Inspection on 21/11/08 for Allerton Avenue

This inspection was carried out on 21st November 2008.

CSCI found this care home to be providing an Good 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.

Other inspections for this house

Allerton Avenue 29/11/06

Allerton Avenue 21/02/06

Allerton Avenue 20/09/05

Allerton Avenue 07/03/05

Allerton Avenue 24/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Allerton Avenue 3 Allerton Avenue Moortown Leeds West Yorkshire LS17 6RE     The quality rating for this care home is:   two star good 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: Frederick Rawlins     Date: 2 1 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Allerton Avenue 3 Allerton Avenue Moortown Leeds West Yorkshire LS17 6RE 01132888577 01132888577 allertonavenue@c-i-c.co.uk 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) : Community Integrated Care care home 4 Number of places (if applicable): Under 65 Over 65 2 learning disability Additional conditions: 2 The 2 places for LD(E) are for the service users named in connection with the variation application December 2003 Date of last inspection Brief description of the care home Allerton Avenue is a large detached house in an area of similar houses in a suburb of Leeds close to local shops and a bus route into the city centre. The home provides residential care for up to four male and female adults with learning disabilities. The home does not provide nursing care. The communal lounge and dining room, separate kitchen and laundry are on the ground floor. Bedrooms on the first floor are of a good size and all are single. There is no lift access to the first floor. The house has a large well-maintained garden and on road parking. All the housemates share the house car. Care Homes for Adults (18-65 years) Page 4 of 26 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: two star good 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: The inspection process included looking at information we have received about the service since the last key inspection, as well as this unannounced visit to the home, which was carried out between 08:40 and 16:30 hrs on the 21 November 2008. The methods we used included looking at records, observing staff at work, talking to people living at the home, talking to staff and looking around the property. Before the visit we had provided some people living at the home, their relatives and other health care professionals with survey questionnaires so that they could share their views of the service with us. The information they provided has been used as evidence in the body of the report. Care Homes for Adults (18-65 years) Page 5 of 26 The home had also completed and returned their Annual Quality Assurance Assessment form and the information provided has also been used as evidence in the body of the report. The purpose of the visit was to assess what progress the home had made in meeting the requirements made in the last inspection report and the impact of any changes in the quality of life experienced by people living at the home. We have recently improved our practice when making requirements to improve national consistency. Some requirements from previous inspections may have been deleted or carried forward as recommendations, but only when it is considered that people that use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. 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 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Care Homes for Adults (18-65 years) Page 8 of 26 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 26 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. People who use the service can be sure that the home will meet their needs following assessment. Also written and verbal information provides enough information for them to decide whether the home will meet their needs. Evidence: The Statement of Purpose, which provides information on the services provided by the home, is available from the manager of the home. People using the service said they were very happy with the home. One said, I like it here, another said, its nice here. The needs of people who use the service have been assessed before they moved into the home. The assessment used covers all aspects of daily living. Care plans are then drawn up from any needs that are identified. People who use the service had also had a re-assessment carried out, if their needs had changed. However, some of the assessments looked at did not have any dates on them so it was difficult to see if this Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: information was current. Care Homes for Adults (18-65 years) Page 11 of 26 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. Staff are, in the main, aware of the individual needs of people who use the service. The lack of detail in some care plans and risk management plans could however, lead to the needs of the people who use the service not being properly met. Evidence: Each person who uses the service has a pen picture, which gives some good information on the person as an individual. It includes some person centred information on peoples history, background and some of the things that are important to them. Some of the plans gave reasonably clear, detailed instruction on how needs are met. However, some care plans need more explanation and more detailed and specific information for staff to make sure that important care needs are not missed. For example, a plan for encouraging continence said, toilet regularly. A good support plan should give clear and detailed information on how and when care is given, taking Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: particular notice of the peoples preferences and choices. Care plans have not been reviewed at regular intervals. Reviews should be carried out to show how the home is adapting to meet peoples needs as they change. Risks to people who use the service have been identified and assessed. The risk management plans for some people do not have enough detail, which again, could lead to needs being overlooked. Some risks to people do not have a management plan in place. For example a person with behavior that challenges others, needs further explanation so that staff are clear on how this behavior is managed. Despite the risk assessment documentation and the lack of regular reviews, staff have good knowledge on some of the care and support needs of the people who use the service. They were able to accurately describe the care they give and talk about the detail of how people like to be supported in their daily routines. People who use the service were offered choices throughout the day, around what to do or what to eat. People who use the service also have meetings a few times per year. Issues discussed are holidays, activities, menus and any dissatisfaction people may be feeling. Staff interactions with people were very good. Staff showed warmth and a positive approach to people who use the service. Care Homes for Adults (18-65 years) Page 13 of 26 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. The home offers opportunities to people who use the service for personal development in addition to a range of leisure activities. People who use the service are able to make choices about their lifestyle. They also benefit from a good, healthy and varied diet. Evidence: Staff said that people who use the service have a variety of activities that they are involved in within their local community. This includes day centerers, shopping, meal out, going out to the pub and going to shows. Staff said they felt there were enough staff to make sure people who use the service get a good level of activity. Activity is also provided and encouraged within the home. Staff said they try to meet the diversity of peoples needs by providing a varied programme of activity such as baking and board games. Staff were respectful of Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: people who use the service when they wanted to do their own thing. People who use