Inspection on 23/10/08 for 62 Second Avenue

This inspection was carried out on 23rd October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

62 Second Avenue 25/04/07

62 Second Avenue 27/06/06

62 Second Avenue 25/10/05

62 Second Avenue 01/06/05

62 Second Avenue 05/01/05

62 Second Avenue 14/07/04

62 Second Avenue 04/02/04

Similar services:

Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 62 Second Avenue 62 Second Avenue Carlton Nottingham NG4 1GS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janis Robinson     Date: 2 3 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 62 Second Avenue 62 Second Avenue Carlton Nottingham NG4 1GS 01158443707 01159104267 kelly.moloney@ncha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: NCHA care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service Users shall be within Category LD Date of last inspection Brief description of the care home 62 Second Avenue is a home providing care and support for up to four adults with a learning disability. The home is a detached property within a residential area of Carlton, conveniently located for easy access to all community amenities. There is parking available at the front of the house for about three to four cars. The garden to the rear of the house is private and secure. All of the bedrooms are located on the first floor via a winding staircase. Therefore, the property is unsuitable for people with mobility problems. Information about the home in the form of a service user guide and a copy of the most recent inspection report are available from the home. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use the service experience good quality outcomes. This was an unannounced inspection carried out by Janis Robinson, regulation inspector. A site visit took place over four hours on the 23rd of October 2008. The registered manager was present during the site visit, she was spoken with about the running of the home. Prior to the visit the registered manager had submitted an Annual Quality Assurance assessment (AQAA) which detailed what the home was doing well, what had improved since the last inspection and any plans for improving the service in the next twelve months. Information from the AQAA is included in the main Care Homes for Adults (18-65 years) Page 5 of 28 body of this report. People living at the home were not present during the site visit, as they were out at day centers. One relative was telephoned to obtain their views about the home. An inspection of the environment was undertaken and a sample of care records and records relating to the running of the home were examined. The assistant manager was present during the site visit and she was spoken with about aspects of her job. The inspector checked all key standards and the standard relating to the requirement outstanding from the last inspection in April 2007. The progress made has been reported on in the relevant standard in this report. At the time of this inspection weekly fees ranged fron 320 to 366 pounds. What the care home does well: What has improved since the last inspection? What they could do better: Medication administration records must be consistently and fully completed so that people are kept safe and written procedures are adhered to. Care Homes for Adults (18-65 years) Page 7 of 28 Consideration should be given to providing support staff with further formal adult protection training to make sure their knowledge is up to date. Consideration should be given to increasing the amount of administrative support to the manager so that she is free to concentrate on her managerial duties. Copies of internal audit reports should be provided to the manager so that she is aware of the information in these. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were provided with the information they needed to make an informed choice. Needs were assessed prior to moving into the home to make sure these could be met. Evidence: The updated statement of purpose and service user guide were seen. They contained specific information on 62 Second Avenue and included pictures and symbols to make them easier to understand. Assessment procedures were discussed with the manager. She confirmed that no person would be admitted to the home without obtaining a social workers assessment and undertaking an assessment herself. Written procedures on the pre admission assessment process were seen. Two care plans were checked. Both contained a formal assessment undertaken by a social worker, and information gathered from other relevant agencies such as day centers. The plans showed that an assessment had been carried out by the manager so that all essential information was obtained. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Prior to moving in people were encouraged to visit the home, for short visits and overnight stays. The manager stated that this would form part of the assessment process and give the person the opportunity to meet other people living at the home, staff and use the accommodation and services. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person had an individual plan of care that set out individual needs, choices and assessed risk so that all needs could be met. Evidence: Two care plans were checked. Most information was stored in the care plan file. Risk assessment reviews and daily records were entered onto the homes computer. Both were checked. The plans seen contained a comprehensive range of information. The documentation in the plans was clear and well set out. They described peoples needs and the actions staff needed to take to make sure these needs were met. The people living at Second Avenue had varying degrees of communication difficulties. The plans clearly described methods of communication, and how individuals expressed their views so that these could be respected. These included verbal signs, gestures, facial expressions and behavior. People were encouraged to make decisions and participate in all aspects of life in the Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: home. The plans included detail of peoples preferences. Several files with picture symbols and photographs were available so that people could communicate by pointing to these, for example choosing an activity. The care plans showed that peoples opinions and views were taken into account. The plans contained risk assessments on all aspects of daily life. The computer records showed that these had been reviewed to keep them up to date. The daily records held on the computer had entries for each section of the care plan, for example in activities and health. The records were detailed and gave a clear picture of peoples current well being and daily life. The staff spoken with had a clear understanding of individuals needs and appeared to know them well. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were provided with social opportunities to enjoy. A healthy and varied diet was provided to maintain health and respect choice. Evidence: From talking to the manager, staff and checking records it was clear that people were offered a wide range of activities and social opportunities both in and outside of the home. These included trips to local pubs, shops and cinemas. Social events were organised, for example people were planning to attend a Halloween party in the near future. Activities in the home included arts and crafts, baking, TV and music. The care plans showed that activities were matched to peoples interest and hobbies, for example one person was supported to wrestling matches. Each person was supported to enjoy an annual holiday of their choice. Trips this year had been abroad and included Tenerife and Lanzarote. People had made files of their holiday that included Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: photographs and souvenirs so that they could enjoy their memories. People attended different local day centers so that they had the opportunity for personal development outside of the home. An open visiting policy was in operation and contact with family and friends was encouraged and maintained. Two people had regular weekly contact at their family home. People had some responsibilities within the home. A chart was on display in the dining kitchen that had pictures and symbols so that people were aware of their tasks, for example helping with meal preparation as far as they were able. The weekly menu was on display and this showed that a varied healthy diet was provided. Choices were offered and people could have alternatives to the menu, these had been recorded. A series of picture cards showing different foods was available to assist people in communicating what they wanted to eat. There were plentiful supplies of food, including fresh fruit and vegetables. The kitchen was clean and well equipped. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were assessed and monitored so that these could be met In the main medication procedures were well managed to meet peoples needs. Staff did not always record medication administration which could pose a risk. Evidence: The two care plans checked contained clear and comprehensive information on health and personal care. Records of any health care issues were maintained and all appointments and treatments had been noted. the files showed that people had contact with their GP, dentist, optician and consultants. The files evidenced that all information relating to specific health issues was available. Two plans showed that support was provided from Speech Therapists to help with communication. Whilst all of the people living at Second Avenue were independently mobile, the plans gave clear information on encouragement, advice and support for personal care that matched individual need. Specific information on the staff actions required to meet Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: individual needs were recorded. Health action plans had been developed for each person that included pictures, symbols and graphics so that people were aware and included in all aspects of their health care. A policy on medication was in place. The medication systems were audited by Boots pharmacist. This took place twice a year and was last audited in May 2008. All staff had been provided with safe medication administration training by Boots, and were in the process of undertaking further and updated training to maintain their skills. The medication was securely stored. Medication Administration Records (MAR) had been completed. However, staff had not consistently recorded when PRN (as and when required ) medication had not been needed. One gap was noted in administration records for other medication. No people were on controlled drugs, however, appropriate storage was available should this be needed. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints and adult protection procedures in place made sure people were listened to and kept safe. Evidence: A written complaints procedure was in place, which was seen. People had been provided with information on how to make a complaint in an appropriate format that included symbols and pictures. This also contained the contact details of the local office of the Commission for Social Care Inspection(CSCI) and stated that we could be contacted at any stage. A record of complaints was kept. The home had received one informal complaint since the last inspection. Records showed the action taken and that the complaint had been satisfactorily resolved. A procedure on adult protection was in place, which was seen. This included information on whistle blowing and was written in line with local multi agency procedures. All staff had been provided with training on adult protection. However, the records seen showed that this had taken place some years previously for some staff. Two staff had undertaken the training in 2003, one staff in 2004, three staff in 2005 and one staff in 2006. Records of staff meetings evidenced that updates on adult protection procedures took place regularly so that staff knowledge was current. The manager was aware of the procedure to follow should an allegation be made. One allegation had been made since the last inspection. Procedures were adhered to and Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: people remained safe. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A clean and well maintained home was provided for people to enjoy. Evidence: An inspection of the environment was undertaken. On the day of this inspection new windows and external doors were being fitted. On the whole the premises were well maintained and homely. The large lounge had two cabinets in a corner that held records for staff as the adjacent office was too small. A small desk was also in the lounge, but this was used by people living at the home. There was a large dining kitchen that was clean and well equipped. Due to the challenging behavior of some people, damage to the environment often took place. One person had a habit of repeatedly slamming doors, as a consequence there was damaged plasterwork in the hallway and a damaged bedroom door frame. However, responsive maintenance took place promptly in an effort to maintain standards. Communal areas were clean and comfortable. Pictures and ornaments were provided Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: to create a pleasant feel to the home. Bedrooms were very individual and reflected the personalities and interests of the occupants. The manager said that plans were being negotiated to remodel the environment to improve living and office space. The home was clean throughout. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient well trained and supervised staff were provided to meet peoples needs. Evidence: The duty rota was examined. This showed that when all of the people living at Second Avenue were home, three staff were on duty. Two waking night staff were provided. A regular relief team that was employed by the organisation was provided to cover any staff shortage. The manager and staff confirmed that the relief staff knew people well and were aware of their needs. The manager stated that very occasional agency staff were used to cover staff absence. They only ever worked with two other permanent staff and were known to the home. Staff spoken with said that they enjoyed working at the home and there was a good staff team. Two staff files were checked. The majority of recruitment records were held at the organisations head office. However, the files held a pro forma that showed all documents had been obtained and gave the number of the enhanced Criminal Records Bureau(CRB) check that had taken place. Staff spoken with confirmed that they had undertaken a police check and provided proof of identity. Staff training records were examined. These showed that all mandatory training was Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: provided to staff. An ongoing programme of training made sure staff skills and knowledge remained up to date. Induction records evidenced that all new staff were provided with relevant induction. Further specialist training, for example in autism awareness and physical intervention had been provided to staff so that they had the specialist knowledge to meet peoples needs. Some training sessions had been provided by individuals psychiatrists to share knowledge on meeting specific individual needs. Staff records seen showed that there was a rota for staff supervisions. These took place regularly and were recorded. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefited from a well run and safe home. The quality assurance system made sure peoples views were obtained and listened to. Evidence: The manager evidenced a commitment to her role. She was well organised. The staff member on duty said the manager was excellent , and very supportive. Regular staff meetings took place, which were recorded. The manager was provided with 7.5 hours administrative support each week. Whilst this was valued, the manager stated that she would benefit from further hours of an admin worker so that she was free to concentrate on managerial duties. A quality assurance system was in operation. Quality audit visits took place monthly by a representative of the organisation. These were not available to examine as copies had not been provided to the manager. Annual surveys were sent to relatives and undertaken with people living at the home. The results of these surveys were audited and the results published. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: A health and safety policy was in operation. Records showed that fire alarms were tested weekly. Regular fire drills took place so that staff had the skills to respond in an emergency. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 All medication that is administered must be recorded so that safe procedures are adhered to 01/01/2009 2 20 13 A consistent procedure for recording PRN medication must be adhered to so that people are kept safe 01/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 23 Consideration should be given to providing the staff team with further formal training in adult protection to ensure knowledge is thorough and up to date. Consideration should be given to increasing administration support to the manager so that she is free to concentrate on managerial duties. Copies of internal audit reports should be provided to the manager so that she is aware of the information contained in them. 2 37 3 39 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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!