Inspection on 03/01/06 for Avenue Care (Fareham) Limited

This inspection was carried out on 3rd 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

Avenue Care (Fareham) Limited 07/03/08

Avenue Care (Fareham) Limited 02/11/06

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 Beverley Rand Unannounced Inspection 3rd January 2006 10:10 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.V275698.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. Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 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.V275698.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category MD and DE referred to above are not to be admitted under the age of 55 years. 20th July 2005 Date of last inspection Brief Description of the Service: The Avenue Rest Home provides residential care for up to 24 older persons, including those 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 grounds. There are two stairlifts and a passenger lift. There is a car park at the front of the house and there are well-maintained gardens at the rear and front of the house. Maintenance and decoration of the home is of a high standard. There are three lounges plus a conservatory, which opens onto the back garden Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the year, and should be read in conjunction with the previous report. The inspector spent four hours at the home, talking with two residents, two visitors, staff and the manager. The inspector spent one and a half hours sitting in the conservatory and lounge area, talking with other residents and watching interactions between residents and residents and staff. On the day of the inspection, a person had come into the home and was doing manicures for anyone who wanted it. This was a positive activity, as it encouraged chatting between residents and visitors, and was enjoyed by all parties. Various records, including maintenance certificates and the accident book, were also looked at. What the service does well: What has improved since the last inspection? What they could do better: The inspector found potentially dangerous gardening substances in the greenhouse, and cleaning fluids in the kitchen, which must be locked away, as they could be dangerous to residents who are confused. The inspector saw a resident being moved in a wheelchair which did not look like a safe way of doing so, and this report states that professional advice must be sought about how to use wheelchairs correctly. Avenue Care (Fareham) Limited DS0000060902.V275698.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. Avenue Care (Fareham) Limited DS0000060902.V275698.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 Avenue Care (Fareham) Limited DS0000060902.V275698.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): These standards were not assessed. Standard 6 does not apply. EVIDENCE: Avenue Care (Fareham) Limited DS0000060902.V275698.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): 8 & 10 The home ensures that residents’ health care needs are met, and that privacy and dignity are maintained. EVIDENCE: On the day of the inspection, a doctor had been called to see a resident who was not well, indicating that staff monitor health needs. Staff sat with the resident whilst they waited for the doctor, which is seen as good practice. Staff had also noted a change in a resident’s physical condition which meant that a doctor was able to give a diagnosis quickly. The home also contacts other healthcare professionals, such as District Nurses, who visit daily if necessary. A chiropodist visits every six to eight weeks, or more if needed. Some residents are registered with a dentist, a person visits the home to clean dentures every three months and the emergency clinic is used for emergency tooth problems. The inspector saw a staff member notice that a residents’ glasses needed cleaning, and cleaned them. Another staff member was seen to bring unopened post to a resident, ask them if they wanted it opened, and did so, in front of them, letting them take it out of the envelope. Staff told the inspector Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 10 how they maintained privacy by closing bathroom doors and using screens in shared rooms. A resident told the inspector that they took telephone calls from family, in the office, which was private. Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 11 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): 13, 14 & 15 The home ensures that residents can make choices, welcome their visitors and enjoy their meals. EVIDENCE: Residents told the inspector that they had visitors. Two visitors told the inspector that they were, ‘welcome at any time, any day’. The inspector observed positive interactions between a number of residents, staff and the two visitors. The visitors also described the home as being, ‘home from home’. Staff said that visitors were welcome to join in with activities, and some did, over Christmas. A resident told the inspector that when they moved into the home, they brought possessions which included a bed, chair and television. The home does not manage money for any residents: families or official authorities do this. Two residents who were asked said that the food was good. One resident said there was always roast potatoes on Wednesday and Sunday. Staff said lunch was a cooked meal, and tea was sometimes cooked, and included eggs and waffles, bacon sandwiches or toasted teacakes. Menus were varied and offered a choice of meal. Staff assist residents as necessary, and help is offered as appropriate, for example, residents may be more independent some Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 12 days than others. One resident had special cutlery to maintain their independence. On the day of the inspection staff offered and prompted a resident to eat some soup, as they were not well. Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 13 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): These standards were not assessed. EVIDENCE: Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 14 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): These standards were not assessed. EVIDENCE: Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 15 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, 29 & 30 The home ensures that residents are supported by trained staff in adequate numbers, and that the staff have been recruited safely. EVIDENCE: The rota shows that the home employs care staff, cooks, cleaners and a laundry person. Staff cover the rota when colleagues are unwell and the manager said that staff were very good at covering at short notice. The manager will also cover if necessary. The home has a stable staff team and has not recruited any new staff since the last time this standard was assessed. The inspector has previously seen the recruitment procedures and they were considered to be appropriate. The home has a high commitment to training. The programme for the last year has included full courses lasting three to six months on Medication Administration, Health and Safety and Infection Control, and the majority of staff have completed these. The NVQ programme continues, to the extent that when the four staff currently studying NVQ2 complete their course, the home will have all of its care staff qualified. The standard states that a minimum of 50 should be qualified, so this is seen as good practice. A health professional has provided training workshops about dementia, and the manager has given staff training regarding care plans. Courses are happening soon for Lifting and Handling and First Aid. Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 16 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 & 38 The manager is fit to run the home and ensures that quality assurance is ongoing. Regular maintenance of equipment ensures it is safe, but further attention must be given to the storage of hazardous substances and the use of wheelchairs. Standard 35 was considered, but does not apply to the home, as they do not look after any money on behalf of residents. EVIDENCE: The manager began working at The Avenue in 1994, and became the manager in 1997. He is currently studying for NVQ4 in management, which he aims to finish by June. The home provides the Commission with monthly visit reports. The manager measures quality control by auditing risk assessments and training needs, and monitoring accident records. A questionnaire for visiting professionals is available. Residents questionnaires have been provided in the past, but a Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 17 survey has not been done in the last year, and the manager said he would action this as a priority this year. The Environmental Health Officer visited the home and recommended that there should be a hot water supply for the hand washbasin. As an interim measure, the manager provides a flask of water, and is considering buying a wall heater. The inspector looked at the accident book. Maintenance certificates are available for equipment, such as the stair lift. Hazardous substances were found stored in the greenhouse and the kitchen, which included plant pest killer, weed killer, bleach, oven cleaner, turpentine substitute and brass polish. Hazardous substances must be locked away to protect residents, particularly those who are confused. The manager removed all the items and locked them elsewhere. During the inspection, the inspector saw a resident being moved in a wheelchair. There were no footplates on the wheelchair, the resident was asleep, and the staff member was pulling the chair on its back wheels, so that the chair was tilted and the resident’s head was hanging over the back (because they were asleep). This is considered poor practice, because the chair could have tipped too far, injuring the resident and staff member. Additionally, wheelchairs should be used with footplates for health and safety reasons, unless there is a clear and documented reason for not doing so, on an individual basis. Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 18 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/A X X 2 Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 19 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. 1. 2. Standard OP38 OP38 Regulation 13 (4)(a)(c) 13 (4)(a)(c) Requirement All hazardous substances must be stored in locked cupboards The manager must seek advice from an appropriately qualified person regarding the correct positioning of wheelchairs in use, and the necessity for using footplates. Generic advice must be documented, as well as any specific advice regarding individual residents. Timescale for action 31/01/06 28/02/06 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.V275698.R01.S.doc Version 5.1 Page 20 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. Extracts may not be used or reproduced without the express permission of CSCI Avenue Care (Fareham) Limited DS0000060902.V275698.R01.S.doc Version 5.1 Page 21 - 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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