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Inspection on 18/10/05 for Avenue Community Nursing Home

Also see our care home review for Avenue Community Nursing Home for more information

This inspection was carried out on 18th October 2005.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The Avenue continues to provide a high quality of care to residents who live there, which is negotiated and consultative. There is a very consistent staff team who understand the needs of the individual residents and who support them very well. When residents were asked what they thought The Avenue did well, they said, "it is a really friendly service, they consult you, you definitely have a say in how things should be", "they are always organising things, like going out to the pub and having a meal", "it`s a nice atmosphere, you have got everything you need".

What has improved since the last inspection?

A new boiler has been installed and some work has been completed in the garden to make is more accessible to residents.

What the care home could do better:

It was identified through discussion with residents that there would be benefit to some residents if the current smoking arrangements in place at The Avenue could be reviewed, as some of the non-smokers felt they were not given the same considerations in terms of environment and comfort.Environmentally, a number of areas are in need some refurbishment. The home is beginning to look somewhat tired and some specific areas required attention, such as the upstairs bathroom wall; the toilet flooring; the smoke/coffee room; some of the widow and the driveway of the home. It is acknowledged plans are being developed to address these matters.

CARE HOME ADULTS 18-65 Avenue Community Nursing Home 47 The Avenue Linthorpe Middlesbrough TS5 6PE Lead Inspector Jackie Herring Unannounced Inspection 18th October 2005 11:00 Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 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 Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 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 Adults 18-65. 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 Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Avenue Community Nursing Home Address 47 The Avenue Linthorpe Middlesbrough TS5 6PE 01642 816721 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 Community Nursing Home Limited Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 2005 Brief Description of the Service: The Avenue Community is a 13 bedded care home for adults with mental disorder. It has been operating for approximately 22 years and is a converted Victorian property close to the centre of Linthorpe in Middlesbrough. There are nine single bedrooms and two double bedrooms none of which have ensuite facilities, however the rooms do meet the size requirements. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection and was completed over one inspection day, two and a half inspection hours in total. The inspector had discussion with the nurse in charge and one member of staff during the inspection process. Medication records and policies and procedures were examined. Two residents were spoken on an individual basis and other residents informally chatted to the inspector. Residents continued to be very happy to share their views of the home and the impact on their lives with the inspector. This was a very positive inspection and the inspector was warmly welcomed to the home by all. What the service does well: What has improved since the last inspection? What they could do better: It was identified through discussion with residents that there would be benefit to some residents if the current smoking arrangements in place at The Avenue could be reviewed, as some of the non-smokers felt they were not given the same considerations in terms of environment and comfort. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 6 Environmentally, a number of areas are in need some refurbishment. The home is beginning to look somewhat tired and some specific areas required attention, such as the upstairs bathroom wall; the toilet flooring; the smoke/coffee room; some of the widow and the driveway of the home. It is acknowledged plans are being developed to address these matters. 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 Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 these standards were inspected on this occasion. EVIDENCE: Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 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 these standards were inspected on this occasion. EVIDENCE: Although these standards were not examined on this occasion, residents said they had enjoyed their recent holidays to Wales and Dublin. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Robust procedures are in place for the storage and administration of medicines. EVIDENCE: The medications systems were examined during the inspection. The sample of medication administration records had been completed appropriately and medication was being stored in accordance with legislation. During discussion with the nurse in charge, the inspector was informed that the deputy manager is responsible for the ordering of medication and that sound systems are in place for this. Arrangements are currently being made to action the new legislation in regard to the safe disposal of waste medicines from care homes (nursing). Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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 these standards were inspected on this occasion. EVIDENCE: Although these standards were not specifically inspected, during discussion with residents, they confirmed if they had any concerns or complaints then they would speak to the manager about them. They understood about abuse and what constituted abuse and were clear about the action they would take if anything untoward occurred within the home. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Overall improvements are needed to the internal and external environment to ensure that residents have a comfortable and safe environment to live in. EVIDENCE: A tour of the environment took place and a small number of residents bedrooms were visited. The environment at The Avenue was beginning to look somewhat tired and in need of some refurbishment and redecoration. The upstairs bathroom had recently had an old boiler removed and the wall needed to be plastered and painted. The flooring in the toilet next to the bathroom needed to be replaced as it was quite stained. Whilst it was acknowledged that some action had been taken to redecorate and improve the ventilation to the smoking/coffee room, the environment was not particularly pleasant and was in need of further refurbishment. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 14 During discussion with residents, views were aired about the home’s current policy on smoking and the smoking areas within the home were of concern. This related primarily to the large lounge, which is the main lounge within the home and offers a very homely, comfortable and spacious accommodation, however this is used as a smoking lounge and the non smokers, who do not want to sit in a smoking environment have to use the dining room or conservatory as their sitting room. The smell of cigarette smoke was also noted throughout the ground floor of the home. In the kitchen, the worktop around the hand-wash sink needed to be repaired or replaced and some of the drawers also needed to be repaired. During discussion with staff members, the inspector was informed that they were in the process of obtaining quotes for replacing the kitchen. Externally, the windows were showing signs of wear and tear and one window in particular was rotting. Again through discussion with a staff member, the inspector was informed that they were in the process of obtaining three quotes for double-glazing and the plan was to replace all of the window in the home and the two external doors. The driveway was also showing signs of wear and there were areas that were potential tripping hazards to residents. This again is in the refurbishment and development plan for the home and it was confirmed that this was going to be addressed. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Residents are in competent and safe hands with their care needs being. However, NVQ training in care should continue. EVIDENCE: Through discussion with the nurse in charge and as detailed within the pre inspection questionnaire, it was confirmed that the manager had recently completed NVQ 4 in management and one of the care workers had completed NVQ 3 in care with another care worker underway with NVQ 2 in care. Residents were satisfied that the staffing levels of the home were sufficient to meet their needs and felt supported by a very friendly and competent staff team. The staff team at The Avenue have worked at the home for years and there is rarely any staff turnover. Residents said, “The staff are smashing, they listen, they help and they are all friendly and approachable”, “definitely believe the staff have the right skills to support me”. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 43 The manager is appropriately qualified and experienced to ensure that residents benefit from a well run home. EVIDENCE: Residents believed that The Avenue was a very well run home and said, “everything is excellent at The Avenue, it runs like clockwork”, “I am listened to, the staff consult you and you definitely have a say on the running of the home”. The manager has recently completed NVQ 4 in Management and is a Registered Mental Nurse. The residents described the manager as, “lovely caring person who is supportive and understanding”. One of the directors informed the inspector that their accountants are currently examining the annual accounts. They were confident that the financial position was satisfactory. Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Avenue Community Nursing Home Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X 3 DS0000000144.V259806.R01.S.doc Version 5.0 Page 18 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 Requirement A detailed refurbishment plan must be produced and dates specified for work to be undertaken to improve the environment. The bathroom wall must be plastered and painted. The flooring to the upstairs toilet must be replace. The décor and general environment in the smoke/coffee room must be improved. Windows must be mended or replaced. Worktop and drawers in the kitchen must be repaired or replaced. The driveway must be improved to reduce the risk of tripping. Steps must be taken to address the odour of cigarettes in the home. Timescale for action 01/12/05 2 YA30 23 01/12/05 Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations There should be a review of the current smoking arrangements in the home to ensure that the needs of non-smokers are also considered in terms of comfort and environment. Care staff should continue to complete the specified National Vocational Qualification. 2. YA35 Avenue Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Community Nursing Home DS0000000144.V259806.R01.S.doc Version 5.0 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. 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. 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