Inspection on 23/10/06 for Avenue House

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 House 01/03/07

Avenue House 25/01/06

Avenue House 04/08/05

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Avenue House Avenue House 26 Clifton Road Tettenhall Wolverhampton West Midlands WV6 9AP Lead Inspector Mr Ian Harris Key Unannounced Inspection 23rd October 2006 08:00 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 House DS0000064388.V297477.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 House DS0000064388.V297477.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avenue House Address Avenue House 26 Clifton Road Tettenhall Wolverhampton West Midlands WV6 9AP 01902 774 710 01902 77 47 12 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) West Midlands Residential Care Homes Ltd Vacant Care Home 21 Category(ies) of Old age, not falling within any other category registration, with number (21) of places Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered as a care home for older people subject to the provider meeting the Conditions of Registration in Appendix 1 dated 17/6/05. 25th January 2006 Date of last inspection Brief Description of the Service: The home is a large detached Grade 2 listed building approximately 143 years old. The home stands in two and a half acres of lawns and woodland. The home is within a short distance of Tettenhall Village where the amenities include a post office, shops and a public house. The home has been completely refurbished, adapted and recently extended for its present use as a residential care home for 21 older people. There are two double bedrooms and 17 single bedrooms, four of which have en-suite facilities, two lounges, a dining room, laundry, kitchen, staff room and Registered Managers office and a staff training room. There is a large car park and very attractive garden and grounds. The current fees range from £336 to £385 per week Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection and took place over 5 hours in the presence of the Acting Care Manager. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked and the last reports of the Fire Prevention Officer and Environmental Health Officer were considered. 3 members of staff and 8 residents were spoken to. What the service does well: What has improved since the last inspection? Considerable improvements have been made to the home and the care provided since the change of ownership these include the redecoration of 10 Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 6 bedrooms, the dining room, office and the refurbishment of the ground floor bathroom. The Acting care manager has introduced new residents files and care plans. 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 House DS0000064388.V297477.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 House DS0000064388.V297477.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 and 6 the Quality in these outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory admissions procedure ensuring the individual needs of the residents are fully met. The home does not provide intermediate care they only provide short stay and introductory stays when the home has a vacancy. EVIDENCE: All the residents who are funded by the Local Authority undergo a full multidisciplinary assessment prior to admission. The residents’ who are self funding are assessed by the Care Manager, using the homes assessment forms. Copies of the assessment, Care Plan and Reviews are on the residents’ files. The Six residents files and care plans inspected contained pre admission assessments of the persons needs, both from assessments by the home’s staff and other relevant professionals. Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 9 Observations and discussions with residents, the Acting Care Manager and staff on duty indicated that the home continues to meet the individual needs of the elderly people living at the home in a satisfactory and sensitive manner. The home does not provide intermediate care they only provide short stay and introductory stays when the home has a vacancy. Avenue House DS0000064388.V297477.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,and 10 the Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each resident has an individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration of medication are good with clear and comprehensive recording arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: The home provides a Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out. However it was noted that some of them lack a detail. Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 11 It was evident during the inspection from looking at records, inspecting the facilities, observation of care given and chatting to staff and residents that individual health, personal and social care needs were being met. Residents were being treated with respect, staff are working sensitively in meeting individual needs, and the frail residents looked comfortable and well cared for. This was confirmed by a number of resident who stated that the staff look after them well “ I don’t know what I do without them” The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out. However it was noted that a number of care plans had not been reviewed on a monthly basis. The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that, these services are provided by local practitioners. A number of residents stated that the staff arrange hospital visits and G.P. visit and that they feel that their health is much better since coming into the home. Medication is administered by means of a monitored dosage system. The system appears to be working very well. The home receives good support from the pharmacist. All Senior Staff have been trained to use the system before they are allowed to administer medication and have completed the Safe Handling of Medication training course. Visitors are able to meet residents in their bedrooms or the dining room on the ground floor, which offers that privacy when not being used. It was observed that residents’ were being treated with respect and staff are working both professionally and sensitively in meeting individual needs. Those residents a spoken to were complimentary regarding the quality of their lives and the care they are receiving at the home. Avenue House DS0000064388.V297477.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): 12,12,14,and 15 the Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a good programme of social activities within the home, which are designed to meet the resident’s capabilities, which, the staff encourage residents to pursue. However there is a lack of outings/trips provided The Care Manager and staff encourage family and friends to maintain good contact with their relatives at the home. The meals in the home are good, however more variety needs to be introduced at teatimes. The quality outcome in this area is adequate. This judgment has been made using available evidence including a visit to this service. EVIDENCE: The routines and activities within the home are flexible and are built around the needs of the residents. The home does not have a staff member Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 13 designated to organise social and leisure activities and who identified interests that the residents wish to pursue. However there was evidence to show staff do consult with the residents regarding the choice of meals and activities within the home through the Acting Care Manager and key-workers. It was noted that the home organises entertainment, music and exercise and musical evenings. Comments from residents regarding these activates were mixed and it is obvious that some of the residents benefit from them. However some residents stated that there was nothing to do but watch television. It was noted that no outings or trips have been arranged throughout the summer months. Staff at the home, encourage regular contact between residents and their relatives by inviting them to parties, fetes, and celebrations at the home. All residents were very complimentary about the standard and choice of food provided and said it had improved since the change of ownership. It was apparent that the menu is changed to incorporate seasonal changes. Several service users told the Inspector that the food was good, tasty and well prepared. However it was noted the evening meal (tea time) menu should be revised to provide a choice other than a selection of sandwiches. Avenue House DS0000064388.V297477.