Inspection on 07/03/08 for Avenue Care (Fareham) Limited

This inspection was carried out on 7th March 2008.

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 02/11/06

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 Michelle Presdee Unannounced Inspection 10:30 7 March 2008 th 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.V359151.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.V359151.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.V359151.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 2nd November 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 £336 to £500 per week. Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this inspection The Commission (we) were assisted by Mr Press the manager of the home. We were able to speak to most people living in the home, some in more depth than other. Members of staff on duty were also spoken with, as were visitors to the home. All feedback was of a very positive nature. Surveys were received from staff, residents and relatives. The home sent us their Annual Quality Assurance Assessment (AQAA) back on time, which had detailed information. A tour of the home including all communal areas, the kitchen, the laundry and most of the bedrooms was taken on the day. Paperwork including assessments, service user plans, menus, staffing records and health and safety checks were seen. All this information has helped form the judgements included in this report. What the service does well: What has improved since the last inspection? The home has improved the environment of the home. The outside has been painted and three bedrooms have been refurbished. A ramp has been built with handrails giving residents access to the well maintained back garden. A new training programme has been purchased, that takes place over ten months. Staff have received training on the Mental Capacity Act and a comprehensive mental capacity admission assessment is completed for each person. Avenue Care (Fareham) Limited DS0000060902.V359151.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. The summary of this inspection report can be made available in other formats on request. Avenue Care (Fareham) Limited DS0000060902.V359151.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.V359151.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have accurate assessments of their needs and are confident the home can support them. EVIDENCE: We were told in the AQAA a full assessment is carried out at the potential residents home or at hospital and if an emergency admission the assessment will be carried out when the resident comes to the home. If a care manager is involved with the person an assessment from them will be sought. The new resident and their next of kin are encouraged to come and look around the home prior to admission. All residents are given a copy of the up to date Service Users Guide and Statement of Purpose. The assessments of three people living in the home were seen. These gave a very clear picture of the persons needs prior to admission and stated what the aims of the care were. The assessment covers a comprehensive mental capacity admission assessment. Two people who had recently come into the home were spoken with, both stated they were very happy with the home and both felt “lucky” to Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 9 be in the home. They both felt so far the home had lived up to their expectations. The home does not provide intermediate care. Avenue Care (Fareham) Limited DS0000060902.V359151.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 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 plan of care to meet each person’s health, personal and social care needs. Medication is managed in a safe way. People’s right to privacy is respected and support is given in a way that maintains dignity. EVIDENCE: The AQAA told us a comprehensive plan of care is developed for each resident. Care plans seen detailed information on moving and handling, personal care, falls, risk assessments, pressure sore assessment, mental physical and emotional health is recorded, likes and dislikes are recorded including the wishes in the event of a person dying. It was noted changes had been recorded on care plans as they had been reviewed monthly. We were advised residents are usually involved in the care plans and reviews. Those seen on the day did not reflect any resident’s involvement, the manager explained the care plans and reviews had recently been delegated to the key workers so he would ensure they recorded the residents involvement where relevant. Plans also included details of resident’s religion, social interests and hobbies. One relative spoken to stated he was “so pleased” with the care his relative received. He Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 11 stated “the family are kept involved and informed” and his relative is “always happy”. Care plans included information on a persons medical needs. Evidence was seen on care plans that a range of health professional visit the service including, dentist, optician, chiropodist, community psychiatric nurse, district nurse and doctor. It was noted in one care plan a visit by a community psychiatric nurse had been recorded as going to take place but no information had been recorded on the outcome of the visit. Surveys from relatives confirmed they were kept in touch with events. The home had a clear medication policy and procedure. Staff spoken to confirmed only staff that have undertaken training are involved with the administration of medication. The home uses a monitored dosage system. We were advised the home manages the medication for most residents, one resident spoken to confirmed she manages her own inhalers. Medication and records held were checked and it was noted these were being stored appropriately and accurate records were maintained. All controlled medication was being stored and recorded appropriately. The medication of two residents was checked against the records and the medication held and found to be accurate. It was clear from observations on the day staff have a respect for all residents and their privacy. Staff were observed to knock on residents door and waited for a verbal response from the occupant before going in. All shared rooms had screens and all doors had appropriate locks. In discussion with one new resident she stated how pleased she was “staff do not interfere all the time” but reported staff are always there to help her. Avenue Care (Fareham) Limited DS0000060902.V359151.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each person is treated as an individual and supported to follow personal interests. People keep in touch with family and friends. People have nutritious meals at a time and place to suit them. EVIDENCE: The service user plan details information on each person’s hobbies, interests and social contacts. The home has a varied social calendar, which is displayed on a notice board in the home. People have the choice to join in events or not. Events include singing and music, birthday parties, arts and crafts, exercise sessions, bingo with prizes, dominoes and bagatelle. The library calls on a regular basis and the home has links with the Fareham Good Neighbours. Religious services are offered in the home and people if they want will be helped to the local church. Outings are arranged and in the last twelve months included trips to Exbury Gardens, the New Forest and the local seaside. One resident spoken to stated how much she had enjoyed her trips to the dentist with the manager as they had always stopped for a coffee and cake. She explained they now go out for a daily walk together. Another two people spoken to stated how happy they were to have been recently taken to the local Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 13 seaside and have afternoon tea out. Surveys from residents all stated they enjoyed the outings and activities organised by the home. Visitor are encouraged and made welcome at the home. Visitors spoken to stated they could visit at any time and were always made welcome. They confirmed they could see their relative in private or in any of the communal areas. It was clear from discussions with residents and visitor’s residents have choices and control over their lives. Residents are asked to join in social events but their choice is respected if they do not want to join in. Care plans record how a person wishes to be addressed. Details are also recorded on how each resident can manage part of their own personal care. The home has a four-week rotating menu. The cook confirmed resident’s wishes have been taken into account when the menus are planned. Recent resident surveys demonstrated they were happy with the meals but wanted more home baked cakes. We were advised these are now cooked daily and on the day cakes for lunch and tea had been baked. Residents have the choice of having their meals in the dining room or in their own rooms. Residents who needed assistance with meals were observed and it was noted this was done in a dignified manner. All residents spoken stated they enjoyed their meals and a choice was available. One resident enjoyed a glass of sherry before lunch and tea. One visitor stated the meals always looked appetising and their relative enjoyed the meals. All surveys from service users confirmed they enjoyed their meals, one person stated “I love my food and I look forward to my meals”. Avenue Care (Fareham) Limited DS0000060902.V359151.