Inspection on 05/01/09 for 71 Middleton Avenue

This inspection was carried out on 5th January 2009.

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

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

71 Middleton Avenue 05/03/07

71 Middleton Avenue 02/02/06

71 Middleton Avenue 07/06/05

71 Middleton Avenue 29/09/04

71 Middleton Avenue 22/04/04

Similar services:

22 Sandown Road

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Dilston College Of Further Education

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Craigmore House

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 71 Middleton Avenue 71 Middleton Avenue Stockton-on-Tees TS17 0LL two star good service The quality rating for this care home is: 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: Stephen Ellis Date: 0 5 0 1 2 0 0 9 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: 71 Middleton Avenue 71 Middleton Avenue Stockton-on-Tees TS17 0LL 01642750617 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Michael Joseph Gatenby Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the followin category: Learning Disability, Code LD, maximum number of places 6 The maximum number of service users who can be accommodated is: 6 Date of last inspection 0 6 0 1 2 0 0 8 A bit about the care home 71 Middleton Avenue is registered with the Commission for Social Care Inspection under the Care Standards Act 2000 as a care home providing care and accommodation for up to 6 adults who have a learning disability in spacious single rooms. The home is a purpose built bungalow and is situated in a residential area near a sports field. The home has been established since 1993 and is located within a short bus journey of local facilities such as shops and a leisure centre. The home provides spacious accommodation and is suitable for wheelchair users. 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 How we did our inspection: This is what the inspector did when they were at the care home This key inspection was carried out on 5th January 2009 and was informed by the homes Annual Quality Assurance Assessment, which it completed on 26th November 2008. The last key inspection took place in January 2008. At the time of inspection there were 5 people who use the service living at the home. Most took part in the inspection and three returned surveys to the inspector. The inspection included a tour of the building, discussions with 4 people who use the service, 3 staff and manager, plus examination of a sample of records that the home is required to keep, such as care plans and medicine records. The weekly fees range from 700 to 1000 pounds, but the actual amount people pay depends on their individual circumstances. What the care home does well The service respects the individuality of each person who uses the service and consults fully with them about their needs, wishes and aspirations. Typical comments from people who use the service include: The staff always treat me well. There are good policies and procedures, reinforced by good staff training,that guide the skilled work of staff in supporting people who use the service. Plans of care are comprehensive and detailed and are regularly reviewed. People who use the service lead varied and satisfying lifestyles. They have opportunities for good links with families, friends and the wider community. They exercise choice in their daily lives and the service helps them maximize their independence. The accommodation is spacious and pleasant, with people who use the service being actively consulted about decoration, furnishing, equipment and use. There is a well-trained and experienced staff team and each person who uses the service has a key worker who works closely with each individual to help him or her achieve personal goals. The home is well run, with an experienced management team. The service has a continuous improvement plan that is reviewed and updated monthly. What has got better from the last inspection What the care home could do better The service should try to ensure that there is adequate personal care and support for people who use the service who have to go into hospital for treatment. The homes medication procedures need to be followed at all times, especially with regard to the recording of details of medicines and their administration. The registered manager should aim to complete the Registered Managers Award and Care Award at National Vocational Qualification level 4 in a timely manner. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Stephen Ellis St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB Tel. 0191 233 3300 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 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 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 . The needs and aspirations of people who are considering using the service are thoroughly assessed and acted on wherever possible. Evidence: Three people who use the service said that they felt they had enough information about the home before they moved in. They felt they could make a positive choice, having had introductory visits and opportunities to meet and talk with other people who use the service, and staff. They felt that their needs were well understood and the service they had received since admission supported that view. They felt that their care needs were well met. This view was reinforced by the support plans of care examined on the day. These showed that detailed and comprehensive assessments of need were completed prior to admission and had been kept under close review ever since. The service provided is accurately described in the homes statement of purpose and service users guide, which are available in accessible formats. 