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Inspection on 27/11/08 for 87 Hazel Avenue

Also see our care home review for 87 Hazel Avenue for more information

This inspection was carried out on 27th November 2008.

CSCI found this care home to be providing an Adequate service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 87 Hazel Avenue 87 Hazel Avenue Farnborough Hampshire GU14 0DW     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Damian Griffiths     Date: 2 7 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 87 Hazel Avenue 87 Hazel Avenue Farnborough Hampshire GU14 0DW 01252371730 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Dimension (NSO) Ltd care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home First registered in May 1994, 87 Hazel Avenue is a care home offering accommodation for up to 5 persons with a learning disability/physical disability.The purpose built bungalow which is situated within 1.5 miles of Farnborough town centre is managed by New Support Options Ltd , now known as Dimensions, who are also responsible for a number of similar facilities across the south of England. All service users are accommodated in their own single bedrooms. Shared /communal space includes a lounge, kitchen/diner,bathroom fitted with a special bath and garden. Care Homes for Adults (18-65 years) Page 4 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was unannounced and took place over seven hours.The inspection was carried out by Damian Griffiths regulation Inspector. CSCI had been informed that the Registered Manager was on leave; therefore the Senior Support Worker (SSW) represented the establishment. It was necessary to arrange another short visit due to information not being available.The area manager was present during the second inspection. A full tour of the premises took place and a number of documents and files including, three service user care plans, staff recruitment files, quality assurance information and the annual quality assurance assessment (AQAA) were examined as part of the inspection process. Care Homes for Adults (18-65 years) Page 5 of 30 The Inspector would like to thank the home, service users and care support staff for their time and hospitality on the day of the inspection. The views of service users and care staff are included in this report. Some details have been changed to ensure confidentiality is maintained. Weekly costs ranged from; One thousand two hundred and thirty-seven pounds to One thousand two hundred and seventy-five. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 7 of 30 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes Service User Guide was available to all new and existing service users was very helpful and contained useful information in an easy to read format. New service users received a full care needs assessment before moving into the home to ensure that thier care needs could be met. Evidence: Information about the home was available in the service user guide and the homes statement of purpose. The information contained in the guides included digitalised photographs of care staff and service users, pictorially descriptive information about the home and conditions of residency. On the day of the inspection there were four service users living at Hazel Avenue. One of service users was at the home on a shortterm basis. Pre admission assessment documentation involving the most recent service user and two existing service users was inspected. The service users had received a thorough assessment of their care needs and aspirations prior to moving into the home. The assessed care needs included details about the service users; health, personal care and abilities, family and personal background information. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: Detailed information was presented in a service user friendly way to describe; likes and dislikes and preferences. The SSW advised that a fith service user may be joining the home in the future. A service user at the home commented that everything at the home was okay. Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had compiled informative and up-to-date care plans to ensure that service users care needs were being met safely and in the way they preferred. Evidence: Three CSCI surveys were completed by care staff and confirmed that they were given up-to-date information about the needs of the people they supported. Care staff interviewed on the day of the inspection had been working with service users for many years and were very knowledgeable about their care needs. The homes AQAA had stated; due to the people we supports lack of verbal communication we put as much variety into their lives through activities, visits, food etc and by observing their reactions so we can ascertain what they like and dislike. The three service users care plans inspected were amongst a number of other care realted documents within large care plan folders. Care staff commented that it was Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: difficult to access information they required easily due to the sheer volume of records contained in each care plan folder. Detailed assessments of care needs support and service user preferences had been recorded and were present in each service users care plans. Records of the days events had been recorded in a diary book detailing the days events and included sections for recording evidence of; what the service user had to eat, what activities they had done, problem areas, outcomes and other important aspects of the service useers daily life, this corresponded with details found in care plans and care need assessments and confirmed the homes AQAA statement. The diary formed an excellent record of what was successful and what was not, however the information was often inconsistent and did not follow the procedures and guidlines included in the diary book. The SSW agreed that there was too much information contained in the care plan folders and confirmed that the home would be reviewing the daily diaries and consider using a summary of the service users care plans in order to make it easier for new and part-time care staff to update their information. A service user who had no planned activities for the day was observed relaxing in his room listening to music. Staff were interacting confidently with him and in a respectful manner. Another service user stated that he wish to go shopping and was observed going out to the shops. All care plans contained a pictorial account of service users care needs and were recorded, usually by the service users link worker, in an easy to read format such as; likes and dislikes and yes and no questions. One service user and their link worker had produced their own care plan on a DVD. This illustrated a innovative approach and willingness to