Inspection on 17/08/06 for Avalon Care Home

This inspection was carried out on 17th August 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 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

Avalon Care Home 20/02/09

Avalon Care Home 14/01/09

Avalon Care Home 03/10/08

Avalon Care Home 12/10/07

Avalon Care Home 16/12/05

Avalon Care Home 02/12/04

Avalon Care Home 03/06/04

Avalon Care Home 26/01/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Avalon Care Home 116 Clipstone Road West Forest Town Nottinghamshire NG21 9JH Lead Inspector Mary O`Loughlin Unannounced Inspection 17th August 2006 10:00 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 Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 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. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avalon Care Home Address 116 Clipstone Road West Forest Town Nottinghamshire NG21 9JH 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) 01623 644195 01623 429977 None Southern Cross Care Homes No 2 Limited Mrs Ann Elizabeth Barlow Ayodele Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users shall be within category OP One named service user as applied for in application dated16/10/05 may be within category PD 15/12/05 Date of last inspection Brief Description of the Service: Avalon Care Centre is a purpose built two-storey, forty bedded care home for older people situated on the outskirts of Mansfield, close to the former mining village of Clipstone. It is situated on a main road, which has a public bus service, and is approximately two miles from Mansfield town centre to the North East. All bedrooms are single occupancy, with half having en-suite facilities. Avalon is close to local shops, and a pub. There is ramped access to the home and a passenger lift is installed. The range of fees are: 319.00 to £550.00 Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted unannounced over 5.5hrs. The inspection looked at the key standards as identified within this report. A range of information was used to inform the report as follows, The service history of significant events. The registered person completed the pre-inspection questionnaire for the Commission for Social Care Inspection. The previous compliance with the national minimum standards and the sustained track record of achievement determined the review of the standards. The main method of inspection was case tracking, this requires the inspector to examine the records of three residents looking at their assessed needs to determine if all appropriate assessments and safeguards are in place to meet the National Minimum Standards. On this occasion three residents were case tracked which involved speaking to them about their experience of living at the home. The environment and the services the resident receives were also checked. Two relatives were spoken with and seven staff were interviewed about care practices. All the residents and relatives spoken with felt very happy with the care they received at the home. What the service does well: The home provides good outcomes for people who use the service, with many of the key National Minimum Standards met or partially met. There are trained nurses on duty throughout the day and night for those residents that require nursing care. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 6 Residents benefit from a well trained staff team who are supervised by the manager regularly to ensure that all aspects of their practice is assessed and any training needs identified which may be required to meet the needs of the residents. This is a well managed service with staff spending time and effort to prepare appropriate care plans that are based on the regular review of risk assessments and with the involvement of the resident or their relative. Residents and relatives said they felt listened to and have opportunities to meet up with the manager or key worker at any time to discuss concerns. Residents are encouraged to retain control over their lives and are supported to live as independently as possible. There are established quality assurance and monitoring systems in place that seek the views of those people who use the service to regularly review and measure the success of the home in meeting its stated purpose. What has improved since the last inspection? What they could do better: The registered person must ensure that there are suitable arrangements in place when staffing the home that considers the periods of high activity and possible absenteeism, which could have poor outcomes for residents if there are long delays in receiving nutrition or assistance with getting up as required. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 7 The registered person should consult with staff at the home, listen and act upon concerns that are voiced. Where staff are unable to complete the required records of fridge and freezer temperatures in working time, arrangements must be in place to ensure food is stored at appropriate temperatures. Delays in the repair of necessary equipment such as hoists and scales should be addressed quickly to enable staff to undertake their role appropriately. 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. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 8 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 Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 9 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): 3-6 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. Prospective residents receive an assessment of their needs by a suitably trained person before they are admitted to the home. Intermediate care is not provided. EVIDENCE: The home has a sustained track record in meeting the standard. The records of recently admitted residents show that staff spent significant time completing a thorough assessment of the persons needs along with obtaining information from any external professionals involved in the care of the prospective resident. One new resident said she had visited the home before coming to stay for a period of short term care. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 10 There is a range of information available to any prospective resident and their relatives which tells them about the home, its facilities and services. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 11 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 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. The health and personal care which residents receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. The home operates a well developed medication system that is quality assured and safeguards the residents. EVIDENCE: The home involves residents in all aspects of their life. Three residents were case tracked on this occasion and all had a robust care plan in place. There are effective systems in place that ensure plans are reviewed monthly or as conditions change. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 12 Any external professional reviews are also documented. Feedback and involvement of the resident and their relatives is a continuous ongoing process, staff spend time with the resident to ensure they understand and agree to the plan of care. There are robust quality monitoring systems in place. The care plans are working tools and are written in clear language that enable people not familiar with the content to use the plan in an emergency. Staff were able to confirm verbally and through training records that they receive training in all areas of their practice which ensures they have the skills to meet the needs of the residents. Discussions with relatives, residents and the staff demonstrated that care is delivered sensitively and maintains the dignity of the resident. The registered provider constantly seeks the views of the residents about experiences to ensure the staff fully observe the policies and procedures to respect privacy and dignity when providing health and personal care. Staff were seen to interact well with residents, assist them with sensitivity and an awareness of maintaining their dignity. Residents said they were treated with respect at all times. Observation of the care practices also reflected that staff responded quickly to any requests by residents and that appropriate techniques were in use when moving and handling those with mobility problems. Specific health needs that are identified had robust plans in place that demonstrated good practice in the management of wounds, with accurate records and strict adherence to treatment. The home operates an efficient medication policy, procedure and practice. Quality assurance systems ensure the medicine policies are put into practice. The individual records of medicine administration for those case tracked were examined and show that the resident receives their medicine as the prescription required. Examination of the storage, receipt and disposal of medicines show that the staff ensure appropriate safeguards in accordance with the Medicines Act. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 13 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): 12-13-14-15 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. The activities provided meet the expectations of the residents. Residents receive a varied and nutritious diet according to their assessed needs. EVIDENCE: An activities person is employed who raises funds to enable the home to provide a variety of social activities for residents to participate in. The activities person said she spends time with each resident getting to know them and their individual preferences. Records of social activities are held and evidenced within displays on notice boards. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 14 Relatives and friends of the residents reported feeling able to visit as often as they wish and confirmed that activities are available on a regular basis. Care plans examined reflected that staff consider the amount of support that residents need and encourage independence with activities of daily living. Staff were observed to encourage people to be independently mobile. The practice and attitude of the staff team gave the residents support as they needed it and encouraged their independence. One resident spoke of how he was able to access community facilities,making visits to the shops and public house as he wished. Staff had considered the risks within the persons care plan and had taken the necessary steps to ensure the person was safe to undertake the activity. A set menu was viewed and the cooks said they considered the different preferences of the residents and altered the menu to suit individual choice. Residents and relatives said they were happy with the choce of meals. Records indicated each resident is regularly assessed for their nutritional needs and where required have access to the community dietitian for assessment and treatment. A key worker system is operated which residents confirmed they were aware of and who discussed their care plans and planned activities in the home. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 15 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): 16-18 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. Residents have access to a robust and effective complaints procedure. Residents are protected from abuse by the homes policies and practice in safeguarding vulnerable adults. EVIDENCE: A robust complaints procedure in place that is made avilable to the residents and visitors to the home.This is displayed on the notice board. The administrater said that records of complaints are held, these were not viewed on this occasion. There is also a suggestion box to enable everyone involved in the service to make suggestions for improvement. Monthly surgeries are held by the manager to enable relatives to come along and chat about any concerns they have. A full list of dates of these surgeries was seen on the events notice board at the home. One relative spoken with felt that her concerns were listened to and acted upon. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 16 Residents said they felt able to complain if they needed to. The systems in place to protect residents from abuse ensure that staff are trained in adult protection and fully understand their role in the protection of vulnerable adults. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 17 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): 19-26 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. A well maintained homely environment that has suitable safeguards in place to enable residents safety and encourage independence. Delays in repairs to equipment necessary for the delivery of care need to be addressed to ensure that residents have access to suitable equipment to meet their needs at all times. EVIDENCE: The home is clean, hygenic and well maintained. There has been extensive redecoration in the previous 6 months. The home has ensured that an extractor fan has been fitted in the smoking room since the last inspection. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 18 Residents had a range of equipment to enable them to be as independent as possible. All hot water is regulated to ensure residents are safe from scalding risks. There are appropriate controls in place for the hot and cold water storage that ensures suitable controls for Legionella. Staff at the home said they were still having problems with periodic failing hot water supplies. Staff were also aware that the work to rectify the problem of air locks in the pipes has been agreed as part of this years programme of maintenance. Staff were concerned that repairs on the hoists and scales were taking a long time and there was slow response to these problems by the manager. There were hoists in use and the residents are being weighed monthly despite the delay in these repairs. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 19 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): 27-28-29-30 Quality in this outcome area is adequate. This Judgement is made using available evidence including a visit to this service. Staff are trained and competant to do their jobs. Residents are protected by the homes recruitment procedure and are in safe hands at all times. The management of the numbers of staff does not reflect the times of high activity and staff absences cannot always be covered in time to ensure the needs of the residents are met in a timely fashion. EVIDENCE: The home has a highly developed recruitment procedure that ensures prospective staff are appropriately checked for their suitability to work with vulnerable adults. New staff receive an induction training period and there is a training plan for all staff that provides them with the skills required to deliver the care to the residents at the home. National Vocational Qualification training is also in place. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 20 The home prepares a record of duties for staff that is prepared based on the number of residents in the home and their dependency. The last 6 weeks of duty records indicated that a minimum staffing level was being organised by the manager which had on several occassions been depleted due to the absence of staff particularly during the morning. 1 relative and 5 staff said that they were often short of staff and that despite the company arrangements in place to cover these duties, they were mostly left to work with less staff. When staff shortages happend there was no change to the daily routine to ensure that residents were not left for long periods before being assisted to get up and have breakfast. Staffing rotas did not take into account the times of high or low activity in the home. Relatives said they did not think that residents were neglected at times of staff shortages but that there was extra strain on the staff left to manage. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 21 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): 31-33-35-38 Quality in this outcome area is good. This Judgement is made using available evidence including a visit to this service. The manager is qualified and has the required experience to run the home. Staff did not feel that their concerns on staff levels were always listened to. The home is run in the best interests of the residents. Residents financial interests are safeguarded. The health, safety and welfare of the residents and staff are promoted and protected. EVIDENCE: The regsistered manager was not on duty at the time of this inspection. Suitable arrangements were in place during her absence. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 22 Although there were opportunities for staff to discuss any concerns or make suggestions for improvement, all those spoken with felt they were unable to influence any change or recognition when they voiced concerns to the manager about staffing levels. The manager was considered by staff to be open and transparent in all other areas of running the home. Records of the management of the residents personal monies were examined and found to safeguard the resident from financial abuse. There were electronic accounts held and written records also, this ensured that staff could easily access the accounts if residents or their relatives wished to see them. Personal cash floats are held and all incoming and outgoing payments are receipted and recorded. There is a well-developed quality assurance system in place that seeks the views of all those involved in the service. The staff work to a clear health and safety policy, on this occasion the records of the arrangements in place for Fire prevention were examined and found to meet the standard required. The last inspection of the home found the records of fridge and freezer temperatures were incomplete. The records were not available for inspection on this occasion, as staff had taken them home to update. The fridges had an external temperature display panel that was operational and read a safe temperature at the time of the inspection. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 23 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 OP19 OP27 OP31 OP38 Good Practice Recommendations The registered person should ensure that the repairs required for the hoists and the scales are undertaken within a suitable timescale. The registered person should ensure that the numbers of staff are sufficient to meet the needs of the residents at all times. The registered person should ensure that all concerns raised by staff are listened to and acted upon. The registered person should ensure that the appropriate safeguards are in place when storing food with records held of the fridge and freezer temperatures. Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Avalon Care Home DS0000024627.V298830.R01.S.doc Version 5.2 Page 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. 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