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People know how to complain and know their concerns will be looked into. The home safeguards people from abuse and neglect. EVIDENCE: The AQAA states all residents are issued with a copy of the complaints procedure, which is incorporated into the service user guide. All residents spoken to stated they would have no concerns complaining to the manger whom they all felt would sort out any problem. Visitors and staff spoken to stated if they had any concerns they would discuss it with the manager who all had confidence it would be sorted out. One relative stated, “staff will pick up on anything we mention and it is resolved”. All surveys received from residents and relatives stating if they had a problem they would know how to complain. The AQAA told us the home had copies of a whistle blowing procedure and safeguarding adults and prevention of abuse procedure. All policies and procedures are kept in the office in the home, where staff have access to them. Members of staff were aware of what action to take and who should be contacted regarding adult protection. The home has a training session booked in March on Adult Protection. Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 15 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): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. EVIDENCE: The home is well maintained and all areas seen on the day were clean and no offensive odours were detected. All bedrooms are personal and have been personalised by the resident. All rooms have views over the homes front and back gardens, which are well maintained. A ramp has been built giving access into the back garden with handrails fitted. Communal areas consist of two lounges, a conservatory and a dining room. All were comfortable, well furnished and clean. The home has a lift and a stair lift giving access to both floors to all residents. Window restrictors have not been fitted to all first floor windows and the manager agreed to assess if these were necessary. All radiators are guarded or have low surface temperature surfaces. Three bedrooms have recently been re-decorated with new curtains and carpets. The Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 16 homes own audit system found residents and visitors liked the environment and ambiance of the home. One visitor stated, “the home is always clean and tidy”. Residents spoken to stated their rooms are always kept clean and the laundry is well is well looked after. One relative in a survey stated, “the care home is my Fathers Home and staff go to every length to make him feel that it is”. Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have appropriate and safe support by competent, experienced and trained staff. They have confidence in the staff as the home makes appropriate checks on staff to ensure they are suitable to care for them. EVIDENCE: We were advised the home has a long-standing and experienced workforce. Most staff have worked in the home for some considerable years and 12 out of thirteen care staff have achieved a National Vocational Qualification (NVQ) Level 2. The other member of staff is due to start the course soon. Staff spoken to stated they enjoyed working in the home and always felt there was enough staff on duty to meet the needs of the people in the home. Staff meetings are held and staff reported new policies and procedures are discussed. Staff felt they worked well together and were supportative of each other. Resident’s and visitors all praised the staff comments included, “you get to know the staff” and “lovely staff”. Resident surveys stated there was always enough staff on duty and one stated, “Staff are always there to help you”. Relative’s surveys stated “we are impressed with the standard of care” and “staff seem to enjoy their work” and “staff are very caring and treat residents with dignity”. Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 18 The staffing records of two members of staff were seen. It was noted these were well organised and mostly contained the correct checks and documentation. For one person there was no photographic identification and confirmation was seen a criminal record bureau check had been obtained but the number had not been recorded. Staff spoken to felt the training offered was adequate for them to do their jobs. We were advised the home has recently employed a company who will provide ten training sessions a year including adult protection, first aid, health and safety, lifting and handling, dementia and mental health. Staff are paid for training sessions. Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have confidence in the care home because it is well managed. The environment is safe for people and appropriate health and safety practices are carried out. EVIDENCE: The manager of the home has a NVQ Level 4 in care and management and has been running the home for the last twelve years. All persons spoken to including residents, visitors and staff were full of praise for the manager. All stated he had an open door policy and could be contacted at any time. It was clear the home is run in the best interests of the people who live there. The home has a friendly open atmosphere and residents are consulted on Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 20 decisions affecting the home. Quality audits are carried out annually and areas identified by the residents will be acted on for example the increase of home baked cakes. All surveys received from residents, staff and relatives praised the home and the management of the home. Relatives confirmed they were always kept in touch with developments regarding their relative and the home. One relative survey stated, “ I would know who to complain to but have had no reason to complain”. We were advised the home does not become involved in any of the resident’s money. The manager explained if he has to pay any money out on the behalf of residents’ for example a hairdressing bill he puts this itemised on the monthly bill. The AQAA advised us the home has clear policies on health and safety. Regular checks are made on the equipment in the home and professionals service these. Staff reported they all have the equipment and training they need and there is always a supply of appropriate gloves and aprons. Alcohol dispensers have been placed around the home. The laundry was well maintained and a new butler sink has been fitted and a new tumble dryer has been purchased. It was noted some fire doors were wedged open; this was brought to the manager’s attention. Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 21 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 N/A 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.V359151.R01.S.doc Version 5.2 Page 22 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.V359151.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Avenue Care (Fareham) Limited DS0000060902.V359151.R01.S.doc Version 5.2 Page 24 - 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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