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Inspection on 21/06/05 for Avalon Residential Home

Also see our care home review for Avalon Residential Home for more information

This inspection was carried out on 21st June 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Providers felt that one of their biggest assets was that the Residents had been living with them for almost 11 years and they had their finger on the pulse of the home daily, and as they employed no staff there were no communication problems at handovers or change of shift. The providers said that they made every effort to help and support the Residents to be as independent as possible, they felt they were good listeners, had a good sense of humour, were diplomatic and easy going. The home was run as a family home and the providers felt that the food given to the Residents was of a high quality.

What has improved since the last inspection?

Since the last inspection the Risk assessments have been evaluated and new flooring has been laid in the front room and bathroom. Plans have been made to replace the flooring in the kitchen and utility room during the summer.

What the care home could do better:

Access to training is difficult due to the high cost and the Providers are trying to join in with other homes. The Providers have looked into the Requirement of the last Inspection regarding completing the NVQ Registered Managers award by December 2006 and this is ongoing. The Inspector advised the Providers that one of them should attend Adult Protection training. Although Risk assessments and Evaluation forms are in place a discussion took place regarding whether the Evaluation form could become part of the Risk Assessment form. One Resident who self medicates keeps her medication to control blood pressure on a shelf in their bedroom, this should be kept in a locked draw or cabinet. Although the Residents are responsible for their finances some of their personal allowance money is kept in a cashbox and they take out what they require for the day, the providers make a note of how much is taken and the balance left which is then signed by the resident, there is however no note of what it is being used for and the Inspector felt that it may be helpful to have a note indicating where the Resident was going but not necessarily what the money was being spent on i.e. Sheerness, Day Centre, Mencap. Although the Residents are used to it, the Inspector was concerned to see that the transport that collected the Residents to take them to the Crawford Day Centre had a timescale to arrive of between 08:15 and 09:00, this seemed to be a large time gap to keep someone waiting.

