Inspection on 25/04/07 for 62 Second Avenue

This inspection was carried out on 25th April 2007.

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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

62 Second Avenue 23/10/08

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

122 Scorer Street

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 08/07/2008.

CARE HOME ADULTS 18-65 62 Second Avenue Carlton Nottingham NG4 1GS Lead Inspector Rob Cooper Key Unannounced Inspection 25th April 2007 10:00 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 62 Second Avenue Address Carlton Nottingham NG4 1GS 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) 0115 9117230 0115 910 4267 dawn.smith@ncha.org.uk www.ncha.org.uk Nottingham Community Housing Association Kelly Marie Maloney Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users shall be within Category LD Date of last inspection 6th November 2006 Brief Description of the Service: 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. Fees: Are in the region of £319 per week 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit as part of the key inspection process – so that no one at 62 Second Avenue knew that the inspection was going to take place. The visit took approximately four hours through the middle of the day, with one inspector present. The method used to carry out this key inspection was to send out a preinspection questionnaire, which asked questions about the service, to gather statistics, such as how many service users there are, the numbers of staff etc. We also sent out a number of surveys to residents and relatives, however none had been returned by the date of this inspection. This was followed with a visit to 62 Second Avenue, where a method called case tracking was used; this involved identifying three residents and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was done by a partial tour of 62 Second Avenue, looking at the activities on offer, and talking to staff about the quality of the service, and their experiences of living and working at 62 Second Avenue. Unfortunately it was not possible to speak with any of the residents at 62 Second Avenue, as two were on holiday in Cyprus, and the other two were at the Day Centre through out this inspection visit. The registered manager – Kelley Maloney was not present at this visit, as she too was in Cyprus with the residents. Therefore the deputy manager at 62 Second Avenue supplied much of the information during the visit. What the service does well: 62 Second Avenue have a good range of activities organised for their residents, and there is good evidence to support the view that residents are fully involved in choosing those activities. Residents have access to good quality holidays, and are able to travel abroad to sunny locations. Menu planning is done with residents and they take turns to choose what meals they would like, although there are alternatives if anyone does not like the choice made. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12&5 Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. Prospective residents at 62 Second Avenue had sufficient information before they moved in, to make an informed choice about where to live. Currently residents are not well informed about the services that Second Avenue offers EVIDENCE: The Statement of Purpose and Service User Guide for 62 Second Avenue were both seen. Both documents are currently under review, as they are in need of updating. The Service User Guide was found to be a broad document produced by the Housing Association which did not contain specific information about 62 Second Avenue. Each of the three resident’s files seen as part of the case tracking process contained a formal assessment completed by a social worker. In each case this was an Extended Community Care Assessment, and there were also other assessments completed by the Day Centres, and in-house. Each of the resident’s files contained a Licence Agreement issued by Nottingham Community Housing Association (NCHA). At the last key inspection a recommendation was made ‘to develop a standard form of contract that was more applicable to the needs of residents with a learning 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 9 disability.’ This is being looked at, at a senior level within the Housing Association, and has not yet been produced. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 & 10 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at 62 Second Avenue have their needs assessed, and have an individual plan of care containing information about their needs, and risk assessments to support them in leading an independent lifestyle. EVIDENCE: Each of the three resident’s files that were seen, contained a clear plan of care, based on their individual assessments. Documentation within the files was clear, and identified resident’s needs and how they would be met. Within resident’s files likes and dislikes were well documented. The communication difficulties that many of the residents have means that they are unlikely to express their preferences in words, but rather through their actions. In effect residents will through their behaviour, their mannerisms, and other non-verbal communication methods make their views and opinions 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 11 known. Each of the three files contained information about resident’s communication difficulties, and ways in which they make their views known. Each of the resident’s files contained risk assessments, which identified risks in the resident’s lives. The files also contained care plans which had been produced as a result of the risk assessments, and which gave staff clear guidance about managing the identified risks for individuals. At the last key inspection issues around confidentiality were identified, as a result of the office being located in the resident’s lounge. This situation has been improved by moving the office into the sleeping in room. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 & 17 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at 62 Second Avenue are offered a stimulating range of activities, and are offered a varied and healthy diet. EVIDENCE: Although it was not possible to speak with any residents during the inspection visit, due to residents being away on holiday or at the day centre, there was good evidence of residents taking part in a wide range of activities in both records within the care plans, and photos of social events. The two residents who were away on holiday were actually in Cyprus, and there was good evidence with regard to resident’s choice of activities and involvement in planning. The resident’s files and the activities diary show that residents are involved in the local community, using local shops and services, and 62 Second Avenue 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 13 now has a minibus which makes accessing the local community easier. There was also evidence in the care plans of residents attending local social groups, and using local pubs and restaurants. Evidence recorded in care plans shows that residents have good contact with their families, and staff said that they tried to make visitors welcome when they come to see residents. The weekly menu was on display, and it indicated which resident had made the choice for that particular meal. Alternatives were available, but residents were encouraged to take responsibilities with regard to deciding what should be the main choice. To assist residents in this process there are a number of picture cards with different foods on, to help those with communication difficulties make choices. 62 Second Avenue has a comfortable dining kitchen. The kitchen is well equipped, and there was evidence that the food provided is of a good quality and variety, with good evidence of fresh fruit and vegetables available. Records relating to food storage, and preparation were seen, and all found to be correct. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 & 20 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at 62 Second Avenue have their health care well managed, and are supported in a positive manner by the staff. Medication is well organised, and safely managed at 62 Second Avenue. EVIDENCE: Each of the three files that were seen identified individual preferences, and the methods by which the residents communicate those preferences. There was also evidence of residents involvement in the support planning process. 