Inspection on 23/02/07 for Avenswood

This inspection was carried out on 23rd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Avenswood 26/01/06

Avenswood 23/09/05

Avenswood 18/01/05

Avenswood 27/09/04

Avenswood 30/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Avenswood 20 Abbotsford Road Blundellsands Liverpool Merseyside L23 6UX Lead Inspector Mr Mike Perry Unannounced Inspection 23rd February 2007 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 Avenswood DS0000017223.V323453.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. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avenswood Address 20 Abbotsford Road Blundellsands Liverpool Merseyside L23 6UX 0151 924 0484 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) Nursing Home Management Limited Mrs Ann McDonnell Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users to Include up to 18 (OP) The service should, at all times, employ a suitably qualified and experienced Manager who is registered with the CSCI. 26th January 2006 Date of last inspection Brief Description of the Service: The Home is registered to provide nursing care. In total the Avenswood Care Home provides care for 18 service users over 65 years of age. The Home is privately owned. The registered manager has worked in the Home for a several of years and is a registered nurse. The Home is a converted building on 3 floors; there is no passenger lift to the 1st and 2nd floors. However the establishment utilises a scalamobile chair that is designed to ascend the stairs. There are 12 single rooms, 5 bedrooms with ensuite facilities and 3 double rooms none of which have ensuite facilities. Bedrooms are situated on all floors with a lounge/dining area on the ground floor. There are gardens to the rear of the establishment accessible from the ground floor. Avenswood is situated in a residential area in a quite cul-de-sac. The local train station is accessible at the bottom of the street and there are a number of shops within walking distance. Parking is available to the front of the building. The fees for the service are £447 - £530 Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a ‘key’ inspection for the service and covered the core Standards the home is expected to achieve. The inspection took place over a period of 10.5 hours over 2 days. The inspector met and spoke with a number of residents and a visiting relative. The inspector also spoke with members of care staff on a one to one basis and the registered manager and the provider who was also in attendance. Resident survey forms [‘comment cards’] were also issued prior to the inspection and a high proportion of these were returned and comments have assisted in the inspection process. A tour of the premises was carried out and this covered all areas of the home including the resident’s bedrooms. Records were examined and these included 3 of the resident’s care plans, staff files, staff training records and health and safety records. The provider was also able to discuss plans for the home over the next year and has produced a business plan covering this. What the service does well: The home has written information [Service User Guide] and this is available for residents and relatives. Residents spoken to where able to show the inspector this document and said that it had been useful as a guide to the home and had assisted them in both choosing and settling into the home. All residents are assessed prior to admission to the home. 3 care files were reviewed and appropriate social care and health care assessments had been completed. There were copies of referral assessments from health and social care professionals to compliment the homes own assessments. This assists staff to meet the care needs of anybody admitted to the home. Residents spoken to felt that staff attended to their needs and they felt safe in the home. The relative spoken to was very positive in support of the staff’s general approach to care and felt that staff had a clear understanding of residents needs. One resident commented ‘I have every confidence in the staff who are very caring’. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 6 Care plans were looked at for three residents. The home are trying to involve both residents and relatives in the planning of the care and some residents had signed plans to say they have discussed how their care is going to be given. The relative interviewed stated that staff are always available to talk about care issues. The plans were very personalised and those seen include entries on social aspects of care. For example one resident ‘likes classical music and enjoys going out into the garden in good weather’. One resident reviewed has needs including a pressure sore currently and this is monitored through the care plan with regular, daily records maintained. The records included wound charts and photographs showing the progress and improvement in the wound. The resident described how staff had given support and how ‘they are a very good team and very caring. They look after me well’. Residents can choose their own GP (General Practitioner) and are visited by a range of health and social care professionals such as social workers, opticians and dentists. Residents and relatives spoken to at the inspection said that they were treated with respect and that privacy was maintained when needed. The home has three rooms, which are shared. It was observed that portable screens were in each room and one resident said that staff always use these and that privacy is respected. Residents were asked about toilet and bathing arrangements and stated that staff were care full to ensure privacy. Staff interviewed highlighted issues around privacy and dignity and were observed to be very respectful when attending to residents [for example at meal times]. During the inspection residents were observed to be appropriately dressed and clean and well presented so that dignity is preserved. Staff have good rapport with residents and the general atmosphere in the home is positive with care staff seen talking to and supporting residents. One comment was that ‘they are like an extension of my family’ and ‘its home from home – I couldn’t have picked a better place’. All of the residents spoken with were complimentary about the food. Staff organise meals very well in inconvenient circumstances as the home is on three floors the meals need to be carried up by the staff who try very hard to make sure that the meals are still hot and nicely presented. One resident likes a Mediterranean type diet and stated that this was well supported ‘ I’m difficult to please some times but they try very hard to make sure I get nice meals’. Those residents and relatives interviewed felt that they were able to approach staff and that their concerns would be listened to. There is a complaints procedue and this is in all of the service user guides which are in bedrooms. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 7 Avenswood is a pleasant and homely care home. The residents like the way the home looks and a full time maintenance man is available to address general maintenance concerns. There is an absence of any offensive odours and the general cleanliness is of a high standard. Bedrooms seen were highly personalised and likewise the shared rooms are made as homely as possible. For 18 residents in the home at the time of the inspection the staffing was 1 trained nurse and 3/4 care staff on days. Appropiate ancilliary staff are also employed on cleaning and in the kitchen [8.30 – 5.30 daily] and laundry which offers good support for care staff and is a mark of good quality in a small care home were such duties are often shared by care staff. Residents and relatives comments were very supportative of the staff who were seen as helpful and kind. ‘staff act very quickly to requests and are always on hand’ ‘they provide very good care and are always helpful’ ‘staff are friendly and you can have a chat with them’ Staff stated that ‘there is plenty of training and I generally feel well supported by the manager and senior staff’. Staff files were inspected and were found to be inclusive of all of the required checks to ensure that residents are protected. Staff interviewed clearly enjoy their work in the home and were very enthusiastic about their role. Ann McDonnell is the manager of the home. She has been in post for a great many years and worked in the deputy role prior to this. She works well with the owner of the home who provides regular support. The relationship was described by both as positive. All staff and residents / relatives were supportive of the managers approach and she was known to all of the residents, relatives and staff spoken to. Residents veiws are sought continually. Being a small home the residents reported that they have a daily dialouge with the owner and manager. Views are sought formally as part of the quality processess. Satifaction with the home is very high. What has improved since the last inspection? There were three recommendations from the previous inspection. All of these have been addressed. These were around the assessment process for residents prior to admission, medication management and monitoring of staffing levels. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 8 What they could do better: Plans were being reviewed by staff on a monthly basis, or sooner if needed. It was agreed that care plan evaluations should contain more than a general statement of ‘continue care’ and should be a discussion and statement of progress made set against the aims / goals of the care plan. Medicines are generally very well managed. There were some issues that need consideration and developing however: • Creams being administered are not routinely recorded with respect to times and staff identity and this was discussed with the manager and practical recording processes should be put in place. The risk assessment in place for residents self medicating could be developed more specifically and this was discussed. The homes policy needs to refer more fully to risk assessment for those residents who may wish or can self medicate. • The policy/procedure document covering adult protection/reporting of abuse in use in the home has been superseded by joint protocols covering both Sefton and Liverpool and the home should get a copy of this for training purposes and future reference. The discussion regarding the provision of more permanent screening in bedrooms should be considered by management in the future with respect to encouraging independence for residents. There has been no formal training around issues of diversity and equality in a wider sense and a deeper understanding of a more social model of care was missing [although in practice the home are trying to remove as many barriers as possible for people with disability]. The owner has undergone some training in this area and should introduce awareness on induction courses for new staff and extend this to existing staff as well. 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. The summary of this inspection report can be made available in other formats on request. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 9 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 Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,2,3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has written information [Service User Guide] and this is available for residents and relatives. Residents spoken to where able to show the inspector this document and said that it had been useful as a guide to the home and had assisted them in both choosing and settling into the home. All of the completed resident surveys evidenced that residents have been issued with contracts following admission to the home so that each resident has awareness of the terms of living in the home. All residents are assessed prior to admission to the home. 3 care files were reviewed and appropriate social care and health care assessments had been Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 11 completed. There were copies of referral