Inspection on 28/06/05 for 85 Highfield Avenue

This inspection was carried out on 28th June 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

85 Highfield Avenue 30/10/08

85 Highfield Avenue 24/01/07

85 Highfield Avenue 05/10/05

85 Highfield Avenue 13/01/05

85 Highfield Avenue 15/07/04

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Treloar College

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

CARE HOME ADULTS 18-65 85 Highfield Avenue Aldershot Hampshire GU11 3DA Lead Inspector Laurie Stride Unannounced 28/06/05 09:45am 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. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 85 Highfield Avenue Address Aldershot, Hampshire, GU11 3DA 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) 01252 350677 United Response Ms Beverley Hilton CRH 6 Category(ies) of LD registration, with number of places 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13/01/05 Brief Description of the Service: 85 Highfield Avenue provides a service for six younger adults with a learning disability. Staffing is provided twenty-four hours a day. Service users are encouraged to maintain their independence and rules are kept to a minimum. Visitors are welcome and service users’ families are encouraged to play an active part in their relative’s life where appropriate. The home has well-established links with local general practitioners and community nursing team to support and enhance the service provided. The home has been developed and managed by United Response and is well established in the local community. The home is situated in a residential area on the outskirts of Aldershot. Transport facilities are provided for service users to access local facilities and larger towns in the area. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit that lasted four hours, during which the inspector spoke with a resident, members of staff and the registered manager, observed staff working with residents and viewed samples of the home’s care plans and other records. What the service does well: 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. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 6 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 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 7 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) These standards were not assessed on this ocassion. EVIDENCE: 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 8 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, 8 and 9 There is a clear and consistent support planning system in place to provide staff with the information they need to satisfactorily meet resident’s needs and provide resident’s with opportunities to participate in day to day life. EVIDENCE: A sample of two care plans for residents was seen. The home uses a Person Centred Planning approach and records a range of ‘agreed working practices’ with individual residents, for example with regard to the provision of personal support. The care plans provided clear guidance for staff, covering a wide range of health and social needs, and included risk assessments. The home utilises a keyworker system and plans are reviewed monthly as a minimum. Evidence was seen of updates and regular reviews covering housing, health, relationships, activities, finances and communication. Person centred care plans were continually being developed, for example files contained a new format for describing individual’s likes and dislikes, aspirations and dreams which were translated into goal plans. Resident’s key workers 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 9 ensured that goal plans were monitored and any relevant outcomes or changes were recorded. Staff were observed supporting residents to participate in activities and daily routines in accordance with residents’ wishes and abilities. A record is kept of each residents’ participation levels and these are then collated every month by a designated member of staff. These figures were used to indicate fluctuations in residents’ levels of participation and when individual residents’ were most likely to take part in activities or to decline. If changes were noted then staff would look to identify any events or occurrences that might be affecting the resident. The manager reported that this was working well and it was evident that staff at the home had gained additional insight into residents’ personalities and preferences through this process. Risk assessments are included in resident’s care plans. These are drawn up with the involvement of residents, their families, and relevant professionals. Staff sign to say they have read and agreed each risk assessment. Examples of individual risk assessments were using public transport, travelling in the house vehicle, accessing the community, bathing, assistance with personal care and finances. Risk management plans were in place for each assessment and were signed and dated by the key worker. Dates for reviews were written on the plans and these were carried out annually, six monthly or as required. The manager checks that reviews are completed at staff supervisions. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 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 standard(s) 11, 13 and 17 Residents have opportunities to develop skills and be part of the local community and have their dietary needs and preferences catered for. EVIDENCE: Staff were observed to be supporting residents in maintaining their living skills and communication. For example residents were individually supported to take part in preparing their own snacks and meals. The home has a ‘communications representative’ selected from the staff team who attends meetings with representatives from other services in order to gather ideas for helping residents to communicate their thoughts, wishes and feelings. This exercise was linked to a continuing assessment of residents’ communication skills and needs. Residents are supported to access community services and facilities, such as adult education and social clubs, shopping trips, going to the cinema or to see a show and have a meal. The diary showed a planned social evening and barbeque that night at a local pub. The home has its own transport and residents also use their bus and taxi tokens. Some residents had recently gone by train to London. The staff rota is adjusted to provide flexible cover for resident’s activities, for example swimming. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 11 There was a choice of lunchtime menu and each day a different resident had one-to-one support in the kitchen to prepare his/her own lunch. A six-week rolling menu of varied main meals was also seen. The manager reported that menus had previously been sent to a dietician for advice and approval. Residents were observed having their lunch in the dining room or out in the garden as preferred. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 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 standard(s) 18, 19 and 20 The health and personal support needs of residents are well met with evidence of relevant professional consultation on a regular basis. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service user’s medication needs are met. EVIDENCE: Agreed working practices were in place for residents detailing how staff should approach assisting them with personal care. These sections of the care plans state which aspects of personal care resident’s can do for themselves and those which they require support with and also their preferences regarding who supports them, when and how. Staff were observed giving appropriate support and assistance in a friendly and respectful manner. Each service user is registered with a GP practice and the home liaises with the surgery on a regular basis. Annual health checks are carried out; and the home maintains links with care managers and other professionals. Specialist input is provided for residents concerning specific issues with physical and health needs, and this is documented in the residents’ files. Each file contains a health plan and medical profile that includes information regarding medical conditions and medication, consent arrangements, allergies, record of any healthcare treatments and appointments, professional and 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 13 relatives contact numbers. This information is organised for use in the event of an emergency hospital admission. The home had a medication policy and procedures for the correct receipt, recording, storage, handling, administration and disposal of medicines. Medication is kept in a secure cabinet and a monitored dosage system is in use. The inspector was informed that all staff have medication training provided by accredited trainers checked by United Response. The manager also completes a checklist in relation to each staff member’s competency in handling resident’s medication. The shift leader is responsible for ensuring that procedures are followed and a designated person ensures that medication supplies are received or returned at the right time. An additional precaution is taken through staff signing daily checklists that includes when medication is given throughout the day. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.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) 22 The home has a suitable complaints procedure to ensure that residents and other stakeholders’ views are listened to and acted upon. EVIDENCE: The home has a clear complaints procedure and this is available to all residents, their families, representatives and staff. The manager stated that a new procedure format was to be included in the home’s Service User Guide. A record is kept of compliments and complaints received by the home including any action taken and by whom. There had been no complaints in the time since the last inspection. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.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) These standards were not assessed on this occasion. EVIDENCE: 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 34, 35 and 36 Residents are supported and protected by suitable numbers of trained staff and the home’s recruitment and supervision policies and practices. EVIDENCE: Two members of staff on duty talked about worker roles and responsibilities. Staff have designated roles such as communications and activities and had given presentations to other homes, sharing good practice ideas. Staff commented that there was good team working and development of resident participation in the home. The manager expressed confidence in the staff team and each member’s knowledge and understanding of their work. The home operates a four-week rolling rota with a full complement of regular support workers. The rota indicated scheduled team meetings and the member of staff nominated to be in charge of the shift. The manager reported there is a minimum of two staff members on each of the early and late shifts and usually a middle shift. The manager is supernumerary and so is often available to provide additional support if necessary. A driver/handyperson is also employed at the home. Staffing levels at the time of the inspection were suitably matched to the service user’s needs and levels of activity in and outside the home. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 17 Through a sample check of three of the home’s staff records it was apparent that these were mostly up-to-date and complete, however two written references for one staff member were not available and are required. The manager phoned the area office immediately and requested copies to be sent. Copies were seen of staff member’s Criminal Records Bureau (CRB) checks, passports, birth certificates and interview records. Each file also contained the original application form, references, health, induction, training and supervision records. The manager discussed with the inspector issues around confidentiality and access to staff records during unannounced inspections when the manager might be absent. Staff training and supervision schedules were displayed in the office and relevant individual records were held on file. Training included statutory health and safety, first aid, food hygiene, moving and handling as well as prevention of harm, challenging behaviour and medication. The schedule clearly showed when refresher training was due for each member of staff. The staff supervision schedule and monitoring record showed that each member of staff had supervision with the manager every two months. The manager held individual supervision records in confidential files. Key worker responsibilities and work with individual residents were among the subjects discussed during supervision. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.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) 39 and 42 The home is further developing systems to obtain residents and other stakeholders’ views and has good systems to promote safe working practices. EVIDENCE: There is an individual approach to obtaining residents’ views, rather than holding resident meetings for example, and this is in keeping with the home’s person centred practices and complex individual needs of residents. The manager was also looking at several different examples of stakeholder survey questionnaires and to work in conjunction with other homes in developing a formalised quality assurance system. The manager reported that the organisation’s area manager conducted visits to observe working practices in the home. A social inclusion development (SID) group provides a forum for residents across and outside the wider organisation and an ‘inclusion day’ was arranged for August 2005 in Aldershot. Evidence was seen that the home promotes safe working practices. A record is kept of health and safety checks including fridge/freezer contents and temperatures, medication stocks and returns and checks for hazards on the 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 19 premises. Thermostatic mixer valves are fitted to taps and serviced every six months. Staff also check bath temperatures for residents. Staff have fire safety training and records were seen of fire evacuation practices during the day and night, extinguisher checks, emergency lighting and fire alarm servicing and portable electrical appliance testing. 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 20 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 x 3 x x x 3 Standard No 31 32 33 34 35 36 Score 3 x 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 85 Highfield Avenue Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 21 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 34 Regulation 19(1)(b) Schedule 2 Requirement Individual staff records must contain two written references relating to the person. Timescale for action 01/08/05 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 Good Practice Recommendations 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 22 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton Hampshire, SO15 1GW 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 85 Highfield Avenue H54 S11850 85 Highfield Avenue V226745 280605.doc Version 1.30 Page 23 - 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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