62 Second Avenue are able to offer residents a choice between a bath and a shower, and staff were aware of which usually residents would prefer. The case tracking of the resident’s files showed that healthcare was well documented, and good records were kept, to keep abreast of any healthcare issues. Visits to the GP and hospital appointments were recorded, and there was evidence that staff were aware of specific health related matters for individuals. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 15 No resident currently self-medicates. Boots the chemists supplies the resident’s medication at 62 Second Avenue. They use a monitored dosage system (each resident having their medication dispensed into a blister pack on a series of cards), which makes dispensing the medication easier. The documentation relating to medication administration was seen, and there were no obvious errors or omissions. Boots last carried out an audit of the medication on 13th November 2006, and everything was found to be correct. They will also be returning on 25th June 2007 to carry out staff training in medication procedures. Storage was secure, and there were clear records for medication coming in and out of the building. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. Residents at 62 Second Avenue are safe, and feel their views are listened to and acted upon. EVIDENCE: 62 Second Avenue has received no complaints since the last key inspection. The complaints records were seen, and evidence that the complaints procedure is on display, and has been made available to residents and their relatives. There is also a positives comments book for visitors to use, although resident’s meetings are not taking place due to the resident’s communication difficulties. At the last key inspection a specific issue relating to resident’s safety was raised. Increasing staffing levels, providing training in autism awareness and safeguarding adults to raise staff awareness and improve practice, have dealt this with. Staff members said they thought that the measures put in place had helped, and the situation had improved. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 25 & 30 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. 62 Second Avenue is a clean and safe care home, with good quality fixtures and fittings. However the cramped office space is affecting the comfort and homeliness of lounge. EVIDENCE: There have been some improvements to the environment since the last key inspection, with the office moving into the former sleeping in room, and out of the lounge area. However this is still far from ideal, and space is severely limited. It does however overcome the issue of confidentiality raised in previous inspections. The lack of space for the office does mean that some office furniture remains in the lounge, and this does affect its homeliness. Staff said that there was a suggestion to build an extension, which would address many of the environmental issues raised at this and previous inspections, but no firm dates or plans are yet in place. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 18 All of the bedrooms at 62 Second Avenue are comfortable and well personalised. Two of the rooms have recently been redecorated, and there are plans to decorate a third shortly. Each of the bedrooms has good quality fixtures and fittings, and meets the resident’s needs. 62 Second Avenue was found to be clean and tidy throughout, with evidence seen of cleaning materials and regimes in place to ensure that it remains clean and hygienic. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 & 36 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. A competent, well-trained and supervised staff team that has been professionally recruited supports residents. EVIDENCE: The staff rota for 62 Second Avenue was seen, and this showed that there was enough staff on duty to meet the resident’s needs, and that there was a structure through the team, which helped decision-making and directed the efforts of the staff. Discussions with two staff members evidenced that they all thought there were enough staff to meet the resident’s needs, and that their team was well organised and managed. The Housing Association has it’s own relief staff team (the SMART team) to help cover any shortages in the staffing rota. Two staff files were seen, however they did not contain all of the necessary documentation to indicate that staff had been recruited in a manner, which would protect residents – this would include: written applications, formal interviews, two written references, and a criminal records bureau check. Both files had evidence of Criminal Records Bureau checks, but the other 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 20 information is held centrally at Nottingham Community Housing Association’s Human Resources department, and an appointment will be made in the future to inspect these documents. Both members of staff who were spoken with said that they had been through a formal recruitment process, and had supplied references, and been criminal records bureau checked. A review of the staff training records showed that there is an ongoing programme of staff training, which also covers the mandatory training courses. Discussions with two members of staff showed that they thought they were well trained, and had access to all of the relevant training courses, including National Vocational Qualification (NVQ), which is the care industry’s standard training course. The staff files contained information relating to formal supervision, and showed that staff have a regular formal supervision session with a senior member of staff. Discussions also indicated that there are regular staff meetings, and that they felt very well supported within the team. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 & 42 Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. 62 Second Avenue is a safe, well managed, and organised care home, with good recruitment and quality assurance systems in place. EVIDENCE: Kelly Maloney who is the registered manager has been through the Commission for Social Care Inspection’s ‘fit person’ process, and has been judged to be fit to manage a residential care home. 62 Second Avenue has a quality assurance system, which is based on both questionnaires being sent to residents, and the comments received and analysed, and an internal auditing system. Evidence was seen that the scheduled internal audits (which should take place regularly throughout the year) had not been carried out, and 62 Second Avenue was behind on the programme. In addition the residents have communication difficulties, which 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 22 make it difficult to gain their views. No evidence of resident’s meetings was seen during the inspection. A range of health & safety records were seen, including fire records, Control of Substances Hazardous to Health records, and water temperature checks, and these were all found to be correct and complete, and indicate that both residents and staff at 62 Second Avenue are kept safe by the policies and procedures in place. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 23 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 2 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA1 Regulation Requirement Timescale for action 31/07/07 Regulations Neither the Statement of 45&6 Purpose nor the Service User Guide contain all of the information that Care Homes Regulations say they should. This particularly relates to specific information about 62 Second Avenue and its organisation and staffing. Both documents must be amended to include the necessary information. 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 YA5 Good Practice Recommendations The Registered Person must develop a standard form of contract for the provision of service and facilities by the registered provider to service users; that is more applicable to the needs of residents with a learning disability. Efforts should be made to remove the office furniture from DS0000008792.V335485.R01.S.doc Version 5.2 Page 25 2. YA24 62 Second Avenue 3. 4. YA39 YA39 the lounge, to make this a homely and comfortable area for resident’s use. The internal audit system in place to monitor the quality of the service should be used in line with the policy, and the timescales identified within the policy. Advice should be sought from speech & language specialists to identify ways in which residents might be able to make their views about the service known. 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 62 Second Avenue DS0000008792.V335485.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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