Inspection on 17/08/07 for 63a Victoria Avenue

This inspection was carried out on 17th August 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

63a Victoria Avenue 27/04/06

63a Victoria Avenue 13/10/05

63a Victoria Avenue 21/04/05

63a Victoria Avenue 16/11/04

63a Victoria Avenue 19/04/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 63a Victoria Avenue Wallington Surrey SM6 7JP Lead Inspector Jon Fry Key Unannounced Inspection 17th August 2007 10:15a 63a Victoria Avenue DS0000007210.V348353.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 63a Victoria Avenue DS0000007210.V348353.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. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 63a Victoria Avenue Address Wallington Surrey SM6 7JP 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) 020 8669 4559 020 8669 4559 manager.victoriaavenue@careuk.com Care Solutions Limited ****Post Vacant**** Care Home 7 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 2. Physical disability (PD). The maximum number of service users to be accommodated is 7. Date of last inspection 27th April 2006 Brief Description of the Service: 63a Victoria Avenue provides residential care for up to seven people with learning and/or physical disabilities. The premises are a modern purpose built two-storey house set back in a quiet residential road. It is situated between Carshalton and Wallington town centres and is also close to local shops and amenities. Each person has a single bedroom and the communal facilities are adapted to meet individual needs. The home has a lift and is fully accessible to the people who live there. Information about the service is available in the Statement of Purpose and User Guide. Fees for the service are currently £1500 per week. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We spent five hours at the home. The people who live there were not able to tell us about their experiences so we observed individuals at various times during this inspection to help us understand. We also spoke to a relative of one person who lives there, the manager and five staff members. Records and documents looked at included care plans, staff files and the home’s User Guide. Completed surveys were received from two relatives, carers or advocates of individuals. One survey was also received from a care manager. The home completed an Annual Quality Assurance Assessment (AQAA) to tell us about the service provided, how it makes sure of good outcomes for the people using it and any planned future developments. What the service does well: What has improved since the last inspection? What they could do better: Comments in surveys reflected that while the care provided to people was usually good, there were times when the quality varied depending on which staff were on duty and if the manager was present in the home. We also observed two instances where we felt that communication by care staff could be improved. We have recommended that the staff team reflects on this area and looks at how improvements could be made. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 6 Health and Safety checks must be regularly completed with action taken if any problems are found. The sensory room should be completed as soon as possible. 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. 63a Victoria Avenue DS0000007210.V348353.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 63a Victoria Avenue DS0000007210.V348353.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): 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information is provided to people about the home. The needs of people using the service are fully assessed to make sure that they can be met. EVIDENCE: A guide about the home is available to users and their carers, relatives or advocates. This provides good information about the service and includes information about staffing, the complaints procedure and contract terms for people living there. This document is also available in a Makaton format. We saw that assessments had been carried out before individuals came to live at the home. Good quality comprehensive information is kept on file for each person living there. One relative, friend or advocate said that the person they knew “appeared to have settled in well” and “seems happy”. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans give good information about the support needs of people using the service. EVIDENCE: We looked at the care plans for two people who live at the home. These were very comprehensive and recorded good quality information about the support needed by each person. The amount of different care plans kept on file sometimes made it difficult to easily find information and we also saw there was a lot of duplication within these different documents. This must also be a lot of work for care staff to keep all this information up to date particularly as some of it is reviewed on a monthly basis. We have recommended that the organisation looks at the care plans being used to see if they can be made more user friendly with all necessary information in one place. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 10 A Person Centred Plan (PCP) has been completed for each person and these used photographs and pictures to try to make the plan accessible to the individual. The goals in these plans were however not up to date and we have recommended that the service look at how aspirations and goals of people using the service could be reflected better in the care plans. A three monthly review process of care plans may also be more appropriate for the people living at this home. Risk assessments are in place and these are up to date. Daily notes kept by staff need to be looked at to make sure that useful information is being recorded. Phrases such as ‘spent quality time with staff’ are too generic and fail to capture what the person was actually doing. Comments such as ‘behaved well’ should not be used by care staff. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are able to take part in activities and be part of the local community. EVIDENCE: Care plans contained good information about individual support needs and their likes and dislikes. Individuals currently living there have no verbal communication and staff help to make choices for them by looking at their facial reaction and body language. Each person has a communication dictionary to help care staff to know when a person is happy or saying yes or no. Staff spoken to said that people living there were supported in going out to places such as the cinema, shopping and local parks. An adapted vehicle is 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 12 available and is used for outings and holidays. Recent trips have included going to Brighton and a holiday to Center Parcs has also taken place. Activity records looked at for one person showed that the activities they took part in included going to college, having aromatherapy, going out for a walk and attending ‘us in a bus’ sessions. One relative, friend or advocate said “people seem to go out regularly and involve people around the house”. As stated previously, we think that care plans should include more future goals for individuals. This could include trying new activities or visiting new places. A care manager commented that they would like to see ‘more evidence of 1-1 based activities for their client’. Good records are kept of the food provided to individuals and typical meals included pasta, fish and chips and roast dinners. Individual likes and dislikes are recorded for each person and staff plan meals with individuals based on these. One relative, friend or advocate told us how the home had worked very positively with one person living there to improve their diet. We watched staff helping people with their lunch and thought that there was opportunity for more interaction and engagement with individuals. Some staff were silent when helping people and this did not create a good atmosphere in the dining area. The manager said that this might have been due to the inspection taking place. People are supported to maintain contact with relatives as appropriate. One person went out with their relatives on the day we visited. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good support is in place to meet resident’s health needs. Medication is well managed. EVIDENCE: All the people who use the service are registered with a local GP. Staff are aware of the health needs of indivduals and how these are to be met. Support from other professionals such as the dentist and chiropodist is obtained as required. We saw that Health Action Plans are in place for each person living at the home. One instance was seen where a person was moved in their chair to another room without the staff member talking to them first. This was discussed with the manager on the day of inspection. Appropriate medication policies, procedures and practices are in place. Staff receive training in administering medication and medicines are labelled and 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 14 stored correctly. We saw that Medication Administration Record Sheets are kept up to date and signed by staff. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a clear complaints procedure which is accessible to people who use the service and their representatives. Individuals are protected from harm. EVIDENCE: A complaints procedure is in place and this is included in the guide for the service. One relative, friend or advocate said “the small niggles are dealt with”. Another person said any concerns have been “picked up and dealt with”. One complaint has been received by the CSCI since the last inspection took place in May 2006. This was passed to the home for investigation at the time of this visit. A policy for Safeguarding Adults is in place and training for staff is provided by the organisation. One referral had been made in 2007 concerning a Safeguarding issue. We saw that this had been dealt with appropriately by the home in co-operation with the Local Authority. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general decoration of the home is good and provides a comfortable, clean and safe environment for people to live in. EVIDENCE: The home is generally kept to a good standard of decoration and feels homely and comfortable. All areas were clean and hygienic when we visited. One relative, friend or advocate said “the home is nicely appointed” but another said “furnishings seem tattered and worn”. Each of the people living there has a single room. All of the bedrooms are personalised and decorated to reflect their individual taste. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 17 The planned sensory room has still not been completed. It is strongly recommended that this room is finished as it will be of benefit to the people living there. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff receive good training and support to meet individual needs however not all staff are putting this training into practice fully. EVIDENCE: Four staff members were spoken to individually. All were generally very positive about the service and how the staff team worked together to achieve good outcomes for individuals. One relative, friend or advocate said “I think there can be a difference with different staff members” when talking about whether people living there get the support they need. This view was also reflected in another survey with another person saying that there was a difference in the support given when the manager was not on duty. We think that the staff team needs to discuss this area and make sure that the ethos and practice of all staff in the home is consistent. It is important to 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 19 reflect on the views expressed above and the observations we made during the inspection visit. The organisation has a training and development plan and all staff have good access to appropriate training. Three staff are currently completing their Level 3 NVQ award. Staff spoken to said that they receive regular supervision with their manager. Full recruitment checks are carried out for new staff that include Criminal Record Bureau (CRB) checks. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager has the knowledge and experience to run the home. Health and Safety systems need some improvement. EVIDENCE: The manager is clearly very experienced and knowledgeable. Staff spoken to were very positive about the support and guidance given to them. Comments included “very down to earth” and “very cooperative”. One relative, friend or advocate said “my impression is that the manager is very good and knows her stuff”. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 21 The organisation has good systems for assuring quality within its services. The home has been audited as part of this and an improvement plan in place to address shortfalls. Staff meetings take place regularly. Regular Health and Safety checks are carried out to protect the welfare of people using the service. We however found instances where checks had been missed for the fire alarm and hot water temperatures. We saw that fridge temperatures were regularly checked but some of these were above the recommended levels for safe food storage. It was not clear whether any action had been taken by staff to address this. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 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 3 2 3 3 3 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 3 25 X 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 2 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 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 2 3 X X 2 X 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 23 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 YA18 Regulation 12 (4) Requirement In order to make sure that peoples living there are always treated with dignity and respect, care staff must always communicate fully with individuals when supporting them. Health and Safety checks for fire safety, hot water temperatures and fridge / freezer temperatures must all be regularly completed with full records kept. Action must be taken and recorded by staff to address any problems identified. This will help to ensure the health and welfare of people living there. Timescale for action 01/10/07 2. YA42 13 (4) 01/10/07 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 24 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. 3. 4. 5. 6. Refer to Standard YA6 YA6 YA6 YA17 YA24 YA31 Good Practice Recommendations It is recommended that the organisation looks at the care plans in use to see if they can be made more user friendly with all the necessary information in one place. The care plans could better reflect the future goals and aspirations of the people living there. The review process for these could be three monthly. Care staff should review how they are writing daily notes to make sure that good quality information is being recorded. Mealtimes should be used as a social occasion and time for everybody present to positively interact. The sensory room should be completed as soon as possible. It is strongly recommended that the staff team reflect on comments made within this report. This is with reference to the consistency of care provided and reflecting the ethos / values of the service. 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 63a Victoria Avenue DS0000007210.V348353.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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