Inspection on 26/01/06 for Avenswood

This inspection was carried out on 26th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Avenswood 23/02/07

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 Mrs Julie Garrity Unannounced Inspection 26th January 2006 10:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 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.V280913.R01.S.doc Version 5.1 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.V280913.R01.S.doc Version 5.1 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. 23rd September 2005 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/dinning 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. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over the period of one day. The inspector arrived at the home at 10:30 and left at 13:00. The inspector spoke to the home the nurse-in-charge, seven residents, two visitor and three staff. The inspector completed the inspection by looking at the home records, a tour of the building, formal and informal interviews and information from previous inspection reports. The inspector followed a plan written before the start of the inspection to ensure that all areas that need covering are done so. Feedback was given to the nurse-in-charge during and at the end of the inspection. The home has been assessed on all the core standards during the 2005/06 inspection year. What the service does well: What has improved since the last inspection? What they could do better: The staff in the home have already identified the areas that they wish to improve such as records for the management of medications and a chair lift to help with access by residents to all three floors in the home. Information on assessments for newly admitted residents should be available when the resident is admitted to the home. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 6 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. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 All residents are assed prior to moving into the home. A copy of the assessments must be available for the person who is to admit the resident, in order that a safe admission and suitable care plan can be done. EVIDENCE: Care plan reviewed had admission assessments available. This is good practice as it assists staff in identify the needs of the residents. Staff explained that the manager assesses all residents or a member of staff trained to do so before they are admitted into the home. A resident recalled their admission to the home and said, “I was so happy to arrive and see the person who’d been out to see me. It was really good to think that they knew all about me when I arrived”. A new resident was due to be admitted that day. The senior staff member in charge was unable to locate the assessment done by the manager. Scrap notes detailing contact details for family and diagnosis of a medical condition were on the notes. The senior staff member described the usual assessment process, which was good practice and would assist staff in identifying the needs of the residents. However the assessment done by the manager for the new resident could not be found. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Medications are stored, given and recorded in a safe manner. Staff identify any potential concerns and take appropriate action to maintain a safe way to manage medications. EVIDENCE: 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. One resident spoken with said “its good it means I get my tablets when I need them and the staff always have them available”. Medication records include a recent photograph to assist with identification. The staff had identified that there was a need to further develop the records for medications in particular medicines disposed of and medicines that were not used up from one monthly order and not accounted for on the next months records. Staff also found the records around recording medicines in the home a little difficult to work with but had identified a good solution that they intended to use within the next two weeks. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Residents are supported to make choices about the foods that they like and to eat where they choose. All residents spoken with enjoyed the food. EVIDENCE: 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. There has been an increase in the amount of residents who need support to eat a good diet. Staff manage this well making sure that all the residents are supported properly or encouraged to be independent. A relative visits frequently at meal times, as she likes to be involved in the care received by the resident. A menu is available for residents and they are asked what meals they would like to have. One resident said the food is very good, is I don’t like something or don’t feel to well staff make sure that something is available that I’d like” Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Records regarding concerns raised by residents, relatives or staff are available all concerns are promptly addressed and dealt with in an appropriate manner. EVIDENCE: The residents spoken with that any concerns or questions they have are promptly dealt with. One resident said, “any little problem gets fixed. There’s no way the staff here would let anything upset you”. A relative confirmed this point of view saying “If I’ve had a problem I’ve just raised it with the staff and they’ve fixed it”. A complaints policy is available within the home. One relative recalled seeing this and said, “I’ve never had a reason to raise a complaint, just talk about stuff that I might want addressing and it was always done, fast”. Residents and residents spoken with were very confident that their care needs were being meet on a regular basis that they felt “safe”, “well-cared for” and “trusted all the staff”. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the standards in this area were fully reviewed at this inspection. 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. The homeowner is planning to install an automated chair lift on the stairs to assist with access to the three floors in the home. Other plans include a conservatory at the rear of the building and replacement of the carpets in the main corridors and stairs in the home. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 Staffing levels are at levels suitable to meet the resident’s needs. These are informally monitored and increased, as residents needs change. EVIDENCE: A resident spoken with said, “there is plenty of staff, they are busy and work very hard, but they are there when you need them”. A relative said, “staff are always willing and able to attend when they are needed”. Staff confirmed that there was sufficient staff available at the moment. A review of the residents detailed an increase in the needs of residents from the previous year. The senior member of staff on duty, said that this had been identified and that the manager was monitoring the situation and would increase the staff if needed. Additional staff have been used in the past when residents had extra needs. Domestic staff are employed in good numbers to ensure that standards are met and maintained. Residents were particularly complimentary with regards to the staff and stated that they kept the home “clean and tidy”. Staff files were reviewed and generally contained suitable information. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 The home is run by caring staff, who always try to determine the best interests of the residents and meet their needs, choices and preferences. Resident’s personal funds are managed in a safe manner. EVIDENCE: A variety of different arrangements are in place within the Small amounts of funds are left with home the by families or residents for safekeeping. 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 residents 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.V280913.R01.S.doc Version 5.1 Page 15 The home has completed a quality assurance system that was external and determined the view of residents. Copies of this are available for residents and relatives to view. Meetings are held with staff, residents and relatives both formally and informally to determine their views of the care and management of the home. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X X Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP9 OP27 Good Practice Recommendations A copy of assessments should be available for all new residents when they admitted in the home in order that staff can be fully aware of the residents needs. The home should continue with the areas that they have identified that will further safeguard the arrangements for dealing with medications. Formal arrangements should be used to monitor staffing levels and a record kept when this is done. Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Avenswood DS0000017223.V280913.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!