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 the 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 satisfactory complaints procedure and there is evidence that residents’ and their families feel that their views are listened to and acted upon The home has good policies and procedures regarding protection from abuse, which includes a whistle blowing policy EVIDENCE: The home has a good comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence, the service users guide, which a is issued on admission to the home. A copy is also placed in the reception hall. The home has a complaints book in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in internal and N.V.Q. training, which all care Staff is undergoing. Avenue House DS0000064388.V297477.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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The new proprietors have carried out some remedial redecoration and refurbishment, which will maintain the home to a good standard. The home would benefit from a rolling programme refurbishment that will maintain a good standard. The home was found to be clean tidy and free of unpleasant odour. EVIDENCE: The home is long established and has undergone alterations over the years in order to provide appropriate accommodation for 21 older people. The home is maintained to a good standard. The general appearance of the internal environment is good but the bedroom furniture is dated and a rolling programme of refurbishment should be introduced to modernise and improve the environment. All bedrooms are personalised and a number of residents proudly show the inspector their rooms. The home was found to be clean and tidy and free from odour. The home has good policies and procedures Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 16 regarding infection control and the staff have received training in food hygiene and Infection Control. From observations and discussions with staff they appeared to be conscious of the dangers of cross infection. Avenue House DS0000064388.V297477.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, and 30 the Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The The The The home is staffed with adequate numbers and skill mix of staff. staff have a very good understanding of the residents support needs. home has good policies and procedures regarding the recruitment of staff. manager has introduced a good staff-training programme. EVIDENCE: The inspection of staff rotas and discussions with staff and residents indicated that the home is adequately staffed. There is a good balance within the staff group, which includes experience, mature and younger staff who are embarking on a new career and ethnic mix. It was noted that there have been minimal staff changes since the last inspection. The home operates an acceptable recruitment procedure. On inspecting 6 staff files, there was evidence within them that all C.R.B. checks are being carried out. All staff at the home are committed to developing their knowledge and skills through training and have regular opportunities to do so through external and internal training activities. The home has a programme of N.V.Q. training has now exceeded the minimum standard. Care staff have also attended courses on Safe handling of medication, Dementia care, Moving and handling Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 18 First Aid and Health and safety at work. It was noted that the home does not have an induction training programme that meeting the standard. Avenue House DS0000064388.V297477.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 and 38 the Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, where service users interests and welfare is promoted. The home is operating a good system to assist residents with the safe handling and keeping of their personal finances and good records are being kept of all transactions made. The records inspected, were found to be well ordered and maintained. The home has good policies and procedures regarding Health and safety and meets the requirements of the Fire Officer and Environmental Health Officer, promoting EVIDENCE: Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 20 The home is without a Registered Care Manager however the home is well managed by an Acting Care Manager who has considerable experience in caring for older people. There are clear lines of accountability within the home and the manager is very supportive of both staff and residents. It was noted the Acting care manager is very well supported by the proprietor. Observations made and discussions with residents’ and staff indicated that the Care Manager is very approachable and operates an open door policy. The staff and residents who could express themselves stated that they are happy to approach the Care Manager and staff with any problems they might have and were confident that they would be responded to. There is a good staff supervision system in place and there is evidence that the staff have regular supervision meetings. It was also noted that the home has a Quality Assurance system in place, which includes questionnaires to residents, visitors and relatives to obtain feedback on the quality of service. The feedback from the last issue was very positive regarding the improvements made since the change of ownership with all feedback stating they are satisfied with the care they are receiving. An action plan has been produced to address issued raised and was pinned to the notice board at the home. The routines and activities within the home are flexible and built around the needs of the residents. All the Financial records and administrative procedures within the home that were, inspected were found to be well ordered and maintained. The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues and a number of staff have received training on these issues. All recommendations and requirements made at the last inspections of the Fire Prevention Officer and Environmental Health Officer have been actioned. All safety equipment is regularly checked and well maintained. Avenue House DS0000064388.V297477.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 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 22 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 OP7 Regulation 13 &15 Requirement The Registered Manager must ensure that all the service users’ care plans are reviewed and updated, and the quality and detailed daily care (day and night) records of the care services received by the service users are appropriately recorded by the care staff as a matter of priority. The registered person must ensure that all residents care plans are reviewed on a monthly basis. The registered person must ensure that a rolling programme of redecoration and refurbishment is implemented. The registered person must ensure that a registered manager is provided for the home. The registered person must ensure that a choice of menu is provided at tea times. The registered provider must ensure that the home has an induction programme DS0000064388.V297477.R01.S.doc Timescale for action 01/12/06 2 OP7 15 01/12/06 3 OP19 23 01/12/06 4 OP31 8 01/12/06 5 6 OP15 OP30 16 (2) (i) 18 01/12/06 01/12/06 Avenue House Version 5.2 Page 23 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 OP9 Good Practice Recommendations The Registered Provider should continue to support those members of staff who as yet not completed their training in safe handling of medication. The Registered Provider should consider providing staff specialist training in Dementia care, Disability Awareness, and adult protection from abuse. The Registered Provider should continue to support those members of staff who as yet have not completed their NVQ Level 2 training. 2. OP18 3. OP28 Avenue House DS0000064388.V297477.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 House DS0000064388.V297477.R01.S.doc Version 5.2 Page 25 - 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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