Inspection on 10/01/06 for Avala Park

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Avala Park 16/09/09

Avala Park 12/06/08

Avala Park 13/06/07

Avala Park 13/11/06

Avala Park 15/08/05

Avala Park 20/10/04

Avala Park 21/06/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Avala Park Mile Road Widdrington Morpeth Northumberland NE61 5QW Lead Inspector Deborah Haugh Announced Inspection 10th January 2006 09:30 X10015.doc Version 1.40 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 Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Avala Park Address Mile Road Widdrington Morpeth Northumberland NE61 5QW 01670-790019 01670 791203 avalapark@highfield-care.com 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) Southern Cross Care Homes Limited Mrs Alison Martin Care Home 35 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (24) of places Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th August 2005 Brief Description of the Service: Avala Park is a purpose built two-storey home located in the rural village of Widdrington. Set back from the road the home has large gardens and ample car parking space.Local amenities and public transport are limited but include a small supermarket, public house, community centre and GP surgery.The home is registered to provide accommodation and personal care to 35 older people, 10 of whom have a dementia.The home is now owned by Southern Cross Care Homes Limited. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place on 10/01/06 from 9.30 until 3.00 pm. The Registered Manager, Mrs Alison Martin was on duty during the visit. There were 22 service users at the time of the visit. Staffing levels were checked. Time was spent looking around the home to check the cleanliness, maintenance and decoration during the visit. Prior to the inspection questionnaires were provided to service users and relatives. None were completed. Service users shared their views with the inspector during the visit. Time was also spent observing the contact between the service users and staff. There were no visitors during the inspection. Two care plans were examined. Arrangements for the administration and management of medication were checked. Recruitment, finances, training, catering, protection and quality assurance were also examined. What the service does well: Staff spoke to service users with respect and service users described them as ‘kind’ and ‘caring’. ‘Good staff, they look after me.’ ‘I’ve been here awhile.’ Service users complimented the food and choice of menu. ‘The food is very good, always get plenty.’ Service users appear to have good relationships with the staff. The arrangements for meals are excellent with home baking and home cooking an essential part of the menus. The cook is experienced and demonstrated her knowledge of nutrition for older people. The cook maintains excellent records of service users nutritional needs, likes and weight charts. The catering arrangements exceed the standard. 95 of care staff are trained to a minimum of NVQ Level 2, which exceeds the standard. The standard required is 50 by 2005. The Registered Manager has the required Registered Manager’s Qualification. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 (NMS 3 was assessed and met at the last inspection, NMS 6 is not The Statement of Purpose and Service User Guide are adequate but do not provide all the required information. EVIDENCE: The Statement of Purpose is being updated due to the change in Provider. Service users views should also be included in the Service User Guide as recommended. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Care plans are in place but more information must be recorded to demonstrate actual care being provided. The health care needs of service users are met and multi disciplinary working is taking place but accountability records must be in place for one service user. The systems for the administration of medication are appropriate but two areas require improvement. Service users are treated with dignity and their privacy respected but one area needs addressing. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 10 EVIDENCE: 7) Two service user care plans were examined and found to be positive and look at a range of needs. Improvements in health are evident such as increased weight, better mobility and skin care. This is a credit to the homes approach to personal care. Although activities are provided in the home care plans continue to not identify individual social care needs. Some people are unable to join in ordinary activities and alternative occupation should be explored. The inspector provided further information after the last inspection and the Manager is developing activities and occupation, which will be examined at the next inspection. Staff demonstrated their knowledge of service users preferences but this is still not recorded such as bathing, dressing and communication. One care plan states that a service user requires a bath but after discussion it was established that the person has a shower. Ambiguous wording is used in some of the care plan actions i.e. ‘appropriate’ ‘comfortable’ clothing. But it is not clear what these mean for that individual for example tracksuit, shirt and tie, trousers/dress. The arrangements for service users finances must be assessed i.e. personal monies, ability, risks, and representative’s support. Care plans must be put in place where appropriate. 