Inspection on 07/06/05 for 71 Middleton Avenue

This inspection was carried out on 7th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

71 Middleton Avenue 05/01/09

71 Middleton Avenue 05/03/07

71 Middleton Avenue 02/02/06

71 Middleton Avenue 29/09/04

71 Middleton Avenue 22/04/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 71 Middleton Avenue Stockton on Tees TS17 0HG Lead Inspector Brenda Grant Unannounced 7 June 2005 11:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 71 Middleton Avenue Address Stockton on Tees TS17 0HG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01642 750617 Royal Mencap Society Mrs Christine Lambert Care Home 6 Category(ies) of LD Learning disability (6) registration, with number of places 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 29th September 2004 Brief Description of the Service: 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. The home is a purpose built bungalow and is situated within a residential area near a sports field. It is indistinguishable from other homes in the area and has been established since 1993. The home provides spacious accommodation and is suitable for wheelchair users. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three hours fifty minutes, the inspector looked around the building and the grounds of the home as well as inspecting a number of records. Three service users, two staff and the manager were spoken to on the day of the inspection. Service users had their own individual weekly programmes showing where and which activities they were regularly involved with. Staff were observed appropriately speaking to service users. Two service users said they, “like them all (meaning staff) and staff are nice.” The other service user demonstrated that s/he was comfortable in the presence of staff. Staff said they “enjoyed working at the home” and 1 staff said, “it’s the best job I have ever had.” Staff training was ongoing with the home providing specialist training for caring of the service user group. The home’s environment had attractive displays of fresh flowers and, on the day of the inspection, it was observed being kept clean and tidy but there were areas where repairs/replacement and maintenance needed to be carried out. What the service does well: What has improved since the last inspection? The home identified that extra security needs to be placed around the exterior of the home; that work has commenced but has yet to be completed. When there are changes to service user’s needs they are recorded in Care Plans and Risk Assessments were updated accordingly. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 6 Service user’s financial transactions were satisfactorily recorded. Light diffusers, in the kitchen, had been cleaned. 50 of care staff had achieved at least NVQ Level 2. 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. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 5 The home’s Statement of Purpose had not been updated to include all the required details. The guide was not in a suitable format for the people for whom the home is intended. Prospective users’ individual aspirations and needs were assessed. Service users had written contracts, with the home, but they had not been updated. EVIDENCE: The home has a Statement of Purpose and a Service User’s Guide that gave information about the home and service provision. They had not been updated to include details of: the Commission for Social Care Inspection, qualifications of staff and the name of the Regional Manager was incorrect. The guide, with the exception of the Complaints Procedure, was not in a suitable format that service users would be able to understand. Service users files had assessments, carried out by a care manager, which gave details of expectations and needs of service users. The assessments showed that service users and their representatives had been involved with the assessment process. The home had a written contract with each service user. Contracts had not been updated this year. The service’s representative signed the contracts but they were not signed by, or someone on behalf of, service users. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 9 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. EVIDENCE: Service users had individual detailed Care Plans that also included Risk Assessments. The home also had information of procedures for managing service user’s behaviour problems. Care Plans had been reviewed and updated every six months when there had been Care Programme Approach reviews. Service users and their representatives were involved with those reviews 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Service users take part in appropriate activities and they are involved with the local community. Service users are supported to maintain their personal contacts. EVIDENCE: Each service user had a weekly programme of training and leisure activities. Staff said they supported service users, with their individual interests, and gave assistance to help service users access those activities. The manager said plans had been made for service users annual holidays. She said individual preferences were being catered for because not all service users shared the same interests. The manager said service users are supported when going out to the local community. One service user said s/he “liked to go to the shops.” Another service user said he enjoyed, “going to watch Middlesbrough football games.” Staff said service users enjoyed going for walks to local places, including the nearby town centre, where there are; pubs, shops and a leisure facility. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 12 Staff said service users are encouraged and supported in maintaining their personal links; that was mainly with families. Staff said they arranged transport when service users wished to visit relatives and service users had access of the home’s telephone to contact people they wished to talk to. The manager said service users also had regular visitors calling to see them at the home. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Where appropriate, service users are supported in controlling their medication. Service users are not wholly are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: The manager said none of the service users had been assessed as having the ability to manage their own medication. The home had policies and procedures to protect service users when dealing with medicines. Medication was stored in a locked facility and recording, with the exception of staff signing when administering medicines, was satisfactory. The procedure was for two staff to sign the Medication Administration Record but there was only on signature for each entry. Staff said they had been trained in the awareness and handling of medicines but the home did not have confirmation that was the case. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Service users are mostly protected from abuse, neglect and self-harm but the home environment needs to have added security. EVIDENCE: The home had evidence that staff had completed training for No Secrets and Whistle Blowing. Staff said they would report, to the manager, if service users were at risk of abuse. The home followed the policies and procedures regarding service user’s money. Each service user’s money was individually kept and separately recorded, with receipts confirming how the money was spent. The record and amount of money was found to be correct on the day of the inspection. The home has gained reports, from the housing association and police, stating which measures the home needs to take to prevent uninvited people gaining access to the home’s grounds. The manager said action, for preventative access measures had commenced and more were planned for the future. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27 & 30 The home was not wholly comfortable and well maintained. Bathrooms and toilets provided sufficient privacy and met the needs of service users. The home was clean and hygienic. EVIDENCE: On the day of the inspection, the home was seen to be comfortable and homely but there were areas in need of repair/replacement or maintenance. They are as follows: • The freezer lid was off the hinges. • Wallpaper, in the hall and lounge was damaged. • Lounge furniture had broken zips and was worn and torn. • The laundry wall, where a unit had recently been removed, had not been redecorated. • The flooring of two bathrooms was stained and a bath was stained. A bathroom radiator’s paintwork was scraped off. Two bathroom ceilings and a bathroom window-sill had paint peeling off. • One bedroom had a drawer front missing and another had the front of a drawer falling off. • A garden fence had panels missing. • The flower tubs had no plants other than weeds in them. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 16 The home had suitable toilets and bath/shower facilities, for the service user group, with equipment for staff to assist service users. On the day of the inspection, the home was observed to be clean and hygienic. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Competent and qualified staff supports service users. EVIDENCE: On the day of the inspection the home was satisfactorily staffed to meet the needs of the number and dependency levels of the service users. The home now has four of the eight care staff that has achieved at least NVQ Level 2; bring the ratio of qualified staff within the National Minimum Standards. All staff have received further specialist training in caring of the service user group. Staff said they work as a team. Staff said the home has a core group of staff that have been working at the home for many years; they guide and advise those staff with less experience. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 & 39 Service users benefit from a well run home but the manager has yet to gain NVQ Level 4 in care and management. The home has a self-monitoring system but it does not seek views and opinions from service users and other interested parties. EVIDENCE: Staff and service users said they thought 71 Middleton Road was a “well run home.” The manager has many years of experience working with adults with a learning disability. She is working towards gaining the Registered Manager’s Award and NVQ Level 4 in care but has not yet completed the training. The home did not have an effective quality assurance system that gained views from service users and all who were involved with the home that would contribute towards the development plans of the service. Monitoring is by means of the Regional Manager’s monthly visits and an annual audit. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 2 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 71 Middleton Avenue Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x x x B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 20 no Are there any outstanding requirements from the last inspection? 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 1 Regulation 4&5 Requirement The Statement of Purpose must include: staffs qualifications and exp[erience. The Service Users Guide must include: the address and telephone number of the Commission, the most recent inspection report and the information about the Regional Manager must be correct. (Previous timescale of 25th November 2004 not met) Service users contracts must be updated and signed by the service user or their representative. The home must follow its procedure when staff administer medicines. The home must provide additional security to prevent unauthorised access to the grounds. (Previous timescale of 31st March 2005 not met) The home must have repairs/replacement or maintenance carried out: The loose freezer lid must be secured. Damaged wallpaper must be repaired. Timescale for action 30th September 2005 2. 5 5 30th September 2005 15th July 2005 30th September 2005 ---------------------------------31th October 2005 Page 21 3. 4. 20 23 13 23 5. 24 23 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 6. 39 24 Lounge furniture that had broken zips and was worn and torn must be repaired or replaced. The laundry wall, where a unit had been removed, must be redecorated. The stained flooring of two bathrooms and a stained bath must be cleaned or replaced. Peeling paint from; two bathroom ceilings and a bathroom window sill must be redecorated. The two drawers, with the fronts coming off, must be repaired. The missing panels of the garden fence must be replaced. The overgrown plant tubs must be properly maintained. The home must have a quality 31st assurance system, that involves October consultation with service users 2005 and their representatives, for reviewing the service. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 1 37 Good Practice Recommendations The Service Users Guide should be in a format that service users can understand. The manager should ensure that NVQ Level 4 in care and management, or equivalent, is achieved by 2005. 71 Middleton Avenue B51_ B01 S13 Middleton Avenue V231759 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton on Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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