CARE HOME ADULTS 18-65
74 Wilson Avenue 74 Wilson Avenue Rochester Kent ME1 2RL Lead Inspector
Andrea Leverett Unannounced Inspection 21st February 2006 10:00 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 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 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 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. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 74 Wilson Avenue Address 74 Wilson Avenue Rochester Kent ME1 2RL 0208 3082900 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) The Avenues Trust Limited Mr Daniel Steven Gower Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 2nd August 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 DS0000064370.V285924.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 21st of March 2006. The inspector spoke with three staff members and the acting manager. Judgements made on the quality of life for service users were made following discussion with staff and the acting manager, observation of staff and service user interaction on the day of the inspection and reading of records. The inspector was impressed with the overall progress made towards meeting the requirements and recommendations from the last inspection and the service users continue to be given a good service at Wilson Avenue. The inspector was particularly impressed with the improvements made to the range and quantity of activities provided. Although there are some requirements still outstanding the inspector is confident that these will be met. 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. Service users benefit from the Home having comprehensive, thoughtful and service user led policies and procedures. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 6 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. 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. The comfort of service users could be improved by replacing the old and worn easy chairs in the bedrooms. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 7 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 DS0000064370.V285924.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 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 the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 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 the following standard(s): 11,12,14 Service users have opportunities for personal development through the provision of a range of age, peer and culturally appropriate therapeutic and leisure activities. EVIDENCE: All service users have access to a Day Centre and in addition the Home provides a range of activities to meet their needs. On the day of the inspection 2 service users were at the day centre and the other service users were preparing to go to hydrotherapy. Records viewed showed that these were being undertaken regularly. Records also showed that service users attended trampolining, massage and sensory activities both at Home and in the community. Visits to cafes, shops and pubs were also regularly undertaken and the inspector was impressed with the range and frequency of activities offered. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 12 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 the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 13 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 the following standard(s): 23 Service users are protected from abuse, neglect and self-harm. EVIDENCE: The Home has appropriate adult protection procedures and policies, which the inspector saw at the last inspection. 3 staff were spoken to, all of who demonstrated a good understanding of Adult Protection issues and how they relate to local authority protocols. The staff informed the inspector that Adult Protection refresher training is undertaken annually. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 14 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 the following standard(s): 25,27 On the whole service users benefit from bedrooms, toilets and bathrooms that are decorated and equipped to a good standard but some improvements are needed. EVIDENCE: 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. It was noted at the last inspection that one service user did not benefit from an appropriate bath hoist and was therefore unable to use his bath in accordance with his wishes and a requirement was made regarding this. The acting manager informed the inspector that although quotes have been supplied, funding has not yet been agreed for this essential equipment to be replaced. There is also an outstanding requirement that service users specially adapted easy chairs that are in poor condition must be replaced or made good. The acting manager informed the inspector that funding has been agreed for this and will now be undertaken. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 15 The Home’s activities room on the first floor has been refurbished and the space is now more welcoming and appropriate to the needs of the service users. A recommendation from the last inspection that the view from one service users room is enhanced by re-siting the homes refuse bins and re-designing the garden area directly under her window has not yet been acted upon. However the acting manager informed the inspector that this work would be done in the near future. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Service users benefit from staff that are supported and supervised. EVIDENCE: Records viewed at the last inspection and staff spoken to during this inspection confirmed that they received regular supervision and felt supported by the acting manager and the organisation. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 18 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 2 26 X 27 2 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 3 12 4 13 X 14 4 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X X X X X X 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 19 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 YA27 Regulation 23.2(n) Requirement The registered person must ensure that appropriate furniture, adaptations and equipment are provided to meet service users needs: In that a hoist 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. Timescale for action 20/08/06 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 YA25 YA25 Good Practice Recommendations 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. 74 Wilson Avenue DS0000064370.V285924.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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