Inspection on 02/08/05 for 74 Wilson Avenue

This inspection was carried out on 2nd August 2005.

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 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

74 Wilson Avenue 24/07/06

74 Wilson Avenue 21/02/06

Similar services:

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Insight - Eastchurch

Southfields

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33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 74 Wilson Avenue Rochester Kent ME1 2RL Lead Inspector Andrea Leverett Announced 2 August 2005 10.00am 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. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 74 Wilson Avenue Address Rochester Kent ME1 2RL 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) Care Home 4 The Avenues Trust Limited Category(ies) of LD Learning Disability (4) registration, with number of places 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th March 2005 Brief Description of the Service: Wilson Rd is a purpose built, residential care, providing a home for four adults with severe learning disabilities and physical disabilities. The property is owned by Medway Council and Avenues Trust are the new service providers.The home is located in a residential area, within walking distance of shops and local amenities and has its own specially adapted vehicle for the benefit of service users. The property is a large, spacious, detached bungalow, providing accessible accommodation on the ground floor. It has a lift to enable service users to access the first floor where the sensory room and office are situated. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place between 5.30pm and 7.30pm on the 21st of July and 9.30am and 2.30pm on the 2nd of August. Relatives of three service users were spoken with and their comments on the service provided were a valuable insight into the home. The inspector also spoke with three staff members and the new manager. Judgements made on the quality of life for service users were made following discussion with relatives, conversations with staff and the manager, observation on the day of the inspection and reading of records. The inspector concluded that on the whole the service users continue to be given a good service at Wilson Avenue, but as discussed and agreed with the manager there is clear scope for improvements in all areas of record keeping and documents relating to service users. It was also agreed that the improvements in staffing levels and the recent input from specialist health services needs to be maintained. A tour of the home was conducted. Overall, the home is comfortable, nicely decorated, clean and free from offensive odours throughout. What the service does well: The service users benefit from an environment which is purpose built, to meet their needs, with a fully accessible patio and garden area. All bedrooms are en suite and have a range of disability equipment in order to promote the quality of life and enhance the safety of service users. Service users benefit from having their own transport that is fully adapted to their needs. It is unmarked and domestic in character. All service users have access to Day Services and are supported to access the local community on a regular basis. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 6 Service users benefit from the Home having comprehensive, thoughtful and service user led policies and procedures. What has improved since the last inspection? What they could do better: The quality of life of one service user could be considerably improved by providing an appropriate hoist to enable him to use his bath. The quality of the environment could be improved for one service user by replacing a high/low institutionalised hospital bed with a bed which is more domestic in character, but which has a high/low feature. Safety of service users could be enhanced by ensuring that shower tray hoists are serviced regularly. The quality of the service users environment could be improved by deep cleaning carpets in most areas of the Home. Health & Safety of all service users could be improved by ensuring that they all have 2 hoist slings and advice is taken as to how long the slings can be safely used before they should be replaced. The view from one service users room could be greatly enhanced by re-siteing the homes refuse bins and re-designing the garden area directly under her window. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 7 The comfort of service users could be improved by replacing the old and worn easy chairs in the bedrooms. Service users environment could be improved by updating the homes’ activities room. The safety of staff and Opportunities for service users to undertake community activities could be improved by ensuring service users wheelchairs are power assisted. 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. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 8 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 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 9 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, 3 & 5 Service users benefit from living in a fully adapted, purpose built home, which meets their specialist needs. Service users do not yet benefit from an individual written contract or Statement of Terms & Conditions with the home. EVIDENCE: The manager informed the inspector that all service users, families and advocates were consulted regarding the design and specifications of this purpose built home. The manager informed the inspector that the new providers are currently in the process of developing new contracts for the service users in this home. The inspector is confident that these will be forthcoming. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 & 7 Some service users currently do not benefit from updated care plans and risk assessments. Staff make efforts to interpret service users needs and choices and reflect this in the care provided. EVIDENCE: It is acknowledged that the service users in this home are in the process of having new assessments undertaken with input from appropriate specialist health services and care managers. Records show that some of this work has already been undertaken, however, it is understood that this will take some time to complete. The home is currently working with old assessments and care plans, pending completion of the new ones. It is also acknowledged that the manager and staff spoken to felt that guidelines and risk assessments currently being used were ensuring the safety of service users in the short term. Service users in this home have complex needs and are considered ‘difficult to reach’. Needs and wishes are identified largely through observation and interpretation. Evidence was seen that simple choices are offered on a daily basis, in relation to food and basic care. The inspector has recommended that 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 11 the home look to improving staff skills and knowledge regarding specialist communication systems that may be particularly suited to this user group. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,15,17 Service users are supported to access the community on a regular basis but their opportunities for personal development are limited because of a lack of structured activities appropriate to their needs. Family and friends are welcomed and their involvement in the life of the Home is encouraged in the best interest of service users. Service users benefit from a varied and nutritious diet suited to their needs and wishes. EVIDENCE: Discussion with relatives, staff and records viewed indicated that service users are supported to access shops, cafes and cinemas on a regular basis. All service users also attend the local day centre for part of the week. Records showed that service users go out most days and benefit from having their own specially adapted vehicle which is unlabeled and domestic in character. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 13 It was noted that structured activities appropriate for this service user group were limited. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 The home ensures that service users receive personal support in a way that they prefer and require and their physical and emotional health needs are met. The home ensures that service users benefit from a safe medication administration system but minor shortfalls were identified. EVIDENCE: Discussion with staff, relatives and records viewed revealed that information was available to ensure that staff were able to meet service users personal needs and that this was being acted upon. Information was also available regarding service users preferred routines. This information is currently being updated as part of the new assessments being undertaken. An inspection of the homes’ administration and medication procedures was undertaken. Records inspected indicated that appropriate record keeping was being maintained and that medication was being stored appropriately. The home is working from a mixture of old and new records, some of the old records are still useful and a sample of records seen included medication care plans (with service user photo and emergency intervention plans) and medication record sheets. It is acknowledged that the home is in the process of updating all of this information. The home has so far completed some PRN’s and has a new signature record sheet. Discussions took place regarding 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 15 secondary dispensing of medication which was taken to the Day Centre for administration. The manager also informed the inspector that Avenues only provides ‘in house’ staff medication training. It was agreed that the home should undergo a pharmacy inspection to ensure safe working practices. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Service users benefit from an appropriate user led complaints system. Concerns raised on their behalf are treated seriously and acted upon. EVIDENCE: The home has a complaints procedure, which includes ‘whistle-blowing’. The procedure includes all the information required by regulation and was a considered and thoughtful document. The procedure reinforced the rights of relatives and advocates to complain on behalf of service users. This is particularly pertinent for this service user group as they would be unable to advocate for themselves. It was clear that the roles of relatives and other persons acting on behalf of service users was supported and respected by staff. The home has had two complaints since Avenues has taken over the service. One of these was substantiated and dealt with immediately. The manager was advised by the inspector that the second complaint should be passed on to the Adult Protection Team, as this is regarding lack of feedback on their behalf. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,29,30 Service users benefit from an environment that is suited to their needs and is homely and comfortable. Service users bedrooms are suited to their needs and reflect their individual preferences but some minor improvements could be made to improve the quality of the bedroom environments. Toilets and bathrooms are decorated and equipped to a good standard but improvements are needed regarding the servicing and maintenance of some moving and handling equipment. On the whole service users benefit from a clean and hygienic environment although some minor improvements could be made. EVIDENCE: As stated previously service users benefit from living in a home that has been purpose built to meet their needs. It is welcoming, nicely decorated and is wheel chair accessible throughout including a patio and garden area. A broad range of disability aids and moving and handling equipment is also provided. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 18 Most of the moving and handling equipment seen on the day was being serviced regularly although it was noted that none of the homes disability shower trays had been serviced within the last 12 months and a requirement has been made regarding this. It was noted that one service user did not benefit from an appropriate bath hoist and was therefore unable to use his bath. It was also noted that service users only have one hoist sling each and the need to ensure that two hoist slings are provided and the manager takes advice as to how long the slings can be safely used before they should be replaced. All service users had specially adapted easy chairs in their rooms but these were in poor condition and were in need of replacement. The home has an activities room on the first floor, this was partly being used for storage and the inspector felt that more could be done to make the space more welcoming and appropriate to the needs of the service users. All service users bedrooms are spacious and have full en-suite facilities with disability aids and equipment. The quality of the environment could be improved for one service user by replacing a high/low institutionalised hospital bed with a bed which is more domestic in character, but which has a high/low feature. The view from one service users room could be greatly enhanced by re-siting the home’s refuse bins and re-designing the garden area directly under her window. The home was clean and free from offensive odours throughout although discussion took place regarding the need to have the carpets in most areas of the home deep cleaned. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,36 Staff are provided with a range of training, support and supervision to ensure that they are competent and qualified to meet service users needs. Appropriate numbers of staff are provided to ensure an effective service for service users. EVIDENCE: Discussion with staff evidenced that a range of core and service specific training is provided and the manager informed the inspector that all staff would be receiving refresher training in Peg Feeding, Epilepsy and Nutrition. Records viewed and discussion with staff showed that appropriate induction was being given to staff. Records also showed that regular 1:1 supervision and staff meetings take place and staff are paid to attend staff meetings if this is out side of their rota hours. The home now has three staff on duty at all times during waking hours and the inspector felt that this was appropriate to meet service users needs. During the night the Home has 1 waking night staff and 1 member of staff sleeping in. The manager informed the inspector that staffing levels have just been reviewed and will continue to be monitored over the next 6 months. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 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) 37,38,40,42 Service users benefit from a qualified, competent and experienced manager, who ensures a well run and accountable management of the service. Service users benefit from the home having comprehensive, thoughtful and service user led policies and procedures. On the whole service users benefit from having their health, safety and welfare promoted and protected but some minor improvements are required. EVIDENCE: The manager has completed the NVQ 4 Management and Care Award and has several years experience of working with this client group as a support worker and later in a management capacity. Observation on the day, records viewed and discussion with staff evidenced that the manager delivered an effective 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 21 client led service. He presented as a motivated and enthusiastic leader and staff spoke highly of him and felt that he was approachable and inclusive in his management style. A sample of the home’s new policies and procedures were inspected and the inspector was impressed with the quality of these. They are well written, detailed and thoughtful documents. A sample of records viewed, information provided by the manager and observation during the inspection showed that on the whole the premises and equipment in the Home were being maintained appropriately. Some shortfalls were identified and these have been dealt with else where in this report. 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 x 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 3 3 x 2 2 Standard No 11 12 13 14 15 16 17 2 2 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 74 Wilson Avenue Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x 2 x H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 23 NA 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 5 Regulation 5,1(c ) Requirement The registered person, must ensure that service users are provided with a standard form of contract,which includes information as listed in standard 5.2 of the Care Standards. The registered person must ensure that all service users undergo assessments that are carried out by people qualified to do so and that these assessments are kept under review and the outcomes are included in service users care plans. The registered person must ensure that service users shower hiost trays are serviced regularly The registered person must ensure that appropriate furniture,adaptations and equipment are provided to meet service users needs: In that a hiost is provided for the service user to have a bath in accordance with his wishes; In that the old and worn specially adapted easy chairs in service users rooms are replaced or made good;In that two hoist slings are provided for service Timescale for action Action plan by 30/09/05 2. 6 14,1(a)& 15.1 Action plan by 30/09/05 3. 4. 24 27 13.4(c ) 23.2(n) Action plan by 30/09/05 Action plan by 30/09/05 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 24 5. 12 12,1(b) users and the manager takes advice as to how long the slings can be safely used before they should be replaced. The registered person must ensure that structured activities appropriate to the service users needs are provided. Action plan by the 30/09/05 6. 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 7 Good Practice Recommendations It is recommended that the Home look to improving staff skills and knowledge regarding specialist communication systems that may be particularly suited to this user group. That service users wheel chairs are power assisted That the homes activities room on the first floor is made more welcoming and appropriate to the needs of the service users. That the high/low institutionalised hospital bed is replaced with a bed which is more domestic in character, but which has a high/low feature. That the rubbish bins are resited and the garden area developed to improve the view from one service users bedroom window. That the carpets are deep cleaned in all areas. 2. 3. 14 24 4. 5. 6. 25 25 30 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection The Oast Hermitage Court Hermitage Lane Maidstone Kent. ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI 74 Wilson Avenue H56-H06 S64370 74 Wilson Avenue V233259 020805 Stage 4.doc Version 1.40 Page 26 - 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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