embrace new technology within the home and strengthening working relationships in a fun way. Risk assessments had been completed and covered a range of service user activity and care support tasks. A service users visits to church and an excursion to the coast had both been assessed. Service users requiring support with eating had also been thoroughly assessed for risk such as; eating the food too quickly and risk of choking. As a consequence every meal had been carefully prepared to ensure that only a small amount of food was available throughout the meal for this service user. Care Homes for Adults (18-65 years) Page 13 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users were supported to take part in regular and meaningful activities in keeping with identified needs and wishes and were supported to keep in contact with family and friends. The home ensured service users were supported in a sensitive way and that they received a varied and balanced diet. Evidence: Care plans located within the care plan folders were up-to-date, informative and completed in picture form to assist service users. Likes and dislikes were well recorded including day and night time routines detailing care staff support for example; how to help service user in and out of his wheelchair. As stated in the previous section there was a variety of methods used to record important information, including a Programmed Action Plan detailing how best to assist each service user to achieve a good outcome with all activities. The diary book also gave a good account of the Care Homes for Adults (18-65 years) Page 14 of 30 Evidence: services users daily activities some of the activities reorded included; swimming, shopping and visits to the local pub. Other activities demonstarted the homes awareness of service users cultural and religious needs being met on a regular basis. This was confirmed by one of the service users consulted who enjoyed going to church. Service users families/relatives were always made welcomed and included in all significant events. Care staff adopted a sensitive approach when supporting service users dealing with family matters;for example, when families were not able to visit as much as the service user would have liked them too. Care staff were observed in conversation with a service user confidently steering him away from this family topic, as was explained by the SSW that the service user had difficulty understanding this issue. Mencap community workers visited the home to ensure service users received independent support to access the local community and places of interest and supported the homes statment in the AQAA in the section titled;We Could Do Better; Introduce circles of support and continue to increase community preference. A service user consulted said his favourite foods were; fish and chips, treacle tart, baked beans and cheese, despite this, the home ensured that service users received a range of healthy and nutritional foods on a regular basis. In order to help the service users chose exactly what food they wanted a selection of books containing pictures of, vegetables, fruit and meat were easily accessible in the kitchen area. Diary records showed that service users were regularly able to participate when meals were cooked. The diary had recorded that the service user observed the meal being cooked. It was not evident how this benefited the service users or whether they had been assisted to cook their own food at any time. Care staff were observed confidently assisting service users during lunch. Care has been taken to record how best to assist each service user, reduce risk of harm and promote their health and welfare. The recording of service users food preferences however had not been consistently recorded in the diary as required by the homes own practice guidance. This was discussed with the SSW who confirmed that the diaries would be reviewed. Care Homes for Adults (18-65 years) Page 15 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal, physical and healthcare needs of service users was respected and recording systems in place ensured service users medication needs were met. Evidence: The homes AQAA stated that; all persons we support have active health plans, risk assessment and guidelines in place. There was comprehensive information relating to service users health care needs. Service users health care books were also to be found in the care plan folder and showed evidence that they had received an assessment of their healthcare needs. A pictorial interpretation had been provided to service users in order to make clearer the questions being asked. The outcome of the answesr was not always clear and some of the questions were of no consequence as they related to the opposite sex. This was a useful tool to establish how the service users required help and assistance but would benefit from a review to ensure that it was personalised and relevant to each individual. The homes AQAA confirmed that service users received; regular contact with the community learning disability team, to, ensure emotional and physical needs of the people we support and deal with. There was evidence in place to support the AQAA statement, details of GP visits and input from health care Care Homes for Adults (18-65 years) Page 16 of 30 Evidence: practitioners could be found throughout the health care plans. An innovative approach summarising each service users health care needs had been put into effect by the design of Grab Books containing essential healthcare information needed in the event of an emergency hospital admittance or GP intervention. These books were stored in the managers office but some staff were not aware of them. It was difficult to identify the grab books amongst the other books and folders on the shelf as they all looked the same. The SSW agreed that the grab books were not clearly labelled or identifiable. This was also brought attention of the area manager during the second inspection visit as the situation had not changed. The area manager confirmed that the files would be made more visible and staff made aware. Medication administration records (MAR) detailing service users prescribed medication had been accurately recorded as directed by the GP. The home had ensured that ample information about the medication being dispensed was available to care staff and this was located alongside the MAR. Care staff were observed dispensed medication carefully and safely to each service user. The homes medication return records however were incorrect and there was evidence to show that some of the medication in storage had not been recorded in the drug returns book. The SSW was present during inspection and was unable to account for two,loose, tablets found in the medication cabinet. The amount of medication discovered was very small