Inspection on 05/10/05 for 85 Highfield Avenue

This inspection was carried out on 5th October 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 28/06/05

85 Highfield Avenue 13/01/05

85 Highfield Avenue 15/07/04

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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 Inspection 5th October 2005 10:45 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 85 Highfield Avenue Address Aldershot Hampshire GU11 3DA 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) 01252 350677 United Response Ms Beverley Hilton Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2005 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 DS0000011850.V255427.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two annual unannounced inspections. This visit lasted approximately five hours, during which the inspector spoke with the registered manager, observed staff working with residents, viewed the premises and samples of the home’s care plans and other records. The inspector looked mainly at the key standards not assessed at the last inspection and therefore this report should be read in conjunction with the previous report. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements or recommendations made as a result of this inspection. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 6 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 DS0000011850.V255427.R01.S.doc Version 5.0 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 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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 home has thorough systems in place for continually assessing resident’s needs and aspirations. EVIDENCE: There had been no new admissions to the home since the last inspection. A Personal Support Assessment is completed for prospective residents and a copy of the care management assessment is obtained where applicable. Support Assessments are completed by key workers working with the residents, give step-by-step guidance for staff giving assistance and are crossreferenced to risk assessments. The assessments are also developed in conjunction with the previous care teams. Reviews are arranged within six months of the person moving in. Through discussion with the registered manager and looking at samples of care plans and records, it was evident that resident’s needs and aspirations were being continually monitored and assessed. For example, the home was in contact with the community learning disability team with regard to changes to a resident’s health and activities. Correspondence was on file showing that the home was requesting further joint review. Records were being kept of the individual’s mood and activity on a day-to-day basis; this information was then collated and sent to a healthcare professional. Risk assessments were being updated and information relevant to the person’s condition had been obtained for further guidance. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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): 7 The home supports residents to make informed decisions and staff are keen to continually develop ways of communicating with residents. EVIDENCE: In accordance with a Person Centred Planning approach, staff respect residents’ rights to make their own decisions. Staff were observed to provide residents with assistance and support to make decisions where needed; and evidence of this is also included in individual care plans as Agreed Working Practices. Flexible support is offered if a more structured day does not work for individual residents. Individual members of the staff team had been working with residents and other homes in the group on building up communication profiles. These staff had put together a presentation for the group that was to be developed as a training pack for the organisation. Staff reported that individual resident’s verbal skills, confidence and assertiveness had increased as a result of this ongoing work. It was evident through these discussions that staff were highly motivated and keen to develop and improve ways of supporting residents. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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, 15 and 16 The service is well organised in providing residents with opportunities for taking part in appropriate activities, maintaining relationships and being involved in the daily routines of the home. EVIDENCE: Residents have opportunities to take part in structured individual and group activities. These are recorded in their person-centred care plans and the home’s diary showed a wide range of activities taking place. For example, residents go to a sports centre, specialised outdoor day centres to do art, train trips and bowling, day services providing evening concerts, disco’s and barbeques. Residents were also supported to attend churches of their choice. At the time of the inspection staff and residents had been out to a music and dance group and were preparing decorations for a Halloween party, organised by the organisation’s Southern Inclusion Development (SID) group. Relationships with significant others are recorded in resident’s individual care plans. Resident’s can invite their family and friends over and visit them with staff support if needed. At the time of the inspection resident’s visitors were seen being welcomed by staff. Resident’s can also communicate with their 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 11 relatives and friends by telephone if they wish and send greeting cards. The home was continuing to support a resident to maintain a relationship from a previous placement. Care plans contain agreed working practices that involve residents in activities within the home that promote independence, such as household chores, laundry, and preparing their own meals. Staff were observed interacting in a friendly and respectful manner with residents, involving them in day-to-day activities and asking their permission before entering their bedrooms. The registered manager said that a resident brings the mail into the office in the morning where it is sorted, staff then assist residents as necessary with information such as bank statements and appointments. Residents were seen to be able to choose when to be alone or in company, and when not to join an activity. All areas of the home are open to residents with the exception of individual’s bedrooms which are private. The kitchen is kept locked when no staff are present as the result of a risk assessment. However residents were observed accessing the kitchen with staff and being supported to make drinks and prepare meals. There is a no smoking policy within the home and a smoking area for staff outside. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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): These standards were not assessed on this occasion. Please refer to the previous report of 28 June 2005. EVIDENCE: 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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 The home’s clear policies, procedures and staff training ensure that residents are protected from abuse, neglect and self-harm. EVIDENCE: The home had both the Hampshire and Surrey adult protection procedures and the organisational practice manual “Getting It Right” had set out company procedures for prevention of harm to service users. There is also a step-bystep in-house procedure to be followed by staff in the event of a disclosure or allegation of abuse. Staff receive training in the prevention of harm within six months of employment and this is updated every two years. Staff had recently undertaken a training update in understanding and managing challenging behaviour. This is also part of the core training for staff, initially as a two-day course followed up with annual one-day refresher training. Care plans contain information and guidance for staff about individual residents’ support needs and risk assessments. There is an organisational policy on challenging behaviour and physical interventions stating that United Response does not sanction any aversive physical intervention techniques. The registered manager confirmed that these were not used or necessary and said that any physical interventions would have to be specific to the individual and an agreed management plan would have to be in place. The home has daily procedures for looking after residents’ money. Staff were observed checking individually stored money and signing records confirming the balances were correct. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 14 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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 and 30 Residents benefit from living in a comfortable, hygienic and well maintained home. EVIDENCE: A tour of the premises was undertaken with a member of staff and the home appeared to be clean, safe and comfortable. Furniture and fittings were of a good quality and suitable for meeting residents’ needs. Adequate private and communal space is provided for each resident; and all areas within the home are accessible with level internal thresholds. There is a sensory area on the upper landing. A well-maintained garden area provides seating space and this is being continually improved by the staff who tend it. A record is made of all repairs needed and completed. Staff do regular checks of the premises and any defects are reported to the housing association responsible for repairs. The contract for this arrangement had recently changed to a new provider. Staff reported that repairs were being completed following a water leak, a new water system had been installed and thermostatic mixer valves had been replaced on all hot water outlets. There were plans to replace the bathroom flooring. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 16 The laundry area is situated away from areas where food is prepared, stored or eaten and there are individual laundry cupboards for each resident. The floor had an impermeable finish and the walls were readily cleanable. Staff reported that a new washing machine was on order. The home had infection control procedures in place, including the use of protective clothing and colour coded mops and buckets. Staff are aware of the risks of cross-contamination and said that mop heads are washed every twenty-four hours. Health and safety training is part of the induction training undertaken by all staff at the company’s head office prior to employment at the home. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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): 34 and 35 Residents are protected by the home’s thorough staff recruitment and training policies and practices. Staff training provision is excellent and exceeds the standard. EVIDENCE: A previous requirement that written references for one member of staff were kept on file had been met. Recruitment records for a new member of staff were seen and these contained all the required information. Records are kept of staff member’s Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks, passports, birth certificates and interview records. Staff files also contain the original application form with employment history, references, health, induction, training and supervision records. A new format had been developed for requesting references and this was designed to encourage a swift response from referees through being easier to complete, while still providing all the relevant information. United Response has a core training programme and a national attendance policy to ensure that staff have the necessary knowledge and skills for the work they do. A regional training budget is provided to equip all staff with relevant training. A Southern Area training calendar was in place and included health and safety, medication, food hygiene, first aid, moving and handling, challenging behaviour and prevention of harm. A plan of training for individual 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 18 members of the staff team and their training certificates were available. Staff also undertake NVQ awards following their induction. There is a structured induction process based around the Learning Disability Award Framework (LDAF), that includes new staff shadowing experienced staff and completing the core training programme before working alone with residents. The registered manager confirmed that any specialist advice, training and information which fell outside of core training requirements was sought from professionally qualified people. A regional training database informs service managers and staff of forthcoming required updates to training. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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 Residents and staff benefit from a well run home and the leadership of the registered manager. EVIDENCE: The registered manager has significant experience in managing the service; had recently completed her NVQ4 Registered Managers Award (RMA) and was now going on to obtain an NVQ4 in care. She also undertakes periodic other training to maintain and update her knowledge; and is aware of her responsibilities with regard to the Care Standards Act and Regulations and other legal requirements. Throughout the inspection, the registered manager was observed to be approachable and accessible to residents and staff. The registered manager receives supervision and support from an area manager who visits the home regularly. 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 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 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 4 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 85 Highfield Avenue Score X X X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000011850.V255427.R01.S.doc Version 5.0 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. Standard Regulation Requirement Timescale for action 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 85 Highfield Avenue DS0000011850.V255427.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton 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. 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