Inspection on 24/10/05 for 89 Hastings Avenue

This inspection was carried out on 24th 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

89 Hastings Avenue 22/02/07

89 Hastings Avenue 10/01/06

89 Hastings Avenue 14/03/05

89 Hastings Avenue 12/10/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 89 Hastings Avenue Margate Kent CT9 2SQ Lead Inspector Brenda Pears Announced 24/10/2005 at 09:30hrs The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 89 Hastings Avenue Address Margate, Kent. CT9 2SQ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01843 232767 01843 232952 Seenquiries@sense.org.uk Sense South East Vacant Registered Care Home 4 Category(ies) of Physical Disability & Learning Disability registration, with number of places 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 89 Hastings Avenue is a purpose built Home that is registered for 4 people with a physical disability. The Home is situated in a residential part of Margate and the young people living there are supported to use facilities in the community. Day Programmes are organised on an individual basis. Staff either have, or are learning British Sign Language at various levels. Public transport is close by as are local amenities and access to facilities in the community. There is wheelchair access to the front and rear of the building plus a large car park to the front with ample parking space and on street parking is also available 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection and the inspection consisted of speaking with staff members and service users. The methods of inspecting the home included checking records, tracking service user care plans, observations and a tour of the building. The focus of this inspection was on the core standards and on the quality of life for service users. The Home was found to be clean, bright and free from odours at this inspection. As part of the pre-inspection process, service users and relatives were consulted for their views of the home. Families returned their comment cards, providing valuable feedback about the home, which helped in the planning of this inspection. Service users who were at home at this time were fully included in this inspection. The Home operates in a relaxed, friendly and comfortable way. The service users are at the centre of any activities and their opinions and preferences are sought on all matters. What the service does well: What has improved since the last inspection? What they could do better: While service users are consulted on how they undertake each day, staff do not always support every conversation with British Sign Language in the presence of service users. To ensure full inclusion and to enable service users to participate in discussions where they are present, staff are expected to sign 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 6 at all times. This is ensuring full inclusion and control for all service users, while promoting independence and autonomy at all times. 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. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 standard(s) 1 &2 A Service User Guide and Statement of Purpose have been produced in line with appropriate guidelines. Formats have been produced as required by each individual and these have also been supported by discussions, providing much needed information for new and current service users. Pre admission assessments are undertaken providing due consideration for the care required by all service users and reviews are regularly undertaken, ensuring appropriate support is provided at all times. This is also recognised as an important process for the people already living in the Home and their opinions are sought regarding any new person being admitted. EVIDENCE: Documentation has been produced in various formats to meet the needs of service users. The organisation is currently in the process of developing a video that encompasses both these documents and policies with sign supported English. Assessments are undertaken by senior staff and also with relevant health care professionals such as speech therapists, physiotherapists and psychiatrists prior to any admission into the home. Files contain clear goals that are agreed prior to being set and person centred plans contain clear information of aspirations, life history and the level of support required 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 standard(s) 6, 7 & 8 All activities are undertaken following discussion with each service user, supported by appropriate staffing levels, ensuring choice and autonomy at all times. While choices are obtained in all areas, staff do not support all discussions they undertake with British Sign Language, causing service users to be excluded from these discussions. Detailed service user plans have been developed and are reviewed regularly to support any changing needs. EVIDENCE: Staff members ensure the wishes of service users are sought and that inclusion is undertaken regarding decisions in the home. This was evidenced at this time by staff constantly asking the preference of the service users present, however, while service users are consulted on how they undertake each day, staff do not always support every conversation with British Sign Language. The handover meeting is carried out in the dining/kitchen area where service users are present and staff do not currently sign all discussions when in the presence of service users. This excludes service users and does 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 10 not allow participation in these routines in the home. Also, this practice does not support new members of staff to develop good use of signing or encourage the full use of British Sign Language at all times. If discussions are confidential in nature, these must be undertaken in the office and not with service users present. When in the presence of service users, however, staff are expected to sign at all times to allow every person present to be included and to inform everyone what is being discussed. Realistic goals are set and monitored with service users and appropriate advocates, who are chosen by the service user themselves. Choices are given at all times with each day being spent as each individual wishes. Planned outings/activities are only undertaken if the service user wishes, if refused, alternatives are offered until a suitable activity is decided upon. This was confirmed through discussions and observations undertaken at this time. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 standard(s) 12,13,15,16 & 17 Service users enjoy their chosen activities, many of which are undertaken in the community, providing both choice and control. Friends and family relationships are encouraged and supported by the home. Meals are chosen on a daily basis by the service user, food eaten is recorded and the lunchtime meal was seen to be relaxed and not rushed. EVIDENCE: 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 12 Daily programmes are in place and developed with each person. Each year, holidays are planned but not everyone wants the same experiences. Therefore, individual holidays or regular outings are planned and developed specifically to meet goals and underpin autonomy and independence. Each day is undertaken as the person wishes, meals are eaten as and when chosen by individuals. Shopping and cooking is undertaken independently and supported by staff as necessary, this ensures both personal choice and physical needs are recognised. Cupboards and fridge areas are clearly identified for each person and appropriate signage is used where necessary for individual needs. All relationships that are important to service users is encouraged and constant contact supported. Events in the home are undertaken with involvement and support from friends and family. Lunch was being prepared at this inspection and food choices were offered to all service users. This meal was unhurried and a very relaxed experience with choices being offered and service users making independent decisions about food and the afternoon activities. A variety of pictures were being shown to one service user to support food choices, independence and control. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 standard(s) 18, 19 & 20 All needs and preferences are clearly recorded on person centred plans, ensuring choices made by each individual are supported. Medication is currently being stored appropriately and administered by trained staff to ensure the full health and safety of service users. EVIDENCE: Days are planned following full consultation with each individual and all personal care is undertaken in each person’s room. Planned staffing and support has been developed where required as needs alter and routines change. Records sampled and both observations and discussions undertaken at this time confirm that privacy and dignity is considered at all times. Individual records sampled at this time clearly evidenced that service user health care needs are met through the involvement of health professionals both in the community and within the home as necessary. When additional care is required due to any health deterioration, guidelines for staff are produced to ensure full support is appropriately given and appropriate staffing levels are allocated. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 14 Medication is administered after appropriate training is completed and staff are assessed as competent. Medication is retained in a locked draw in service user rooms following discussions with staff and the completion of risk assessments. This supports autonomy and also gives individual control and responsibility to each person, while ensuring full safety at all times. Keys are retained in the staff office and all medication is administered in the service user’s room. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 standard(s) 22 & 23 Service users are protected and supported by policies, procedures and training in the home. EVIDENCE: A policy is in place with clear guidelines establishing complaints procedures for both service users and their families and this is in an appropriate format for each service user. Observations at this inspection clearly evidence that staff create a relaxed and inclusive environment and service users were seen to be comfortable when discussing matters at this time. Sense has extensive procedures in place that include how to address challenging behaviour, physical intervention techniques and avoidance plus guidelines on physical and sexual abuse. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 standard(s) 24,25,28 & 30 The home was found to be clean and hygienic at this time with individual rooms meeting the needs of service users. There is currently only one communal lounge area and the much needed conservatory has been approved and service users are looking forward to enjoying this additional space. EVIDENCE: 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 17 Accommodation is provided in single rooms only and these are all over 10 square metres. One room is suitable for a person using a wheelchair and this room is over 16 square metres and is on ground level with en suite facilities. There is appropriate access to the front and rear of the building. Pictures of outings, holidays and events enjoyed throughout the year are in evidence in service user rooms. There is a lounge and a kitchen/dining room area with a rear garden area that is easily accessed. Currently, there is not a private area available for family and friends to meet with service users. The building of a conservatory has been confirmed and this much needed space will enhance the current environment considerably and meet this particular standard. This additional space would provide a suitable area for visitors to undertake discussions in private and ensure a peaceful and calm area is available to those living in the home. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35 & 36 Service users are supported and protected by the staff training, recruitment and the supervision process. EVIDENCE: 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 19 Training and service user needs are at the centre of all plans and service delivery in the Home. The induction programme supports both service users and staff as this is undertaken through the organisation in the first instance and then continues in the allocated home until the member of staff is assessed as being fully competent. All CRB and POVA checks are in place prior to any new person starting work in the home, which ensures the full safety of service users at all times. An agreement confirming this was evidenced during a sampling of staff files undertaken at this time. All staffing levels are set after an assessment of daily needs is undertaken. Depending on the daily activities, the rota then reflects the service user support that is required. There is also a key worker system in place to provide each service user with individual support at all times. Due to the relocation of the registered manager, a new acting manager is currently in place and awaiting registration. This change has therefore caused supervisions to become irregular and formal supervisions are to commence as soon as possible. Newly allocated members of staff are working towards their British Sign Language (BSL) level 1 qualification and those with this level of qualification are undertaking BSL stage 2. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 Policies, procedures, regular monthly monitoring and meetings, and discussions with service users, ensure developments in the home are service user led. The home protects and promotes the safety and well being of service users. EVIDENCE: 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 21 Policies, Procedures and practices are regularly reviewed by the organisation. Self assessments are also regularly completed and these surveys include questionnaires and service user focus groups. Action plans are developed that address any issues arising from this consultation process and full reports are developed that clearly reflect responses and future targets. The home was found to be clean and fresh in all areas at this time. The health and well being of service users is considered at all times and staff expressed a thorough knowledge of service user needs. All staff are trained in safe handling of medication, moving and handling, fire safety, first aid, food hygiene and infection control. Regulation 26 audit visits are regularly undertaken with appropriate action plans and copies are forwarded to the Commission for Social Care Inspection. 89 Hastings Avenue H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 2 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 2 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 89 Hastings Avenue Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x H56-H05 S23298 89 Hastings Avenue V244716 241005 Stage4 .doc Version 1.40 Page 23 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 8 Regulation 12 & 24 Requirement That staff sign at all times while service users are present to promote inclusion and independence. The planned provision for a conservatory to go ahead as agreed to provide adequate communal space in the home. Timescale for action 30/11/05 2. 28 16 & 23 As soon as practicable RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 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