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 . Peoples individual needs and choices are well assessed and acted on, so that people who use the service are supported in their daily lives and decision-making and encouraged to take responsible risks to maximize opportunities for personal fulfillment. Evidence: Three plans of care were examined and found to be comprehensive and detailed in all the areas of daily life where people required support. They were person centred in their focus on the individual identity of each person using the service. They were not fully person centred, in so far as staff training in this aspect of care planning is ongoing, with further training scheduled for January 2009. People who use the service and one relative made comments about the quality of care planning, decision making and risk taking. Typical comments included: I am able to choose how I spend my time. Staff listen to me and help me do the things I want, like going out to places I want to go to and wearing clothes and jewelry that I like. Another person who used the service went out in the evening by taxi and enjoyed the independence that this mode of transport brought. People were encouraged to take responsible risks and these were found to be well documented in individual plans of care, including detailed assessments of risk and means by which risks could be minimized without adversely affecting peoples right to choice and independence. 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 . The service helps to promote person centred lifestyles that provide opportunities for independence, choice, social inclusion and fulfillment. Evidence: Three people who use the service said that they were happy with the lifestyles they had developed since moving to this home. They were able to take part in educational and leisure activities appropriate to their needs and interests, both in and out of the home. For example, one person said they enjoyed going to the local day service centre where they were involved in an array of interesting and stimulating activities. Another person said they enjoyed the aromatherapy massage provided by a visiting therapist. Staff said that they always tried to support people in ways that they preferred and took care to ensure that people were fully consulted about their choices. For example, holidays were planned on an individual basis, both in this country and abroad, taking into account the views and wishes of people who use the service and their families. These consultations and support arrangements were well documented in individual care plans. Typical comments from people who use the service included: The staff listen to me and support me so that I can do the things I choose, like where I eat when were out. 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 . The health and personal care of people who use the service is based on their individual needs and wishes. The principles of respect, dignity and privacy are put into practice. Evidence: Comments received from three people who use the service and one relative were positive and complimentary about personal support and healthcare arrangements. People said they had full confidence in the plans of care and staff team. They felt their personal care needs were met with sensitivity and understanding by a dedicated staff team. People who use the service said that their individuality was respected and their wishes were supported wherever possible. There were good relationships with all members of staff, especially key workers, who have a special relationship with the individual person who uses the service. People who use the service felt they understood their plans of care and were involved in reviewing them with staff. Typical comments included: The staff always treat me well. They also felt satisfied with their healthcare arrangements, saying that the doctor or nurse would see them whenever required. Plans of care confirmed detailed records of healthcare needs and interventions by medical practitioners. The home is trying to promote healthy eating and lifestyle choices, whilst always respecting individual preferences and decisions about these matters. It was noted that the home has not always been able to give the level of support it would have liked for people who have gone into hospital. It is recommended that where such support is seen as being crucial for the wellbeing of the individual, that every effort is made to supply staff or volunteer input, to provide personal care, emotional support and advocacy where needed. This should be fully documented in the individuals plan of care. The arrangements for medication were found to be generally good, with good storage, administration and disposal procedures. Also, all members of staff responsible for medicines at the home have undergone Safe Handling of Medicines Training and have refresher courses every 3 Evidence: years, plus periodic competency assessments. It was noted that some handwritten entries in the Medication Administration Record (MAR) sheets had not been fully checked and countersigned and some administration entries had not been signed contemporaneously. However, these were the exception rather than the rule. Nonetheless, it is essential that the homes medication policy is fully implemented at all times, to reduce the risk of maladministration. 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 . People who use the service have access to a robust, effective complaints procedure and are protected from abuse. Evidence: People who use the service and one relative said they were confident about being able to complain should the need arise. They felt able to talk to any of the staff about any concern or complaint they might have. Staff members said they had undergone training in protection of vulnerable adults and whistle blowing and would not hesitate to alert the appropriate authorities to any suspicion of abuse or neglect, in keeping with Mencaps policies. Each person who uses the service has been given a copy of the homes complaints procedure and there is a poster on the wall telling people how they can complain. People who use the service are frequently reminded that the service welcomes their concerns or complaints and promises to take those seriously and investigate them thoroughly, involving the Local Authority safeguarding procedures wherever appropriate. Thorough pre-employment checks are carried out on all staff, including enhanced Criminal Record Bureau checks, Protection of Vulnerable Adult register checks and the taking up of two written references. Both internal and external management monitor any complaints, compliments and general comments very carefully, as documented in the homes complaints and compliments file. 