Inspection on 24/07/06 for 74 Wilson Avenue

This inspection was carried out on 24th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

74 Wilson Avenue 21/02/06

74 Wilson Avenue 02/08/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

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 74 Wilson Avenue Rochester Kent ME1 2RL Lead Inspector Andrea Leverett Unannounced Inspection 24th July 2006 10:00 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 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 Post Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Wilson Road is a purpose built, residential care, providing a home for four adults with severe learning disabilities and physical disabilities. Medway Council owns the property 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.V302368.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key unannounced inspection took place on the 24th of July 2006. The inspector spoke with two staff members during the site visit and was able to observe and interact with two service users who were present at the time. Judgements made on the quality of life for service users were made following discussion with staff, comment cards seen, observation of staff and service user interaction on the day of the inspection and reading of records. The inspector was impressed with the continued progress made towards meeting the requirements and recommendations from the last inspection. Although the Home is currently without a registered manager, staff spoken to said they received appropriate support and supervision and evidence seen during the inspection process showed that a good standard of service continued to be provided. A tour of the home was conducted. Overall, the home is comfortable, nicely decorated, clean and free from offensive odours throughout. The current charges for this service are £1341.00. 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 access to a good range and quantity of activities both at Home and in the community, including access to a day centre. They have their own transport that is fully adapted to their needs and is unmarked and domestic in character. Two service users also have powerassisted wheelchairs. Service users benefit from the Home having comprehensive, thoughtful and service user led policies and procedures. Promoting communication for service users is given a high priority and a range of communication aids and systems are in use to help service users make choices. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality of service in this outcome area is judged as excellent. Prospective service users benefit from having their individual needs and aspirations assessed. EVIDENCE: Although no new service users have been admitted to the Home for many years Avenues trust have taken over as the new service provider and have carried out their own comprehensive assessments of all service users. An inspection of these showed that the assessment and care planning system was very detailed and comprehensive and in line with good practice had a Person Centred approach. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The quality of service in this outcome area is judged as excellent. Service users benefit from having their assessed and changing needs and personal gaols reflected in their Person centred Plan and are supported to make decisions and take risks as part of an independent life style. EVIDENCE: The inspector tracked the assessment and person centred planning systems for two service users and was impressed with the comprehensive and detailed information. Information included activities time table, participation record, holistic profiles, What an average day and a best day would look like, Likes and dislikes, risk assessments, epilepsy guidelines, weight charts, health visits, assessment of cultural needs and faiths, therapeutic certificates, record of reviews, speech and language records and medication reviews. Discussion with staff and observation on the day of the site visit showed that this information was being used to aid choice making and guide daily living. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 10 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): 12,13,15,16,17 The quality of service in this outcome area is judged as excellent. Service users have opportunities for personal development through the provision of a range of age, peer and culturally appropriate therapeutic and leisure activities. Service users benefit from having good family contact and living in a Home that encourages their involvement. Service users have a healthy diet and are supported to make choices regarding food and drink. EVIDENCE: All service users have access to a Day Centre and in addition the Home provides a range of activities to meet their needs. Records viewed showed that these were being undertaken regularly. On the day of the inspection two service users were at the day centre and the other service users were preparing to go on activities organised by the Home. The Home has its own transport, which is fully adapted to meet service users needs. Records also showed that service users attended trampoline, massage and sensory activities 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 11 both at Home and in the community. Visits to cafes and evening clubs. Overall the inspector continues to be impressed with the range and frequency of activities offered. Feedback and meetings with family members at this and previous inspections have shown that family contact and their involvement in the Home is promoted and valued by the staff. An inspection of the homes kitchen, food storage and menus was undertaken. A broad range of healthy food was seen in stock including a variety of fresh fruits and vegetables. Menus were varied and balanced and service users daily records and their records of likes and dislikes showed that their choices around food were respected and promoted. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 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): 18,19,20 The quality of service in this outcome area is judged as good. Overall service users receive support in the way they prefer and require and their physical and emotional health needs are met. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Records of assessments and care plans seen and observation and discussion with staff showed that service users receive personal care and support in the way they prefer and require. Records included guidelines for undertaking aspects of personal care and daily records evidenced that preferred choices in daily living were respected. There is however an outstanding requirement regarding a service users bath hoist. Currently he is not able to use his bath because an appropriate hoist is not in place. Records have also shown that the service user would prefer a bath to a shower. Records seen and discussion with staff showed that access to routine and specialist health services was provided. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 13 An inspection of the Home’s medication storage and administration systems showed that medication was being stored administered and recorded appropriately. Records included staff signatures and detailed guidelines for administering individual medications. Training records showed that staff are trained to administer medication, although the inspector was unable to establish if the course included all aspects of medication administration and record keeping, was undertaken by a person qualified to do so and whether the training included a competency test. A requirement has been made for the Home to evidence that medication administration training provided by the service meets these requirements. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 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 the following standard(s): 22,23 The quality of service in this outcome area is judged as good. Service users and their families know that their concerns will be listened to and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: The Home has a complaints procedure, which meets all the requirements of this standard. Feedback from relatives showed that their views are listened to and acted upon in the best interests of the service users. Given the profound learning difficulties and limited communication skills of the service users the inspector was impressed with the work done to establish communication systems in order to seek and respect service users wishes and needs. The Home has appropriate Adult Protection procedures and policies, 2 staff spoken to demonstrate 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 and a sample of staff training records seen confirmed this. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 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 the following standard(s): 24,30,29 The quality of service in this outcome area is judged as excellent. Service users live in a homely comfortable, safe environment that is clean and free from offensive odours. 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 previous two inspections 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. This requirement has still not been met. The Home has an activities room on the first floor, which is nicely refurbished and equipped, appropriate to the needs of the service users. The garden area was a little overgrown and a requirement has been made regarding the need to ensure that the garden area is maintained appropriately. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 16 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 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 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): 32,33,35 The quality of service in this outcome area is judged as good. On the whole service users individual and joint needs are met by an effective and appropriately trained and supervised staff team, although more could be done to improve staff consistency. EVIDENCE: An inspection of the home’s rotas, daily records and discussion with staff evidenced that service users benefit from having sufficient staff to meet their needs at all times. However the Home does have several vacancies, which are currently being filled by agency staff, two of which were present during the inspection. An inspection of the home’s rota showed that there is quite often only one permanent staff member on duty with two agency staff. It is acknowledged that one of the agency staff spoken to had worked at the Home for over a year and knew service users very well, however the inspector felt more should be done to ensure a more consistent staff team and reduce the high level of agency staff being used. Records viewed and discussion with staff showed that staff were trained and supervised to a good standard and staff felt supported by the organisation despite the fact that the Home does not currently have a registered manager in post. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 18 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 19 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): 37,39,42 The quality of service in this outcome area is judged as good. Although more could be done to ensure that service users benefit from a well run home, the health, safety and welfare of service users is promoted and protected. Service users can be confident that their views underpin all self-monitoring, review and development by the Home. EVIDENCE: The Home is still in the process of recruiting a new manager and team leaders and the area manager are undertaking the day-to-day management of the Home. Staff spoken to and observation and records seen demonstrated that despite the lack of a manager the Home continues to provide a high standard of care and have made continues progress towards meeting requirements from the last inspection. Staff spoken to felt supported by the temporary management structure and records showed that they were receiving regular supervision. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 20 Establishing service users views and needs is given a high priority and, as stated previously, the inspector has been impressed with the systems in place to ensure effective assessments and communication with service users. Records seen and discussion with staff have also evidenced how this information is used to plan service provision and day-to-day living. 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 21 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 4 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 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 3 30 4 STAFFING Standard No Score 31 X 32 4 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 2 X 3 X X 4 X 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 22 Yes 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. Action plan by 20/09/06 The registered person must evidence that staff have received appropriate medication administration training. Action plan by The registered person must ensure that the garden area is maintained appropriately. The registered person must review the staffing arrangements to ensure that there is a reasonably consistent staff team. Action plan by: The registered person must ensure that there is a registered manager in place. Action plan by: Timescale for action 20/09/06 2 YA20 18(1)(c ) (i) 20/09/06 3 4 YA24 YA33 23(2)(o) 18(1)(b) 20/09/06 20/09/06 5 YA37 8(1)(a)(i) 20/09/06 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 74 Wilson Avenue DS0000064370.V302368.R01.S.doc Version 5.2 Page 24 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 © 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 DS0000064370.V302368.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!