Inspection on 07/06/06 for 87 Hazel Avenue

This inspection was carried out on 7th June 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

87 Hazel Avenue 27/11/08

87 Hazel Avenue 15/02/06

87 Hazel Avenue 01/08/05

87 Hazel Avenue 29/11/04

87 Hazel Avenue 28/06/04

87 Hazel Avenue 09/02/04

Similar services:

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

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

CARE HOME ADULTS 18-65 87 Hazel Avenue Farnborough Hampshire GU14 0DW Lead Inspector Debbie Oliver Unannounced Inspection 7th June 2006 10:30 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 87 Hazel Avenue Address Farnborough Hampshire GU14 0DW 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 371 730 www.new-support.org.uk New Support Options Limited Ms Lynda Anne Young Care Home 5 Category(ies) of Learning disability (5), Physical disability (3) registration, with number of places 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: 87 Hazel Avenue is registered to provide care and accommodation for five people with learning disabilities between the ages of 18 and 65 years. The home is a purpose built bungalow, located within a mile and a half of Farnborough town centre and is managed by New Support Options Ltd. All service users have their own single bedroom and share the use of the lounge, kitchen/diner, bathrooms and garden. On the 7th June 2006 the fees for the home ranged from £1219.14 to £1244.26 a week. Information about the service provided at the home would be made available to potential service users by providing a copy of the home’s service users guide and statement of purpose. A copy of the last inspection report is also available in the home. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was unannounced beginning at 10.30 and finishing at 17.15. During the visit, records and documents were examined, an opportunity was taken to tour the premises and staff working practice was observed. Two staff members and the manager were spoken to. Due to the nature of the service users’ disabilities it was quite difficult to talk to them but observation enabled the inspector to gain a better understanding of how the needs of service users were being met. On the day of the visit all six service users were at home at some point during the visit. At the time of the visit there were no vacancies with six service users being accommodated, all male. There was one service user who has family from Jamaica and is Afro Caribbean. A pre-inspection questionnaire was received prior to the visit. What the service does well: What has improved since the last inspection? Each service user now has detailed care plans and risk assessments with regular reviews showing how they should be supported. The manager is in the process of obtaining quotes for new flooring in the hallway. The service user who paid for the flooring in their bedroom has been reimbursed by the organisation. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 6 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. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 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 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home’s systems and procedures for identifying the needs of existing service users are satisfactory. EVIDENCE: The home has had no new admissions and during the last visit it was evident through the assessments sampled that the assessed needs of service users are being met. It was seen that each service user has a handbook detailing information that they need including; what you pay for, your rights, your responsibilities and if you are unhappy. This is pictorial and includes pictures that are prominent to the individual such as photographs of themselves and the home itself. As there were no new admissions and the current service users have lived in the home for many years the assessments were not viewed on this occasion. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a clear and consistent care planning system in place, which provides staff with the information they need to satisfactorily meet service users’ needs. Service users are also able to make decisions about their lives. Risk assessments are in place and ensure service users are able to take risks as part of an independent lifestyle. EVIDENCE: Three service users were case tracked and the information available detailed what support an individual requires with regular reviews in place showing the information is current. Each service user has quality standards to be achieved including accessing the community four times a day, but there was not always the evidence to show this was happening. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 10 It was discussed with the manager that the plans could be centred with information evident to indicate how the plans people such as whether aspirations are being attained The that all plans are being developed to become more person more person are working for manager confirmed centred. During the visit one service user requested a cup of tea using gestures. This was easily understood and responded to. Another service user was able to manoeuvre their wheelchair and access parts of the house as they wished. Some service users also had a communication passport in their plans indicating how they make their wishes and needs known. One staff member spoken to said service users make decisions on a daily basis using pictures and objects of reference. The manager stated she had tried to access advocacy services but this is limited in Farnborough, this was also confirmed by the area manager. Evidence was seen within the files to support that risk assessments are available and that service users are supported to take risks including having unlimited access to the kitchen and going out on activities. There was also a risk assessment in place for the use of bed rails and the documentation was appropriate and showed inclusion of all relevant parties. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users have opportunities to engage in suitable activities and are part of the local community, so promoting independence and choice. Contact with families is well supported, and nutritional needs of service users are well managed. EVIDENCE: There is an activity plan detailing activities undertaken and during the visit one service user was out with their community support worker having lunch and a haircut and another was at a painting and music activity. It was also detailed in daily diaries activities such as aromatherapy, walking to the shops and spending time in the garden smelling and looking at the plants. One staff member spoken to said they take service users out on public transport and have shown one service user how to use a bus. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 12 There is one service user who has family that originated from Jamaica and the staff work hard to gain information relating to his culture such as the local Afro Caribbean society. Additionally the service user has developed a relationship with another service user from another home who is Afro Caribbean. The manager confirmed that some service users have positive contact with family members and pictures of their families were seen in their bedrooms. It was evident throughout the visit that service users’ rights are respected such as being addressed by their preferred names as indicated in their plans. Additionally staff were seen knocking on bedroom doors before entering. Keys are also kept in individual’s bedrooms. The menu was seen and offered a varied and nutritious diet and staff also confirmed that alternatives are available if needed. It was discussed with the manager the pictorial menu did not display the menu relating to the day of the visit. It was also noted that a student nurse was assisting a service user with their lunch and although she talked to them throughout and told them what they were eating, she was stood up and so was not at eye level. Additionally it was written in the plan that the service user could eat with minimal support yet the student nurse was feeding the individual. This information was discussed with the manager. Each service user had a nutritional assessment and as they showed no level of risk this information could be archived. Service users were seen to be enjoying the food offered to them during the visit. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The personal, physical and health care needs of service users are well met and there are good systems in place that ensures the medication needs of service users are also met. EVIDENCE: Care plans showed how service users like to be supported in regard to their personal care. The manager confirmed service users have access to health care professionals but agreed evidence needs to be documented in the plans. The chiropodist was visiting on the day and stated she enjoys coming to the home and feels service users are very well supported. The home has a policy on medication and a copy of The Royal Pharmaceutical Society Guidelines. It was stated in the pre-inspection questionnaire that the policy remains unchanged and it was therefore not viewed during this visit. There was a medication cabinet and the storage of medication was 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 14 satisfactory. All the relevant documentation was in place relating to receiving, administering and disposal of medication and the inspector viewed this, although there were some gaps to indicate staff signing to say they have administered medication. The manager confirmed staff have been spoken to regarding this matter. It was also discussed with the manager that the recording of the receipt of medication could be put onto the MARS sheet rather than using additional documentation to record this information. There is also clear documentation in place for the use of ‘as required’ medication including how service users show they are in pain or need ‘as required’ medication. All staff have received the one day drug administration course run by the organisation and then yearly updates happen within the home. None of the service users in the home self-administer or receive controlled medication. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Arrangements for protecting service users and responding to concerns are satisfactory. EVIDENCE: The home has a complaints procedure containing the relevant timescales and stages and this is also available in pictorial format suitable for the service users living in the home. Staff spoken to were clear on what to do if they received a complaint or had a complaint themselves. Most staff have received training on adult protection with the exception of the newest staff members. The manager is awaiting dates for this training. Staff spoken to were clear on the procedure to follow in the event of suspected abuse. The home has all the relevant procedures and policies and the manager demonstrated their knowledge and understanding of the policy. The money for service users was also being checked during the visit and all the relevant paperwork was in place. It was confirmed by the Regional Director that since the last inspection the service user who paid for the flooring in their bedroom has been reimbursed by the organisation. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 16 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Service users live in a clean, hygienic home that generally meets their needs, however the identified deficiencies could compromise the safety and comfort of the service users. EVIDENCE: The inspector toured the premises and since the last inspection the organisation continues to work with the Housing Association to complete the work in the shower room. They are also in the process of obtaining quotes so if the Housing Association remains uncooperative they will look to complete the works themselves and then charge the Housing Association on completion. The manager confirmed written confirmation would be sent to the Commission on completion. The manager is also in the process of obtaining quotes for new flooring in the hallway as there are many stains on the carpet and there is also a faint smell of urine. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 17 There was also some discussion regarding one service user’s bedroom that was very bare. Although the service user chooses to have limited ornaments and pictures some thoughts should be given to see how the room can be brightened up such as painting pictures directly onto the walls. There was adequate living space for the service users living there; the premises were bright with adequate lighting and ventilation. The home has an infection control procedure and protective clothing was readily available and staff were observed using it appropriately. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 18 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, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home has procedures and systems in place to ensure staff are properly recruited and that there is always enough staff on duty. Staff training is appropriate and ensures staff have the necessary skills and knowledge to meet the complex needs of service users accommodated in the home. The regular supervision for staff ensures they are well supported. EVIDENCE: From observation and discussion with staff members, they have built good relationships with service users and have a good understanding of their behaviours. The manager confirmed two permanent staff and one bank staff have completed a National Vocational Qualification and another bank staff and permanent staff are about to start. All staff are also about to start the Learning Disability Awards Framework (LDAF). Training records were viewed and showed staff have undertaken training in food hygiene, manual handling and first aid. They have also completed training 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 19 suitable to the needs of the service users living in the home such as training on person centred plans and listening and enabling training. The staff member spoken to felt the training they have received was extremely useful and helps them to do their job. In the pre-inspection questionnaire the manager has stated that the training needs have been forwarded to the training department and they are awaiting dates and availability. There was adequate staff on duty at the time of the visit and staff spoken to confirmed this. The inspector sampled two staff files and they contained all the necessary information relating to recruitment. One staff member only had one reference but had worked in the home for nine years. The manager confirmed that the staff members who require a work permit have one. All staff receive supervision on a monthly basis and staff that supervise have received the relevant training. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The management of the home is organised and efficient. The views of Service users and that of their families are taken into account for the review and development of the home. Staff training and practices in the home ensures the health, safety and welfare of service users are fully promoted. EVIDENCE: The registered manager communicates a clear sense of direction and leadership through staff meetings, staff supervision and makes herself available to support service users and staff. The staff meeting minutes were seen and showed clear instructions to staff on areas relating to medication and care planning. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 21 All staff have been trained in fire safety and all other fire checks have been tested in March 2006 as written in the pre-inspection questionnaire. Each service user also has a risk assessment in place in the event of a fire. The area manager recently undertook a management audit and this included looking at servicing of equipment and fire checks. Staff spoken to were clear on their role in relation to health and safety and had received the necessary training including health and safety, first aid, and food hygiene. Systems are in place to review and monitor the service including monthly visits from the area manager, a copy of which is sent to the Commission. One staff member spoken to said they are asked their views as part of the regulation 26 visit. The daily diaries are also used as a monthly audit to gain the views of service users in areas such as activities and care plans but it was agreed this information needs to be clearer and more detailed in the diaries. Surveys have been sent to service users and their families and the results from these are made available to whoever wishes to see them. The regional director would respond personally to any particular areas of concern raised. There is also a regional advisory forum for service users and families and this is attended from various services in the organisation. There has also been some discussion for another service user to visit the home and work with the service users and report as to how they feel the people living in the home are supported. The accident book was seen and any accident is filed in the appropriate service user’s file or staff file but it was discussed with the manager there is no way of looking at the accident file and seeing what accident has happened as there is no correlation between the accident book and the accidents filed away. 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 23 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 (2 ab) Requirement The registered person must ensure that repairs to the floor, wall tiles and radiator in the shower room are carried out. This requirement is repeated, as the previous timescales of 1/8/05 and 31/03/06 were not met. Timescale for action 07/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overlie 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. Extracts may not be used or reproduced without the express permission of CSCI 87 Hazel Avenue DS0000012086.V291755.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!