8) One person stays in their bedroom and an accountability chart is required to be in place for fluid intake. However the charts have not been consistently maintained. Only 6/1/06 and 1 undated chart was present. The Manager checked with staff and established that 10/1/06 was included in the undated chart. Periods of bed rest and sitting in a chair are required for the service user pressure care management but no timings are evidence of this practice being put in place. There is evidence of good multi-disciplinary approach to care and GP’s and other health care professionals are consulted regularly. 9) The arrangements for the adminstration of medication was checked. Typed Medication Adminstration Record (MAR) sheets must still be be signed and countersigned. The lunch time medication round was observed and medication was given to two service users on the inspectors table in pots. The responsible senior staff Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 11 member left the table without ensuring that the tablets had been taken. The service users showed some levels of confusion and although they took their medication one was unsure and another tried to take the tablets off the other service user. The responsible person administering medication must witness service users taking their medication. 10) Service users are able to have their own telephone in their bedrooms. All the rooms have a telephone point. People are addressed by their preferred name and this is recorded in the care records. Peoples dignity is respected and personal care is provided in private. The laundry was inspected and a large bag of un-named hosiery was found. The Manager is strongly recommended to provide individual delicate bags for hosiery to prevent communal shared clothing. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14 & 15 (NMS 13 was assessed and met at the last inspection) Service users are provided with activities and new activities are to be developed. Care plans must reflect social needs. Service users have control over their lives. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets resident’s tastes and choices as well as special dietary needs. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 13 EVIDENCE: 12) A range of activities for service users are provided which include sing-alongs, board games, entertainers, arts and crafts and outings. However some service users are unable to join in these activities and other ones should be developed. The Manager is looking into alternative activities and occupations for people. Individualised care plans must be provided which reflect ability and preference. On the day of the visit some people were having their hair styled by a staff member and later playing skittles. 14) Within the context of risk assessments service users are able to maximise their control over their lives. People are able to bring their own possessions with them and handle their own affairs. 15) Service users spoke positively about the food. The inspector shared lunch with service users. Lunch was unhurried and service users are able to have alternatives to the menu at anytime. The lunch choice was steak and ale pie with a puff pastry topping, Brussels sprouts, Swede, turnip with creamed and roast potatoes. Homemade broth soup, egg, sausage and chips were the alternative. Salad was always available. Rice pudding made with full cream milk, mandarin and orange or fresh fruit were for dessert. The cook spoke in detail about home cooking, baking and fortifying meals with butter and cream for those service users vulnerable to malnutrition. There is evidence of service users improving. Excellent information is available in the kitchen regarding service users nutritional needs, weights (loss of weight is highlighted and addressed) and preferences. The cook is competent and knowledgeable about the dietary needs of older people. The catering arrangements exceed the standard. The inspector observed one-service users being assisted to eat in their bedroom by a member of the care staff. The atmosphere in the bedroom was relaxed and conducive to ensuring a pleasant mealtime experience for the person. The staff member was sat on a stool, attentive and encouraged the person to eat. The meal was relaxed and unhurried. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 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 (NMS 16 was assessed and met at the last inspection.) Systems are in place to protect service users from abuse EVIDENCE: Staff have received training in the policy and procedure for the Protection of Vulnerable Adults (POVA). Staff are clear about their responsibilities to report poor practice. The Manager is planning to provide more training. The Manager and her team have demonstrated their commitment to protecting service users. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21,24 & 26 The standard of the environment within this home is satisfactory providing service users with a safe and homely place to live but some areas of cleanliness and decoration must be addressed. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 16 EVIDENCE: 21 & 26) The washing and toilet facilities of the home were inspected in the presence of the Registered Manager. Cleaning and infection control arrangements must improve. The two shower chairs were very dirty and stained underneath. Two paper towel dispensers were dirty underneath. These areas compromise infection control. At the last inspection the home was recommended to provide plastic covered pull cords to be used in bathrooms and toilets for infection control. The practice of double bagging clinical waste to manage odours was also recommended but neither has been addressed. 