and easily overlooked however it indicated that medication kept on the premises needed to be overseen by the senior/manager on a more regular basis. The SSW confirmed that regular medication reviews would be forthcoming. Care Homes for Adults (18-65 years) Page 17 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was committed to enabling service users their families and representatives to express their views, complaints and concerns and actively work to ensure service users health safety and welfare were safeguarded. Evidence: There was clear indication in the service users guide and notices throughout the home in pictorial form, indicating how to make a complaint. Care staff completing the CSCI survey all agreed that they knew what to do if the service user, relative or friend had concerns about the home. One care worker commented; we keep information about who they contact clearly available at all times. The home acknowledged the difficulty for service users wishing to express their discomfort or unhappiness. The AQAA stated in the section titled; What We Do Well, confirmed that there was; A stable core of senior staff who understand language and communication methods of the people we support. Care staff were extremely knowledgeable and able to interpret the care needs of each individual service user at the home. The specific form of communication chosen by the service user could be found amongst the wealth of information in the care plan folders. Care staff completing CSCI survey commented in the section titled; Do You Know What to Do if the Service User, Relative,Adovcate or Friend Are Concerned about the Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: Home,stated; Arrange a meeting with the advocates ASAP to discuss the worry or problem in hand and try to understand and sort it out making it better for both parties. The homes AQAA stated that it had received no complaints in the last 12 months, this was confirmed during inspection. As stated, care staff were aware of noticing signs of distress displayed by the service users and were also aware of what to do in the event of there being safeguarding concerns. Service users all required help with their personal cash accounts.A small amount of money was available to each service user . Care staff were observed helping a service user returning from a shopping trip. His money was recorded in a individual receipt book and signed by two staff members. The home had recorded in the AQAA that its policy and procedure titled; Safeguarding Adults and the Prevention of Abuse, was last reviewed in 2005 and there was no evidence in the training files to indicate that care staff had attended any recent safeguarding training other than that received by new care staff as part of thier induction programme. It is recommended that the home review care staff attendance of safeguarding training and update its policies accordingly. Care Homes for Adults (18-65 years) Page 19 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefited from living in a purpose-built home that was completely wheelchair accessible and situated close to town and reasonably clean and tidy. There were some concerns relating to health safety and hygien requiring attention. Evidence: A tour of the premises confirmed that, overall the home was clean and tidy but showing signs of everyday wear and tear requiring attention. The fence at the front of the house supporting the gate was in poor condition due to wet rot making it difficult to open. The homes SSW and area manager were aware of this advised that it would be replaced. The homes garden area situated at the rear of the premises appeared to be in good order and contained a summer house that had been won by service user in a competition. The kitchen was well-designed and offered a safe environment for service users to observe cooking activities without being exposed to potentially dangerous cooking implements. The kitchen was divided into two halves by a broad worktop separating the cooking and dining areas. There was considerable wear and tear to the small door attached to the worktop that ensured security. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The hallway area was equipped with specially designed equipment to stimulated sensory awareness. The area provided a versatile space for service users activities. Service users bedrooms were clean and tidy and reflected their personality with pictures and important personal objects arranged on walls and furniture. The laundry area contained a washing machine with sluice facility with a range of essential cleaning cycles. Service users laundered clothes were well organised and the area was clean and tidy. There were hand washing facilities situated in this area with liquid soap and paper towels. The home was owned by a housing association. The AQAA stated in the section titled; What We Could Do Better; follow up on dialogue with the housing association maintenance issues weekly to get work completed quickly. There was evidence that the home needed to apply this action as soon as possible particularly in the shower room area. Due to constant use and failure to dry and air sufficiently after using the shower room was particularly malodorous. Water had not been mopped up after use and the extractor fan, in good working order, had not been used. Evidence of past neglect and hygiene practices were evident in the buildup of black mould found covering the lower part of the shower stall where service users had their shower. There was also three tiles missing on the wall above the radiator. The floor was in good condition. The homes AQAA did not mention any of these maintenance issues. The shower area may compromise service users health and safety if left in its current condition. The showere room continues to be an area that the home finds difficult to remedy as it has featured in the last two key inspection reports.The home was committed to providing good quality outcomes to its service users and confirmed that they would be addressing this problem but in light of previous difficulties a requirement has been made. Care Homes for Adults (18-65 years) Page 21 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were supported by competent staff and there were thorough recruitment procedure in place. Training and development arrangements at the home ensured residents needs were met. Evidence: On the day the inspection there was a mix of permanent and care bank staff available to support service users. Care staff were observed to be very approachable and sensitive to the service users needs,quite often intervening withour being promted. The care bank staff employed by Dimensions confirmed that they enjoyed the flexibility and choice of homes open to them. Care bank staff consulted had been working within the organisation for many years