assessments from health and social care professionals to compliment the homes own assessments. Following admission there are further, more detailed, assessments carried out covering areas such as manual handling, falls, and nutrition so that a plan of care can be drawn up. All of those seen where detailed and highlighted the care needs. Residents spoken to felt that staff attended to their needs and they felt safe in the home. The relative spoken to was very positive in support of the staff’s general approach to care and felt that staff had a clear understanding of residents needs. One resident commented ‘I have every confidence in the staff who are very caring’. The home is keen to provide additional information once residents are admitted to the home. A current example of this was that following a recent television programme concerning poor care in a care home the management at Avenswood are sending around a letter of reassurance and highlighting the complaints process as well at the local adult protection policy. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): All key standards Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were looked at for three residents. The home are trying to involve both residents and relatives in the planning of the care and some residents had signed plans to say they have discussed how their care is going to be given. The relative interviewed stated that staff are always available to talk about care issues and that he is kept regularly updated, particularly if there are any changes to care needs. Plans were being reviewed by staff on a monthly basis, or sooner if needed. This evaluation process was discussed. It was agreed that care plan evaluations should contain more than a general statement of ‘continue care’ Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 13 and should be a discussion and statement of progress made set against the aims / goals of the care plan. This should show evidence of discussion with key workers and periodically relatives and residents. The care plans are based on a recognised model of nursing, which centres on the daily activity residents are able to achieve and the aim of the care is to support this. The plans were very personalised and those seen include entries on social aspects of care. For example one resident ‘likes classical music and enjoys going out into the garden in good weather’. The care plans seen could be followed easily and gave a good out line of the care needs of the residents concerned. Residents have any care risks assessed using a particular form and assessments were seen around, for example, bed rails and one resident who was self medicating. The form, whilst being generally useful, could be better developed for use in self medication [see below]. One resident reviewed has needs including a pressure sore currently and this is monitored through the care plan with regular, daily records maintained. The records included wound charts and photographs showing the progress and improvement in the wound. The resident when interviewed was fully aware of the condition of the wounds and said that the staff gave continual updates. The resident described how staff had given support and how ‘they are a very good team and very caring. They look after me well’. The same resident has been supported through medical appointments and the liaison with the health professionals outside the home was very good. The provision of specialist nursing equipment and aids such as pressure relief mattresses is very good and all of the residents at risk had a mattress in place. Although the home does not have a lift fitted so that level access is impossible the provider has fitted stair lifts and stated that this will extend to the top floor eventually. [Currently using a machine that transports residents up and down stairs]. Residents can choose their own GP (General Practitioner) and are visited by a range of health and social care professionals such as social workers, opticians and dentists. One resident with diabetes is monitored by the diabetic services. The relevant nursing observations were in place for this resident and the nursing staff in the home were regularly monitoring blood glucose levels. Residents and relatives spoken to at the inspection said that they were treated with respect and that privacy was maintained when needed. The home has three rooms, which are shared. It was observed that portable screens were in each room and one resident said that staff always use these and that privacy is respected. There was some discussion around the practicalities of these screens as opposed to fixed curtains which can be drawn around more easily Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 14 and would have particular benefits to more able residents as it would assist in independence [could perform this task unaided instead of relying on staff to move screens]. The resident interviewed stated that the advantage of the current screens were their portability and felt that they were better because of this. The residents in the shared rooms are currently very dependent. Residents were asked about toilet and bathing arrangements and stated that staff were care full to ensure privacy. Staff interviewed highlighted issues around privacy and dignity and were observed to be very respectful when attending to residents [for example at meal times]. During the inspection residents were observed to be appropriately dressed and clean and well presented so that dignity is preserved. Staff have good rapport with residents and the general atmosphere in the home is positive with care staff seen talking to and supporting residents. Residents reported that medication is always given on time. The medication administration records [MAR] were seen and were clear and accurate for those residents reviewed. Creams being administered are not routinely recorded with respect to times and staff identity and this was discussed wit the manager and practical recording processes should be put in place. Each resident has a secured and locked space in their bedrooms. This is good practice as it assists staff in making sure that they give the medicines to the correct resident and keeps them secure at all times. Only one resident is self-medicating at present. The risk assessment in place could be developed more specifically and this was discussed. The homes policy needs to refer more fully to risk assessment for those residents who may wish or can self medicate. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): All key standards. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The general atmosphere in the home is warm and friendly. Residents reported that staff were very friendly and supportative and spent time with them on a daily basis. One comment was that ‘they are like an extension of my family’. One resident discussed how care staff accompanies him out a lot to various appointments and also to church on a regular basis. Visitors are encouraged and can visit at any time. One relative commented that staff are always welcoming. Another resident described the monthly ‘special meal’ that the home provide by asking each resident what they would like and making a special effort to Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 16 cook this. The residents appreciated this. One commented ‘ its home from home – I couldn’t have picked a better place’. The dependency of residents is high generally and the lounge is not often used and there are no daily-organised group activities. One member of staff is designated as extra cover in the afternoons however and provides some individual input for residents. The home make the effort to have an entertainer regularly and again this was appreciated by those residents attending. Staff reported that they had time to spend with residents and the key worker system helped ensure that care is more personalised. Staff spoken to were very knowledgeable about the residents and could give a social history as well as their immediate care needs. The pace of the day is very relaxed and this was supported by statements form residents who said that they could get up and go to bed when they wished. All of the residents spoken with were complimentary about the food. Staff organise meals very well in inconvenient circumstances as the home is on three floors the meals need to be carried up by the staff who try very hard to make sure that the meals are still hot and nicely presented. Residents were observed being supported by staff when they needed help with feeding and staff were patient and personalised the experience. One resident likes a Mediterranean type diet and stated that this was well supported ‘ I’m difficult to please some times but they try very hard to make sure I get nice meals’. There were entries in the care plans for each resident on likes and dislikes and it is clear that this aspect of care is given a high priority. Other residents stated that they could choose what they like if they do not want what is on the menu. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Those residents and relatives interviewed felt that they were able to approach staff and that their concerns would be listened to. There is a complaints procedue and this is in all of the service user guides which are in bedrooms. There have been two complaints about care in the home since the last inspection and both were minor issues that the management responded to very quickly. Staff in the home have attended training sessions with around abuse awareness and the local adult protection protocols and those interviewed were aware of how to report any allegations of concerns. The policy / procedure document in use in the home has been superseded by joint protocols covering both Sefton and Liverpool and the home should get a copy of this for training purposes and future reference. The management are aware of the principals of good care in this area and are sensitive to the anxieties of residents following a recent TV programme on Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 18 abuse. Consequently the have issued a personal letter to all residents and again made them aware of contact numbers and policy ion this area. Residents interviewed felt very safe in the home and felt that staff could be trusted and approached. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Key standards plus standard 24. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Avenswood is a pleasant and homely care home. The residents like the way the home looks and a full time maintenance man is available to address general maintenance concerns. There is an absence of any offensive odours and the general cleanliness is of a high standard. The home does not have a lift so that access to the three floors is more difficult. The owner has installed a chair lift on all stairways apart from the top floor although there are plans to include this. The inclusion of a conservatory Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 20 area will give greater access to day space for some residents and this is included in the business and development plan for next year and is dependant on funding sources. The management are aware of the shortfalls in the environment of the home and are making positive plans to address them and maintain existing facilities to a high standard. Bedrooms seen were highly personalised and likewise the shared rooms are made as homely as possible. The discussion regarding the provision of more permanent screening should be considered by management in the future with respect to encouraging independence for residents. [See discussion under health and personal care]. The laundry area was clean and tidy and fit for purpose and is staffed independently. The walls of the laundry were flaking paint in some areas and would benefit from decorating so that it remains easy to clean. The owner made a commitment to attend to this immediately and the work was completed within a few days evidencing a highly responsive management. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): All key standards Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: For 18 residents in the home at the time of the inspection the staffing was 1 trained nurse and 3/4 care staff on days. Appropiate ancilliary staff are also employed on cleaning and in the kitchen [8.30 – 5.30 daily] and laundry which offers good support for care staff and is a mark of good quality in a small care home were such duties are often shared by care staff. The provider is a regular feature in the home and takes an active role in the daily life and events. There is a steady core of staff who maintain consistency of care with no use of agency staff. The home employs a maintainance cover on a daily basis. Residents and relatives comments were very supportative of the staff who were seen as helpful and kind. All comments recieved from both comment cards and during the inspection were very positive and evidenced a personalised and individulalised approach. ‘staff act very quickly to requests and are always on hand’ Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 22 ‘they provide very good care and are always helpful’ ‘staff are friendly and you can have a chat with them’ Staff training is organised well and there is a training plan for the forthcoming year. Staff talked about supervision sessions and training needs are identified. Staff stated that ‘there is plenty of training and I generally feel well supported by the manager and senior staff’. There is currently slightly less than 50 of the care staff trained to NVQ level but this is being addressed with more staff soon to start courses. Staff were able to identify care which covered a diverse range of care needs and understood the principals surrounding equality of care and how this is materialised through individual assessment and attention to care needs. There has been no formal training around issues of diversity and equality in a wider sense however and a deeper understanding of a more social model of care was missing. The owner has undergone some training in this area and should introduce awareness on induction courses for new staff and extend to existing staff as well. Staff files were inspected and were found to be inclusive of all of the required checks to ensure that residents are protected. Staff interviewed clearly enjoy their work in the home and were very enthusiastic about their role. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): All key standards Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ann McDonnell is the manager of the home. She has been in post for a great many years and worked in the deputy role prior to this. She works well wit the owner of the home who provides regular support. The relationship was described by both as positive. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 24 Ann has very good experience in the clinical field and has completed the Registered Managers Award. She has completed updates in clinical nursing practice including palliative care and the home have linked in well with good practice in this area. All staff and residents / relatives were supportive of the managers approach and she was known to all of the residents, relatives and staff spoken to. The home is subject to some external Quality Assurance processess such as a yearly quality audit. The owner also carries out their own audit on a regular basis and this was seen covering areas such as care planning and health and saftey. The home have a very good record of meeting any requirments and recommendations and are quick to respond to sugestions made. For example the recomended decorating of the laundry was carried out in days. Residents veiws are sought continually. Being a small home the residents reported that they have a daily dialouge with the owner and manager. Views are sought formally as part of the quality processess. Health and Saftey records were seen [fire records and risk assessments] and this area is managed well. Arrangements are in place to manage resident’s funds. Residents or their relatives are billed for any spends that the resident has such as hairdressing, toiletries etc. Any spending supported by the staff has suitable records in place and receipts of spending are retained for resident’s information. Residents can access small amounts of money immediately; larger amounts can be obtained within a couple of days. Residents and relatives are aware of these arrangements. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 25 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 X X 4 Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 26 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. 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. Refer to Standard OP7 Good Practice Recommendations Plans were being reviewed by staff on a monthly basis, or sooner if needed. It was agreed that care plan evaluations should contain more than a general statement of ‘continue care’ and should be a discussion and statement of progress made set against the aims / goals of the care plan. The adult protection policy / procedure document in use in the home has been superseded by joint protocols covering both Sefton and Liverpool and the home should get a copy of this for training purposes and future reference. The discussion regarding the provision of more permanent screening in bedrooms should be considered by management in the future with respect to encouraging independence for residents. 2 OP18 3 OP24 Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 27 4 OP30 There has been no formal training around issues of diversity and equality in a wider sense. The owner has undergone some training in this area and should introduce awareness on induction courses for new staff and extend to existing staff as well. Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 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 © 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 Avenswood DS0000017223.V323453.R01.S.doc Version 5.2 Page 29 - 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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