Inspection on 24/11/08 for Avalon House

This inspection was carried out on 24th 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

Avalon House 28/12/07

Avalon House 05/04/07

Avalon House 27/02/06

Avalon House 17/08/05

Avalon House 09/11/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Avalon House 114-116 Manor Avenue Brockley London SE4 1TE     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: James Pitts     Date: 2 4 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. the things that people have said are important to them: They reflect 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: Avalon House 114-116 Manor Avenue Brockley London SE4 1TE 02084692071 02086915107 gail@auroraoptions.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Paul Ellenworth Farquhar Type of registration: Number of places registered: Aurora Options care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 12 The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD Date of last inspection Brief description of the care home Avalon House provides a care home to a maximum of twelve women and men with severe learning disabilities, who might also have other support needs. The overall aim is to provide a service driven by the needs, abilities and aspirations of the service users and placing their rights at the forefront. The home declares its core values to be: individual approaches, equal opportunities, inclusion and shared values. Avalon House aims to achieve this by ensuring that the service would be based on a thorough assessment of needs and delivered in collaboration with external agencies. Staff would seek to advance the rights to privacy, dignity, independence, security, civil rights, Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 12 Brief description of the care home choice and fulfilment in all aspects of their work and of the environment. The provider, an organisation originally named The Aurora Charity has recently changed its name to `Aurora Options?. It also runs other homes. A chief executive and a service manager, to whom all the staff are ultimately accountable, direct the service. The day-to-day running of the home is delegated to a care manager, who leads a team of staff. Accommodation is provided in two converted, adjacent, Victorian houses and is set on four floors. There is a small garden and a multi sensory room. There are 12 single bedrooms. None have en-suite facilities. Provision has been made for one of the bedrooms to accommodate a person using a wheelchair. There is a minibus to facilitate group outings. The area is served by public transport and has a selection of shops and a supermarket. At the time the inspection was held there were two vacancies. In respect to making information about the service available to potential service users the home has a brochure, which it sends out to referrers. The service user guide is presently under review. CSCI inspection reports are made available by directing individuals to the CSCI web site or a copy will be sent to individuals on request. The home has a block contract with Lewisham Social Service Care Homes for Adults (18-65 years) Page 5 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: This inspection involved a review of all of the information that has been received since the previous key standards inspection that took place in December 2007. The home also sent us the Annual Quality Assurance Assessment. A visit took place and this involved a tour of the premises, discussion with some of the people who use the service as well as discussions with the manager. We also received written surveys from 5 people who live at the home, 2 relatives and 3 members of staff. Without question all of these responses show that there is a high degree of satisfaction with how the service is run, not least considering the changes that are happening for the people who live at the home (please refer to the main body of this report for further comments about these changes). Care Homes for Adults (18-65 years) Page 6 of 26 Care Homes for Adults (18-65 years) Page 7 of 26 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 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. The people who use this service can continue to feel confident that proper assessments are carried out for any new people who are referred to the service. Evidence: Given that the service is in the process of closing the statement of purpose and guide for people who use the service remain unchanged. Two new people, both related, have been admitted since the previous key standards inspection. Each person was properly assessed in light of the plan to close the home in 2009 and to support these people to move to supporting people services. Care Homes for Adults (18-65 years) Page 10 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. The people who use this service can feel confident that their wishes are considered when discussions are held, and plans are made, for their future. Evidence: The sample of care plans and assessments that were seen show that the previously required improvements to care planning have occurred. Everyone who uses this service is currently in the process of moving to supporting people services. This may be individually or in small groups. The decision making for these moves has fully involved each of the people who live here. Detailed discussions have taken place and show that the preferences and wishes of each person have been properly sought and fully considered. Risk assessments have improved as previously required and these have more recently been reviewed in light of the planned moves. Care Homes for Adults (18-65 years) Page 11 of 26 Care Homes for Adults (18-65 years) Page 12 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 people who use this service can feel confident that they will be supported to live the lifestyle that they can meaningfully choose and that personal development opportunities are encouraged and actively supported. Evidence: The service continues to support the people who live at the home to be engaged in meaningful activities and leisure interests that reflect their wishes and needs. The home actively supports the development and maintenance of family and other personal relationships. Given the planned move of each person to supporting people services a lot of emphasis is being placed on personal and life skill development, as well as lifestyle choices and opportunities that will arise in the new settings that each person will move Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: on to. Those people who replied to the questionnaires that were sent prior to this inspection, and those who spoke during this visit, all confirmed that their wishes and choices are respected and are properly