and had built up a good knowledge of the service users care needs. Care staff demonstrated excellent communication skills matching the detailed assessments found in the service users care plan. The homes AQAA stated that two out of six permanent care staff had attained level 2 of the National Vocational Award (NVQ). The SSW in charge, had not attained a level 3 NVQ. We were advised that two SSWs were working towards their level 3NVQ awards. The SSW acknowledged that the home promoted professional development. CSCI surveys received from staff agreed that they met regularly with the manager to Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: discuss how they were working. The personnel files of three care staff including two new care staff were inspected for evidence of appropriate recruitment procedures. Criminal Records Bureau (CRB) notifications had been received for all care staff,references and evidence of identity such as, birth certificates, driving licences and home addresses had been supplied. Care staff with driving responsibilities had provided up-to-date insurance documentation. Care staff completing CSCI survey confirmed that they had received training that was; relevant to their role, helped them understand and meet the individual needs of the service users and that the home kept them up-to-date with new ways of working. Training programs were in place and a range of training relative to meeting the needs of the service users was in evidenc and included; epilepsy awareness, makaton, autism awareness, person centered planning and challenging behaviour. A range of health and safety-related training programs had also been attended by staff these included; health and safety, safe manual handling, food hygiene and emergency first aid. Care Homes for Adults (18-65 years) Page 23 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Outcomes for service users were good despite there being problems with recording and accessing information. Arrangements were in place to monitor the quality of service provided. Health and safety records and general home maintenance were in need of review to ensure the wellbeing of the service users and care staff. Evidence: CSCI had been informed of the registered managers absence earlier in the year and she was expected back in the near future. There was evidence of innovation and creative use of recording such as use of DVDs and of the Grab Books devised by the home. All records were in a pictorial form demonstarting a keen awarness of the communication difficulties experienced by the service users and it was evident that service users were well cared for. There was only one major area of concern that related to the overall maintence of the home and the condition of the shower room. The need for better recording and administrative practices were relatively simple to overcome with the experience care staff employed at the home and the support given Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: by the area manager. The SSW in charge was doing the job to the best of her ability but there were inherent failures accessing docmentation only to be found in the homes computer that wasnt working. This most cetainly contributed to the recording and administrative problems . The SSW and area manager confirmed that the computor system had not been working for the past two months and was still unresolved. The record keeping in all areas required improvement as did the need for IT support and for evidence of SSW supervision. Staff training , overall was good and focused on the needs of the service user in most areas, but, safeguarding policies, procedures and practices needed updating. The inspection of personnel files could not be completed because the SSW did not have access to the locked filing cabinet. It was therefore necessary to arrange another visit to the home with the area manager who had access to the cabinet containing the personnel files. Only three CSCI surveys returned from the home that had been sent out to service users, their relatives and social and healthcare practitioners however the Dimensions organisation had completed its own quality audit (QA) at the home. As in all the documentation inspected at Hazel Avenue, the home had ensured that it was in a pictorial format for the benefit of the service users. The QA was dated and contained the results of the survey in areas titled; my home, my support, my family friends and community, my day and my life. The majority of the areas surveyed showed that the service users experienced good outcomes at the home. The dimensions organisation were firm believers of promoting service users and seeking to obtain their views. The Everybody Counts in the South conference was held in June and regional representatives from the homes took part. The training records that were available showed evidence that care staff had received Health and Safety training including food hygiene and the home was clean and tidy in most areas. Accident recording procedures were in place and chemicals that posed a risk to service users were safely locked away. As stated in previous sections of this report there was a need for routine maintenance and decoration at the home. There was however no apparent reason why the home had not attended to basic good hygiene practices to keep the shower room clean, fresh and in good condition. A WC used primarily by care staff and had an ordinary light switch instead of a pull cord creating a minor risk of electrocution if used with wet hands. There was a need for attention to fire safety recording as records of fire safety procedures were incomplete. This section did not meet the health and safety needs of the service users at the home. Please see the environment section of this report. Care Homes for Adults (18-65 years) Page 25 of 30 Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The home must make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The home manager and SSWs must ensure that the medication cabinet is regularly checked to make sure that medication stored is fully recorded and accounted for. 09/02/2009 2 30 23 Fitness of premises; That 09/02/2009 the premises are kept clean and reasonably decorated and free of any unnecessary hazards to health and safety including the need for up-todate records in this area. Maintenance was required to the front gate,kitchen and shower room to ensure that the premises were kept clean, safe,hygienic and free Care Homes for Adults (18-65 years) Page 28 of 30 from offensive odours throughout. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 23 That the home review safeguarding training to ensure that care staff are up-to-date with their practice and an update its policies accordingly. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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