Inspection on 02/11/06 for Avenue Care (Fareham) Limited

This inspection was carried out on 2nd November 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

Avenue Care (Fareham) Limited 07/03/08

Avenue Care (Fareham) Limited 03/01/06

Avenue Care (Fareham) Limited 20/07/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Avenue Care (Fareham) Limited 36 The Avenue Fareham Hampshire PO14 1NY Lead Inspector Keith Hopkins Unannounced Inspection 2nd November 2006 12:20 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 Avenue Care (Fareham) Limited DS0000060902.V315106.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. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avenue Care (Fareham) Limited Address 36 The Avenue Fareham Hampshire PO14 1NY 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) Avenue Care (Fareham) Limited Mr Stephen Press Care Home 24 Category(ies) of Dementia (24), Dementia - over 65 years of age registration, with number (24), Mental disorder, excluding learning of places disability or dementia (24), Mental Disorder, excluding learning disability or dementia - over 65 years of age (24), Old age, not falling within any other category (24) Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users must be at least 55 years of age. Date of last inspection 3rd January 2006 Brief Description of the Service: The Avenue Rest Home provides residential care for up to 24 older persons, including some with dementia and mental disorder. The home is near to the town of Fareham, with a bus stop outside. The building is a detached property with car parking to the front and garden to the rear. There are two stairlifts and a passenger lift. Maintenance and decoration of the home is of a high standard. There are three lounges plus a conservatory, which opens onto the rear garden. Fees range from £326 to £450 per week. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Four and a half hours were spent visiting the home, during which time the opportunity was taken to look around the home, view records and policies and to talk to the manager. The inspector also spoke privately with two members of the care staff. Most of the service users were observed making use of communal areas and their bedrooms and a number were spoken with briefly during the tour of the building. Three service users were spoken with at greater length in private, and the inspector was also able to speak with two visitors. What the service does well: What has improved since the last inspection? Service users’ enjoyment of their surroundings has been enhanced through the landscaping of some garden areas. Service users’ protection has been enhanced through a fuller understanding of adult protection procedures. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 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. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 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 Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has assessed the needs of its current service users well. These needs are clearly recorded and known to staff. EVIDENCE: Three service users’ files, one relating to a more recently admitted person, were inspected and needs assessments seen within these files contained a good level of detail. There was, for example, information regarding vision, hearing, mobility, and eating and drinking, together with a detailed medical history. The manager explained that it was usually himself who undertook the initial assessment prior to any decision regarding admission. The two visitors to the home confirmed that their relative had been visited by the manager beforehand, saying that ‘he told us what we needed to know’, and went on to say that they had been given a good level of information, including the level of fees. The inspector saw evidence that assessments were reviewed after admission, and service users spoken with confirmed their involvement in the Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 9 review process. One person, for example, said that she dealt with some of her own personal needs. Staff spoken with were clearly aware of the needs assessments and explained how they met these needs on an individual basis. The home does not admit service users for intermediate care. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good care planning regime, which addresses identified personal, social and health care needs and involves service users. EVIDENCE: Three care plans were examined and contained information for staff to ensure that all aspects of health, personal and social care needs could be met. There was, for example, information in one of the plans examined regarding the specific help the service user needed with eating. Another plan contained a risk assessment regarding the possibility of pressure sores and instruction to staff on how to prevent this. Plans are reviewed on a regular monthly basis and service users confirmed their involvement in this process, together with that of their keyworker. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 11 Plans contained information regarding more specific health care needs, and details of any contact with a GP or nurse. The inspector noted that several GPs from two different surgeries were involved with the home and that service users were able to choose a male or female GP if they wished. The home has a policy and procedure for dealing with medication, which enables service users to exercise choice over whether they wish to deal with their own medication. The inspector was informed that no-one is currently doing this but that it had happened in the past. One service user said that they ‘deal with my medication for me’. A pharmacist had inspected the system for dealing with medication on 26th August 2006, the result being a rating of ‘excellent’. The drugs cupboard, including the separate controlled drugs cabinet, was secure at the time of the inspection. Records relating to three service users were examined and were in order and up to date. A check was made on one person’s controlled medication with the amount tallying with the record held. The home does not currently need to refrigerate any medicines. Staff responsible for dealing with medication have been trained. Two visitors to the home said that they were very happy with the care provided for their relative and that she ‘was well looked after’. Staff were observed to be providing assistance to service users in a calm and dignified manner, and knocked on doors, awaiting a response, before entering. Screening is available and used in double rooms. Service users’ wishes regarding the way in which they are addressed by staff are recorded in their care plan and respected by staff. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users enjoy varied lifestyles and undertake activities of their choice. Visitors to the home are encouraged. Service users enjoy their meals in congenial surroundings. EVIDENCE: Care plans clearly detail what each service user’s interests are and service users themselves confirmed, variously, that they enjoyed activities such as reading and playing dominoes. The home provides a range of activities on a regular basis, such as reminiscence therapy weekly, exercises fortnightly and arts and craft every month as well as a number of ‘one-off’ events. A 50th wedding anniversary had recently, for example, been celebrated by a trip to the New Forest, and a number of service users had also visited the Spinnaker Tower in Portsmouth. During the inspection the inspector observed that service users were, on an individual basis, being accompanied on walks in the garden. The inspector spoke with two visitors to the home who were pleased with the services offered to their relative. Service users were observed during the Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 13 inspection to be entertaining their visitors either in the communal areas of the home or in private in their bedrooms. Service users are able to move freely around the building and were seen to be making use of all communal areas as well as their bedrooms. Menus at the home were varied and the inspector was told by service users that there was ‘good food, well cooked’ and also that the food was ’plain but that’s what I prefer’. The cook finds out from service users the day before which of the two choices of main meal they would like. Service users may choose where to take their meals, the inspector being told that several service users have breakfast in bed, one person spoken with confirming this, with one service user having a regular ‘lie-in’ and breakfast at 9:30am. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 14 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a suitable complaints procedure, which service users are aware of and feel able to use. Service users are protected through an adult protection policy and procedure known to and understood by staff. EVIDENCE: The home has a complaints policy and procedure, a copy of which was included in the information available to potential service users. Two of the service users spoken with privately said that they had no complaints and were aware of what to do if they had. Service users all appeared to have a good degree of confidence that any issues raised would be dealt with, although it was reported by the manager that the home had had no complaints to deal with in the previous 12 months. Staff when interviewed said that they would report to a more senior person any complaints made to them by service users. The home also has a policy and procedure relating to adult protection, with information produced by Hampshire Social Services being available for staff to consult. Staff have been trained in this and when interviewed confirmed their understanding of what to do in the case of suspected abuse. Both members of staff interviewed said that they would report anything they needed to. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 15 Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable environment, which is suitably furnished and well maintained. EVIDENCE: The tour of the building showed this to be clean and tidy throughout and there were no undue odours. Communal areas were well furnished and adequate bathroom and toilet facilities with aids were available. Communal areas include three well-furnished lounge/dining rooms, together with a conservatory. The inspector examined four bedrooms, which were all adequate in size, and had clearly been personalised, to considerable degrees. Comments made variously by service users included that it was ‘nice here’, with one service user saying that ‘it is just like home’. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 17 Service users were observed to be freely making use of communal areas, such as the lounges and other communal areas and accessed their bedrooms as they wished. The home’s laundry was inspected and was fit for purpose with machines being capable of meeting disinfection standards. An issue regarding the lack of a hot water supply for hand-washing purposes in the laundry had been resolved. Members of staff spoken with were clearly aware of good practice and there were procedures in place to deal with soiled items. Staff were aware of these procedures and confirmed that gloves and aprons were available. The building is well maintained with any faults or items requiring attention being recorded in the maintenance book and subsequently dealt with. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are well supported by a well-trained staff team who are deployed in sufficient numbers to meet their needs. EVIDENCE: Two staff files examined contained evidence of written references being obtained following the completion of an appropriate application form and interview. There was evidence of Criminal Record Bureau (CRB) disclosures having been obtained, and staff confirmed this. The two files contained evidence of a sound and comprehensive induction process and further details of short courses undertaken. Courses included Safe Handling of Medicines, Moving and Handling, Health and Safety, First Aid, Adult Protection and Dementia. Staff spoken with said that there were good opportunities for training and that they could do whatever courses they wanted to. It is understood that of the eleven care staff employed, nine have obtained a National Vocational Qualification at Level 2 or above. During the inspection the inspector observed staff interacting with service users in a friendly yet professional manner. The staff rota indicated there to normally be three members of the care staff on duty in the mornings and three in the afternoons, supported by ancillary staff and the manager. There are two Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 19 waking members of staff on duty at night. Staff spoken with said that there were generally enough of them on duty to meet service user’s needs. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a qualified and competent manager, supported by comprehensive policies known to staff. EVIDENCE: The home’s manager has worked in the home for a considerable number of years and has obtained a National Vocational Qualification in management at level 4. A survey of the home’ services has recently been undertaken by way of a questionnaire to service users and visiting professionals with a total of some 20 or so responses. These were overwhelmingly positive although a comment was made about a seeming lack of clarity regarding information about the Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 21 choice available at mealtimes. The home has acted on this and service users are now individually asked about their choice of main meal. The home does not deal with any service users’ monies, and any sundries purchased on behalf of service users are billed separately. The home has a policy for the control of substances hazardous to health known to staff. Chemicals and other items were securely stored in a locked cupboard in the kitchen and staff were aware of health and safety issues. The home has a health and safety policy known to staff. Since the last inspection advice has been sought from an occupational therapist regarding what could have been an unsafe practice when transporting a service user in a wheelchair, and the issue resolved. A sample of policies, procedures and records required by regulation were inspected and were in order and up to date. This included the home’s fire records and accident book. The inspector also saw the home’s policies on voting, quality management and infection control. Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 22 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Avenue Care (Fareham) Limited DS0000060902.V315106.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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