the service said they were looking forward to Christmas and all the celebrations. One person said they were excited about putting the tree and decorations up. Menus are developed based on the likes and dislikes of people who use the service. A good variety of food is available and staff make sure there is plenty of fresh produce such as fruit and vegetables. People who use the service said they enjoyed the food. Comments included We have all sorts of different things. Im not told to eat what I dont like. Staff said people are alway asked what they would like to eat. Care Homes for Adults (18-65 years) Page 15 of 26 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 lack of some written documentation could lead to personal and health care support needs being overlooked. Evidence: Case tracking was done for people living in the home. This involved looking at their care record and medication charts. The care plans provided useful information about how care needs were met and showed that in some case regular reviews have not taken place. Which means some peoples health care could be over looked. Two care plans stated that there has been no change in the persons weight. However on examination of the record there was no evidence that these people had been weighed for over four months. The care records must clearly show the weight of people who uses the service and what action has been taken by staff to ensure dietary needs are addressed to prevent serious consequences to their health. Though most care plans indicated the medical diagnosis for each person, the plan did not specifically differentiate and /or highlight the symptoms/behavior exhibited by each person and the ways in which staff managed these symptoms. For example one care plan stated; Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: has seizures but contained little detail about the actions staff would need to take. The support plans have details of any health professionals that people who use the service see. Good records are kept of any health appointments and their outcome. Medication record sheets were also looked at. There were no errors in the recording of medicines that had been administered. Care Homes for Adults (18-65 years) Page 17 of 26 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. People are comfortable in raising concerns and complaints to the management, and the management will resolve the situation in the best interest of the person. Staff are aware of how to protect people from abuse. Evidence: The home has a complaints policy, which provides staff with the policy they should follow if a complaint is made. The organisation has adult protection policies and information in place and the home has got copies of the local authority adult protection procedures. Staff said that they would report suspected or actual abuse to the person in charge. Two people said they were aware of who to complain to and felt comfortable when raising concerns with the manager. Care Homes for Adults (18-65 years) Page 18 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment in the home is homely, clean, safe and hygienic. Staffs practices, in the main, control the spread of infection. Evidence: The home is clean and homely, providing sufficient space for people. Bedrooms have been decorated and furnished to suit individuals and their interests and personality. People who use the service said they had been able to choose how they wanted their rooms. One said, I am the boss in here. The home is nicely decorated and has furniture and furnishings of a good standard. There is a maintenance book and the manager makes sure any maintenance work is attended to promptly. Communal areas were clean and there were no odours noted. Clinical waste is properly managed and staff wear protective clothing when attending to personal care needs of people who use the service. Care Homes for Adults (18-65 years) Page 19 of 26 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. There are sufficient staff employed to make sure peoples needs are met and staff are given training to make sure they can care for people. Evidence: The home has a through staff recruitment and selection procedure, which includes obtaining at least two written references and a Criminal Record Bureau (CRB) before new staff start work. This makes sure only people suitable to work in the caring profession are employed. All staff are provided with written job descriptions, which outlines their roles and responsibilities and a copy of the staff handbook. We reviewed the recruitment files and found that the recruitment policy was being followed. However some files need to be put in order and updating. The manager is aware of this and is working to address this. The staff rota showed that sufficient staff are employed on day and night duty to meet peoples needs and the home has a stable staff team and a low-turnover, which helps to make sure people receive continuity of care. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The manager confirmed that all new staff receive induction training in line with the skills required to work with this group of people. Following induction there is an expectation that staff will study for a National Vocational Qualification (NVQ) at level two or above. Feedback from staff indicates that they are pleased with the level and standard of training provided and are encouraged to take up training opportunities. Regular supervision was provided to all staff and annual appraisals were undertaken. Care Homes for Adults (18-65 years) Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management structure in place makes sure the home is well managed and run in the best interest of the people living there. Evidence: Both the registered providers and manager have a positive attitude to the inspection process and have shown a willingness to work with us to maintain and improve standards at the home. The manager confirmed that she is well supported by the providers and there are clear lines of accountability, which makes sure the home is managed affectively and in the best interest of the people living there. To make sure that there are clear lines of communication within the home regular staff meetings are held. Formal one-to-one staff supervision gives staff the opportunity to discuss their training and any concerns they have. The home holds money in safekeeping for people and receipts are obtained for any items purchased on their behalf. We checked a number of transaction sheets and no Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: concerns were raised. Policies and procedures are in place to ensure the health and safety of people living at the home, visitors and staff, which are audited on a regular basis to make sure that they comply with changes in legislation and good practice guideline. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 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 2 2 6 All assessments should show the dates when done so we are able to see if the information is up to date. People who use the service must have an up to date detailed care plan, which includes their specific health needs. This will ensure that they receive person centered support that meets their needs. All identified risks for people who use the service should have in place detailed up to date action plan in place in order to minimise or prevent the risk. Care plans should specifically differentiate and /or highlight the symptoms/behavior exhibited by each person and the ways in which staff managed these symptoms. For example one care plan stated; has seizures but contained little detail about the actions staff would need to take. The care records must clearly show the weight of people who uses the service and what action has been taken by staff to ensure dietary needs are addressed to prevent serious consequences to their health People should have regular reviews of their care to make sure their health care needs are not over looked. 3 9 4 18 5 19 6 19 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!