered, including mobility and health issues, and risk assessments were completed as part of this process. Service users, their families and significant professionals were involved in the assessment process. The home did not offer a place to a service user unless they were completely satisfied that they were able to meet the service users needs. The needs and preferences of service users from ethnic communities were recognised and met. Staff were trained and skilled and could communicate effectively with service users. Service users contracts needed to be updated, those observed on file at the time of the inspection were out of date. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 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, 9 and 10. Not all service users had a care plan. Service users were enabled to make decisions and choices during their stay. Not all potential risks to service users had been identified and actioned appropriately. EVIDENCE: Since the last inspection the acting registered manager had begun to introduce care plans known as ‘Individual Support Plans’. Not all files seen at the time of the inspection contained and individual support plan. Support staff told the inspector that the implementation of individual support plans was ongoing and that support plans were usually updated when service users were visiting the home. The new individual support plans contained detailed information on what a service users care needs were and how staff were to meet these needs. Service users’ were encouraged to make their own decisions and choices whilst they were staying at Beech Avenue. Staff discussed individually with service users what food they would like for their teatime meal and how they spent their evening. The home has recently purchased a ‘people carrier’ type vehicle and this has enabled staff to widen service users choices in respect of leisure activities. Those service users who required assistance with day-to-day choices and decisions, due to their disability were assisted in an appropriate and sensitive manner. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 10 Risks were considered and identified as part of the assessment process and before a service users admission. However risk assessments still did not take into account those service users who required the use of bed rails during their stay. At the time of the inspection two of the visiting service users required the use of bed rails and neither had a risk assessment in place to reflect this. Confidentiality issues were covered during induction training and during supervision sessions with staff. Service users records were now stored in a locked cabinet in the home. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 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, 15, 16 and 17. Service users took part in appropriate activities, including local community activities. Service users privacy and rights were respected. Service users were offered a healthy diet. EVIDENCE: Service users did not stay at the home for more that a two week period at any one time and therefore continued to take part in activities engaged in prior to their admission, this may be attendance at day care, adult education or one to one support from support workers. Service users took part in community activities such as visits to the cinema, to pubs for meals, and shopping. In-built into the shift pattern was a system whereby staff had a number of flexible hours they could use to help support service users in a variety of activities as indicated in their assessment, two service users were going to see an ‘Abba’ concert at the weekend accompanied by staff. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 12 Those service users who visited 55a Beech Avenue for a short break usually lived with a main carer or long-term adult placement carer, consequently the time service users spent at 55a Beech Avenue was as much for the carers as it was for the service user and, as such, the service user may not receive visits from family and friends. All the service users had a single room and if they wished to spend time alone and in private, they could do so. Depending on their abilities, service users were encouraged to make drinks and snacks for themselves and could also undertake small household jobs ie assisting with clearing away after a meal. On the day of the inspection, the Inspector observed staff interacting with the service users, in a warm, relaxed and positive manner. The home does not have a set menu, meals were planned around the group of service users visiting the home, and it was the usual practice of the home that the meal choice would be discussed with the service users. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 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 and 20. Service users received personal support in privacy and in a way in which they preferred. Service users health needs were understood, however the administration of medicines was unsatisfactory. EVIDENCE: As part of the assessment process service users likes and dislikes were recorded, and their preferred styles of receiving personal care. All service users had a single room and personal care was given in privacy. Whilst resident at the home service users were temporarily registered with a local GP, staff told the inspector that this arrangement worked well and that GP’s had responded in the past when required. Staff were skilled to undertake the role of carers and had up dated their training in moving and handling techniques, food hygiene and first aid. Medication brought into the home by service users relatives was supplied in blister packs or in original packaging. There were several issues regarding the way medicines were administered in the home e.g. secondary dispensing of medicines, the altering of instructions on medication by relatives and inadequately labelled medicines. The registered providers must review the way in which medication is administered at the home. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 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 and 23. The home had a complaints policy and procedure. Service users were protected from abuse. EVIDENCE: The home had a complaints policy and procedure, which responded to complaints made by relatives on behalf of service users. All complaints received at the home were recorded in a hardback book, which contained information relating to several service users. This information was not maintained in accordance with the Data Protection Act 1998. Since the last inspection Independent Options had reviewed its policy and procedure in relation to adult protection, however this was not available at the time of the inspection. Staff had undertaken training in the protection of vulnerable adults. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 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, 29 and 30. The home was well maintained and provided comfortable living accommodation for service users. Fire safety arrangements at the home were unsatisfactory. EVIDENCE: The home was well maintained, provided comfortable accommodation throughout and was free from offensive odours. The grounds and garden areas were kept tidy, safe and accessible. The inspector observed that doors to the kitchen and living room areas were wedged open and the use of door wedges throughout the home was evident, this had been observed on a previous inspection. A member of staff informed the inspector that the home was in the process of having automatic door closures and appropriate fire safety signage fitted in response to a previous requirement made in December 2004. Service users had the use of specialist equipment to maximise their independence. The kitchen had been designed to assist service users in wheelchairs and had incorporated adjustable work surfaces into its design, enabling service users to make hot drinks. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 16 The bathroom on the ground floor had a King Kraft Easi bath with an overhead multirail to hoist service users into the bath. In addition to this there was a sink, which had the facility to be lowered and raised to suit individual service users needs with electrical controls for turning on and off the water flow. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 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) 35 and 36. A trained and competent staff group who were supervised appropriately met Service users needs. EVIDENCE: Independent Options had a designated person with responsibility for training and development of staff within the organisation and each member of staff has a training and development programme. Staff spoke positively about the level of training provided by the organisation. In addition to undertaking mandatory training courses staff had also completed training in quality assurance, written communication, HIV awareness and POVA. Staff confirmed that they received supervision on a regular basis from the acting registered manager and that they found this supportive. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 18 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, 40 and 42. A qualified and competent manager ran the home, however fire safety practices were poor. Not all policies affecting staff and service users were in place. EVIDENCE: The acting manager, Ms Elizabeth Cunliffe has applied to become the registered manager at Beech Close. Ms Cunliffe is responsible for the ‘short breaks service’, which includes 55a Beech Avenue and 3 Harwich Close. Ms Cunliffe is qualified, competent and experienced to run to home. She holds a Masters Degree in Social Work, a Diploma in Social Work, an assessor’s award and has enrolled on the registered managers award. The home had a number of written policies and procedures, however the registered providers have still not produced a policy on Aggression towards staff. Staff had updated their training in safe handling and moving procedures, fire safety, food hygiene and health and safety. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 19 The home maintained records in respect of fire safety at the home, however fire safety practices in the home were poor. (See standard 24.) 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 20 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 3 3 3 x 2 Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 55a Beech Avenue Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 2 x F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 YA 5 Regulation 5(1) Requirement The registered providers must ensure that all service users have an up to date service user contract that details the terms and conditions of their stay. The registered providers must continue to put in place updated care plans for all service users. The registered providers must ensue that risk assessments are in place for all service users who require the use of bed rails during their stay at the home. (Timescale of 16.02.05 not met) The registered providers must review the way medicines are administered in the home. The registered provider must ensure that all information stored in relation to complaints made by service users or their relatives is maintained in accordance with the Data Protection Act 1998 The registered provider must take adequate precautions against the risk of fire in the home and ensure that the practice of wedging fire doors open ceases and appropriate fire signage is put in place. Timescale for action 30th September 2005. 30th June 2006. 30th June 2005. 2. 3. YA 6 YA 9 15(1) 13(4)(a)( b)(c) 4. 5. YA20 YA 22 13(2) 12(4)(a) 30th June 2005. 30th September 2005. 6. YA 24 23(4)(a) 30th June 2005. 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 22 7. 8. 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 Good Practice Recommendations 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor, Heritage Wharf Portland Place Ashton-under-Lyne OL7 0QD 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 55a Beech Avenue F54-F04 s8533 55a Beech Abe v230761 090605 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!