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 . The physical design and layout of the building enables people who use the service to live in a safe, well-maintained and comfortable environment, which promotes independence. Evidence: This six bedroom, bungalow-accommodation is spacious, well equipped and clean. It is well maintained, with servicing and repairs being carried out in a timely manner. Decoration reflects the wishes of people who use the service, especially in their own bedrooms. People who use the service said that they liked the building and could get around easily. Liquid soap and paper towels are used in communal toilets and bathrooms to combat the risk of cross-infection. Staff members have undergone training in infection control and food safety. 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 . Staff members are trained, skilled and in sufficient numbers to fulfill the aims of the home and the changing needs of people who use the service. Evidence: People who use the service said that they got on well with staff and were involved in the recruitment process, helping to select suitable people to work at the home. Staff members confirmed that people who use the service were involved in recruitment as part of Mencaps national policy. An examination of staff files confirmed that staff members are only appointed after careful checks and references have been taken up, including enhanced Criminal Record Bureau checks. They undergo a comprehensive 12 week induction period to equip them with essential skills and knowledge so that they can do their work safely. All mandatory subjects are covered, including moving and handling, food safety, infection control and fire safety. In addition, Mencaps values and principles of care are explored in depth. The training provided is good and there is on-going training needs assessments for each member of staff. Three staff members confirmed the nature and quality of their training, as evidenced in their files. Just under 50 of staff members have achieved National Vocational Qualifications in care at level 2 or above, but that figure is expected to rise significantly during 2009. Most staff training is compatible with the Learning Disability Award Framework or equivalent, ensuring it is focused on the needs of people who use the service. Staffing levels were found to be appropriate for the needs of the people being accommodated (maximum of six) with 2 to 3 members of staff typically on duty during the day, and one at night. Staffing levels are carefully monitored and vary in accordance with the number of people on the premises and their dependency needs. Staff members felt that the numbers on duty were about right, and this was reflected also in comments made by people who use the service and one relative. 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 . The management and administration of the home is based on openness and respect, with effective quality assurance systems implemented by an experienced registered manager and wider management team within Mencap. Evidence: The home is generally well run, with monthly team meetings of staff, regular key worker meetings with people who use the service and monthly visits from Mencaps Operations Manager. Records of these meetings and visits are kept. The registered manager has substantial experience in the field of working with people with learning disabilities, including management, and is working towards the Registered Managers Award and Care Award, both at National Vocational Qualification level 4. Each month he completes Mencaps monthly compliance confirmation report and the service receives a visit from a senior manager to check on how well the home is doing. Surveys are carried out annually, inviting feedback from people who use the service and their representatives. The home acts on these results wherever appropriate, by incorporating proposed actions into the homes continuous improvement plan. The service has well developed policies and procedures to guide staff in all areas, plus a Family Charter that helps the home focus on effective working relationships with families, in the best interests of people who use the service. Full health and safety checks are carried out at regular intervals and reported on, so that progress can be monitored. People who use the service said they were confident in the management of the home and valued the fact that they were regularly consulted about all key matters. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 20 13 Handwritten entries in medicine records must be fully checked and countersigned. 23/05/2009 This will ensure that such entries are correct as to name, strength and dose etc. 2 20 13 The recording of medicines administered must be contemporaneous. 23/05/2009 This will reduce the risk of errors being made in the safe administration of medicines. 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 18 Personal support should be arranged for people who use the service when they go into hospital, if this is deemed necessary for their wellbeing and recovery. 2 37 It is strongly recommended that the registered manager completes the Registered Managers Award and Care Award, both at National Vocational Qualification level 4, in a timely manner. Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) 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. 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