CARE HOME ADULTS 18-65 Avalon Residential Home Sexburga Drive Minster on Sea Sheerness Kent ME12 2LF Lead Inspector Graham Cummings Announced 21/06/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Avalon Residential Home Address Sexburga Drive, Minster on Sea, Sheerness, Kent, ME12 2LF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01795 877289 Mrs Evelyn Iris Marchington Mrs Evelyn Iris Marchington Registered Care Home 3 Category(ies) of Care Home for Younger Adults 18-65 - Learning registration, with number Disability of places Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Residents receiving care will be over 19 years of age Date of last inspection 02/02/05 Brief Description of the Service: Avalon is a Home for three adults with a learning disability. The Residents have their own room and live very much as part of the family in a large family home. The home itself is very near the coast in Minster on The Isle of Sheppy. The Residents are within easy reach of Sheerness, which affords access to local shops. Transport is by bus or taxi, there is a main line railway station in Sheerness. The home is located on an unmade road which local residents do their best to keep reasonable. The Home has a large well-maintained garden, which is enjoyed by all the Residents. The home has several cats and nine chickens; the Residents enjoy having them around and are involved in their care. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Graham Cummings carried out the Announced Inspection on Tuesday 21st June 2005. The Inspector arrived at 09:45 and left at 15:45. The Inspector spent the visit talking to the Providers/Manager and looking through records. The three Residents living at Avalon had gone to the Crawford Day Centre, it was one of the Residents birthday and he wanted to spend it with his friends and the Inspector did not have an opportunity to speak with them to discuss their views of living at Avalon, they did however leave permission with the Providers to say the Inspector could access their rooms. A long discussion took place regarding the Residents who have all been living at the home for almost 11 years and have become part of ‘the family’. Since the change of the boundaries within Kent to make Medway a unitary authority, no permanent contracts have been made to secure the placements and the Providers are concerned at the lack of security this places them in as a small home. The Residents would benefit from a re-assessment of need from Care Managers to ensure that their needs are still being met appropriately. The Residents are responsible for their own finances and are able to travel independently into Sheerness by bus at weekends if they wish. The Providers manage the home by themselves and there are no staff employed. The home is run as a family home and the Residents are encouraged to take appropriate responsibilities within it, they all have keys to the back door of the house. The Inspector was told that 1 Resident had just completed his time as Chair of the Swale Partnership. The home was clean and tidy with a relaxed atmosphere. What the service does well: What has improved since the last inspection? Since the last inspection the Risk assessments have been evaluated and new flooring has been laid in the front room and bathroom. Plans have been made to replace the flooring in the kitchen and utility room during the summer. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 6 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. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Prospective users individual aspirations and needs are assessed. EVIDENCE: The inspector was shown a pre placement assessment form, although this form has not been required for use it was comprehensive and available should it be needed. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Residents Care Plans are evaluated and changed when required. Residents make decisions daily. Risk assessments are completed on all activities. EVIDENCE: Residents Care Plans were seen and found to contain relevant documents, the Care Plans had been evaluated since the last inspection. The Residents are able to make decision and choices daily. The Inspector was told that Residents choose daily whether or not they want to attend the Day Centre and the clothes they wear. Risk assessments and evaluation forms were seen, a discussion relating to the amalgamation of both forms took place, it was left to the providers to decide the outcome. The home has initiated Care Management Assessment on the individual Residents to ensure that their changing needs were being met. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15,17 Residents take part in age appropriate activities. Residents are part of the local community. Residents have contact with family and friends. Residents have a healthy and nutritious diet EVIDENCE: The Residents attend the Crawford Day Centre in Sheerness, 2 of them attend 5 days and 1 attends for 3 days and works at a Chemist on Mondays and Fridays. One Resident attends the Swale Partnership and has been chair of this for the last year. The Residents go into Sheerness at weekends by themselves using local transport and have the option to go to a local disco run by Mencap on Friday nights. The Residents are known to their neighbours and the local community and often come back from their outings with updated local information. One Resident has overnight stays with a member of their family and the two others have contact as and when they wish. The inspector was shown a menu that indicated a wide variety of food was offered to the Residents and that they were given a healthy and nutritious diet. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 Residents who self medicate need to be protected. EVIDENCE: One Resident who self medicates keeps their medication for blood pressure on a shelf in their room, this needs to kept in a locked cupboard or cabinet with the providers having a spare key. The Medication Administration Records for another Resident not self-administering were seen and met with the standards. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Residents are protected from abuse. EVIDENCE: All the Residents money is put straight into their individual bank accounts and the funding authority are appointees. The Inspector was told by the providers that the two of the Residents have in the region of a £1,000 and the third has none, they were not sure why, the Inspector advised that they contact the funding authority to get the reasons for this. The Inspector advised that one of the Providers attended an Adult Protection training course in the near future to update their knowledge. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,28,30 The home is comfortable and safe. Residents bedrooms meet their needs and promote their independence. Communal space enhances the Residents lifestyle. The home is clean and hygienic. EVIDENCE: The Residents had left permission with the Providers to say the Inspector could view their rooms. The home was comfortable and provided a safe environment for the Residents. The home is well decorated and Residents bedrooms were furnished with personal belongings. Downstairs the communal space consisted of a separate dining and lounge area. The home was clean and free from any offensive odours. The home has a large garden at the rear where chickens are kept and supply the home with eggs on a daily basis. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) No Staff are employed in the home. EVIDENCE: Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,41,42 The home is well run and Residents have an input into the way this happens. The homes record keeping safeguards the Residents best interests and their health, welfare and safety are promoted. EVIDENCE: The Residents have been living with the Providers for almost 11 years and the home is run as a normal ‘family home’. The Providers have adapted to the new legislation well and have put in place most of the Regulations, apart from the completion of NVQ 4 Registered Managers Award, this was a Requirement from the last inspection and has a completion date of 31st December 2006. The Inspector was not able to confirm with the Residents any details in the report as they were all at the Crawford Day Centre. The Inspector has no reason to believe that the Residents do not benefit from a well run home or that their rights and views are not considered in the development of the home. The Inspector felt that the Residents health, safety and welfare were promoted and protected. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score N/A N/A N/A N/A N/A N/A CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Avalon Residential Home Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x 3 3 x H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 17 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 20 Regulation 13(4)( c ) Requirement The registered person shall ensure that - unnecessary risks to the health or safety of Residents are identified and so far as is possible eliminated, in that any Resident who is deemed able to self medicate has a lockable space in which to store medication. Timescale for action 31st August 2005 2. 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. Refer to Standard 23 23 Good Practice Recommendations That one of the Providers attend an Adult Protection training course. That the recording of where the Resident is going when individual daily finances of money is given out, i.e Day Centre; Sheerness; Pub, there is no need to get receipts. Avalon Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Residential Home H56-H05 S23808 Avalon V223815 210605 Stage 4.doc Version 1.30 Page 19 - 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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