considered. The people who use this service are guided and supported to maintain healthy lifestyles and gain skills to enable each to maintain a balanced and nutritious diet. Care Homes for Adults (18-65 years) Page 14 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 people who use this service can feel confident that the necessary medication recording improvements have occurred and that their personal preferences in the way in which they are supported are respected. Evidence: As referred to earlier in this report there is comprehensive discussion and planning taking place in light of each persons move to supporting people services. The extent and frequency of keywork input has improved as was required at the previous inspection. The previous inspection also identified that medication administration records needed improvement, not least in making sure that correct medication records were kept. All medication records were examined at this inspection. This improvement has occurred and no subsequent errors were noted in either the details of prescribed medicines or the way in which administration records are kept. The room temperature where medication is kept is monitored and staff have had medication competency assessed as previously required. Care Homes for Adults (18-65 years) Page 15 of 26 Care Homes for Adults (18-65 years) Page 16 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. The people who use this service can feel confident that any complaints or concerns about their welfare will be properly responded to. Further improvements are, however, necessary in the way in which personal finances for each person are recorded by staff. Evidence: No complaints have been made to either the service or to the Commission or others about the service since the previous inspection. No concerns of harm or abuse have been raised and in this respect the service demonstrates that there is the necessary awareness of what to do if any concerns were to be raised. As a part of the significant changes that are occurring the service has sought independent advocacy involvement, not least for those who may not have either family or other persons who can act in this capacity. Cash tins for three people who have their money held for safe keeping were checked in light of errors that were identified at the previous inspection. That inspection noted that more money was held than the recorded balance in the tins, as was seen again in two of the three cash tins that were examined. These amounts were between 8 pence and 55 pence more money than was recorded. There is nothing to suggest that anyones personal finances are being abused, however, it remains important to properly record and verify these amounts. Even though the previously required audits have happened the home should now address this by implementing a daily check at Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: each day shift handover. Subsequent to the draft report being issued the service later confirmed that a policy of checking tin balances has now been implemented at each shift handover. 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 people who use this service can feel confident that their home will be maintained to an acceptable standard until they move to other accommodation. Evidence: Given that the service is in the process of closing in the next few months there are no plans for any refurbishment of the property as this will be taken back by the housing association that own it. A tour of the building did, however, show that it is of an acceptable standard and should remain so until closure. The previously identified mould in the bathrooms has been dealt with and the issue of unpleasant odour has also been resolved. The house is kept clean and is a comfortable place for the people who live here. 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. The people who use this service can feel confident that the staff who work with them have been recruited properly, are safe and are well trained to perform their duties. Evidence: Three more recently employed staff recruitment records were checked. Each of these staff had the required recruitment and background checks in place, including application forms, interview notes, references and Criminal Records Bureau checks. The organisation have an induction programme for new staff and it was evident that this is still being used for new employees. Staff training and development programmes are in place, however, considering the home will soon close these will not be applicable for this service for much longer. It is expected that staff will all transfer to new supporting people services once those who live here have moved. The staff training and development needs will then be re-assessed in light of the new settings in which staff will work. It is positive to note that 60 of staff hold the NVQ level 2 or higher which exceeds the national minimum standard of 50 . Staff supervision frequency has also improved as was required at the previous inspection. A sample of staff supervision records show that this is arranged to occur at Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: least once per month. Even if the occasional supervision session is missed it should still mean that the minimum of six supervision sessions per year can be achieved. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service can feel confident that it is well managed and that the changes that are being made are being given a great deal of consideration. Evidence: The manager of the home came into post a little over three weeks before the previous inspection. Having a permanent manager present since that time has helped the service to make the necessary improvements and to plan for change. As referred to throughout this report, the service is in the process of closing down once all of those who live here have moved to supporting people services. It is clearly evident that a lot of careful thought, discussion and planning has been happening to facilitate the moves. Given that many of those who live at the home have done so for a number of years in is highly encouraging to see how sensitively this process is being managed. The thoughts, feelings and preferences of the people who use this service are being given priority. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The necessary standard safety checks for the premises have all been carried out within the last year as required. 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 23 The service should ensure that service users cash tins are checked daily at each afternoon shift change so that any recording errors can be rectified. 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. 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