19) The kitchen was clean tidy and well organised. The experienced cook has re-arranged the storage room and improved the design. 19, 21 & 25) The ground floor bathroom ceiling has been damaged by a water leak and must be redecorated. The lighting in this bathroom is poor and brighter lighting must be provided. The ground floor shower pole must be replaced, as it is rusty. 26) The laundry was clean and organised. Appropriate measures are taken to wash items at required temperatures. 24) One of the standards for service users bedrooms is for two chairs to be provided by the home. However some bedrooms do not have two chairs. Where service users or their representatives prefer only to have one chair a written agreement should be in place that if wanted another chair can be provided. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Staffing numbers are appropriate to the assessed needs of the service users, size, layout and purpose of the home. The Registered Provider ensures that service users are cared for by staff that are trained. Robust staff vetting protects Service users. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 18 EVIDENCE: 27) The home maintains the level of staffing in accordance with previous agreements with the local authority and this reflects the size and layout of the building and the needs of the residents currently living in the home. The current levels of staffing are a minimum of 4 care staff on duty during the day and 2 waking night staff. 28 & 30) The home has exceeded National Minimum Standards for NVQ Level 2 training for care staff at 95 by end of 2005. (Required level is 50 ). Staff have also received training in medication, Protection of Vulnerable Adults (POVA), fire safety, moving and handling, falls and fracture prevention, Control of Substances Hazardous to Health (COSHH). Staff receive induction training. 29) Two staff recruitment records were sampled. Suitable systems and checks were found. Two references, Police and Protection of Vulnerable Adults checks and staff identity are in place. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 37 & 38 (NMS 31 was assessed and met at the last inspection.) Southern Cross is developing quality assurance systems. Arrangements for the management of service users own personal money protects service users. Service users are protected from robust health and safety arrangements. Policies and procedures guide the practice of staff which protects service users. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 20 EVIDENCE: 33) Southern Cross Care Homes Ltd acquired Highfield Care Homes and is developing quality assurance arrangements. 35) Service users money, which is looked after by the home, is securely stored. Only the Registered Manager, Deputy and Administrator have access. Care plans must be put in place where service users require assistance with finances. 37) The Manager confirmed that service users are only admitted on a planned basis so a policy is not in place for emergency admissions. A policy exists for dealing with behaviours, which challenge the home. 38) Fire instruction and drills are in place for staff at the appropriate timescales. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 X 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X 2 X X 2 2 2 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X 3 3 Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13(2) Requirement The typed Medication Adminstration Record (MAR) sheets must be signed and countersigned. The responsible person administering medication must witness service users taking their medication. 2 OP25OP26 OP19OP21 16(2) 23(2) The two shower chairs and paper towel dispensers must be cleaned regularly for infection control. The ground floor bathroom must be redecorated and brighter lighting provided. The ground floor shower pole must be replaced, as it is rusty. Identify individual social care needs appropriate to their ability and interests. OUTSTANDING 30/09/05 Accountability charts must be completed as directed in the care plan for those service users requiring continued care in their Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 23 Timescale for action 11/01/06 31/03/06 3 OP8OP7OP 12 15 31/03/06 rooms due to frailty ie turning and daily nutritional intake. OUTSTANDING 30/09/05 Service users preferences must be recorded such as bathing, dressing and communication. OUTSTANDING 30/09/05 The arrangements for service users finances must be assessed i.e. personal monies, ability, risks, and representative’s support. Care plans must be put in place where appropriate. 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 2 3 4 Refer to Standard OP10 OP26 OP24 OP1 Good Practice Recommendations Provide individual delicate bags for hosiery to prevent communal shared clothing. Consider providing plastic covered pull cords to be used in bathrooms and toilets for infection control. Consider double bagging clinical waste to manage odours. Agree with residents the suitability of furnishings where these fall short of the desired standard and record outcomes in the resident’s individual records. Include the views of service users in the Service Users Guide. Avala Park DS0000000553.V259551.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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