Inspection on 25/10/05 for Avenue Lodge

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Avenue Lodge 04/09/06

Avenue Lodge 30/04/05

Avenue Lodge 21/10/04

Avenue Lodge 02/06/04

Avenue Lodge 29/01/04

Similar services:

Townley Road, 2-3

Foxley Lane (121a)

Tudor Lodge

Stacey Street Nursing Home

Delrose House Ltd

Clovelly House Residential Home Ltd

Abbey Road [53]

Cherry Tree House

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

CARE HOME ADULTS 18-65 Avenue Lodge 53 Avenue Road London SW16 4HJ Lead Inspector Liz O`Reilly Unannounced Inspection 10:00 25 October 2005 th Avenue Lodge DS0000027251.V266663.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 Lodge DS0000027251.V266663.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 Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Avenue Lodge Address 53 Avenue Road London SW16 4HJ 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) 0208 764 6125 Mr Nizma Hosanee Mrs Anna Maria Oozeerally Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (6) Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th April 2005 Brief Description of the Service: Avenue Lodge is a care home for up to six adults with mental health needs. The home is owned by Mr N. Hosanee. The property consists of two terraced properties which have been joined together and extended. The home is situated in a residential area of Mitcham, close to local shops and public transport links. Unrestricted parking is available in the street. The property is not identifiable as a care home. The aims and objectives of the home are set out in the Service Users Guide with is provided to each resident. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one regulation inspector on 25th October 2005 over four hours. The inspector had the opportunity to speak with four of the five residents in the home at the time of this visit. A sample of records were examined. What the service does well: What has improved since the last inspection? What they could do better: As noted in previous inspections the basic contract price for residents should include the opportunity to take a seven day holiday away from the home annually. The home owner must ensure that a copy of the monthly report on the home is sent to the Commission. A copy of the report following the annual review of the home must also be sent to the Commission. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 6 To ensure that all parties are aware of any agreements the manager must ensure that where arrangements have been made for any resident to contribute towards their fees this is clearly set out in the admission documentation, the care plan and the formal review of the placement. 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 Lodge DS0000027251.V266663.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 Lodge DS0000027251.V266663.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): 2, 3 & 4 Pre admission assessments ensure that staff have knowledge of the needs of each individual prior to them moving into the home. Prospective residents have opportunities to visit the home before admission. EVIDENCE: To ensure that the home is able to meet the needs and aspirations of prospective residents an assessment process is carried out for each person before admission. The home receives assessments carried out by health care professionals and social services. Staff from the home meet with the person and carry out their own assessment. This process ensures that staff have an understanding of the strengths, needs and expectations of each new resident. Arrangements are made for residents to visit the home for varying lengths of time before they make a decision to move in. Residents can visit for a meal, overnight and for a few days to “try out” the home, meet the staff and other residents according to their needs and wishes. Avenue Lodge DS0000027251.V266663.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): 6, 7, 8 & 9 Staff make sure that individual care plans set out the needs and personal goals of residents. Residents confirmed that they make their own decisions about their lives. Residents are encouraged to participate in the day to day running of the home. Staff carry out individual risk assessments to assist in promoting personal independence. EVIDENCE: Individual care plans set out needs, objectives, actions to be taken and review dates. Issues addressed in care plans include mental health issues, independence, rights, social activities and personal relationships. Care plans are developed in consultation with residents who sign the plan once completed. Care plans are reviewed on a regular basis throughout the year. Staff work with residents to complete a number of assessments including; what is important to the person in relation to individual rights, an Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 10 independence plan, and an assessment of choice which included good information on individual preferences. Residents are provided with an opportunity to include information for staff on their previous life history. This is to be commended in enabling residents to present what has been important to them and allowing staff some insight into the previous experiences of each person. Staff work with residents to develop or maintain independence at a pace which is comfortable to the individual. Staff acknowledge that risk taking is part of developing independence and appropriate individual assessments are carried out to support this. Residents confirmed that they were encouraged and supported in making their own decisions about their lives with staff providing support if needed. Residents meetings are held on a regular basis where issues relating to the home are discussed and residents can put forward ideas. Records showed that staff use these meetings to go through key policies and procedures to ensure that residents are aware of their rights. Residents confirmed that they found these meetings helpful but that they could choose whether to attend or not. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 11 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): 12, 14, 16 & 17 Residents confirmed that staff supported them in engaging in activities and attendance at day centres according to their own wishes. Staff work towards supporting residents in making their own decisions on daily living and expanding the opportunities and experiences available. EVIDENCE: Certain residents attend day centres and work based centres according to their own wishes. Staff spend time with new residents helping them to find out about the local facilities and services which they may wish to use. Residents make trips out to local cafes, shops, the library and pubs either independently or with staff. Discussion with residents confirmed that they are encouraged and supported to follow their individual interests. Residents confirmed they discussed group trips and enjoy outings to the coast, parks and art exhibitions. The National Minimum Standards state that residents should be offered a minimum seven day holiday away from the home which they have helped to choose as part of the basic contract price. This is not available to residents in this home. The manager informed the inspector that this issue had been Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 12 raised with the placing authorities but no progress had been made in adjusting the fees paid. Residents confirmed that daily routines in the home take into account personal preferences and activities. Residents informed the inspector that they were free to spend time alone in their room or join others in the communal areas according to their own wishes. All residents are offered a key to their bedroom. Residents informed the inspector that staff always knocked on bedroom or bathroom doors before entering and respected their privacy. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 13 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): 19 & 20 The health care needs of residents are met. Staff protect the health and welfare of residents through the good management of medication. EVIDENCE: Residents confirmed they were registered with local GP practices and met with their GP in private unless they requested staff to be present. Arrangements are in place for residents to access dental, optical and other health care services in the local community. Residents confirmed staff support them to attend hospital appointments and the manager reported that the home had good links with the community psychiatric services whom staff can call upon for advice if required. Staff monitor the physical and mental health of residents and take action should they have any concerns. At the time of this visit none of the resident group were self medicating. Residents spoken to at this visit confirmed that they were happy for staff to “look after” their medication. Staff were seen to keep accurate and up to date records of all medication administered. A record of medication received into Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 14 the home and returned to the pharmacists is also maintained. Medication was seen to be stored safely. The pharmacist visits the home on a regular basis and is available for staff to call on for advice should they have any concerns or questions. All staff except one have received accredited training on the management of medication which assists in ensuring the safety of residents. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 15 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): 22 & 23 A clear complaints procedure is in place. Discussions with residents indicated that they felt confident that should they have a complaint staff would listen to their concerns and were aware of who they might go to outside the home. Staff are provided with training and clear procedures are in place to protect residents from abuse. EVIDENCE: The complaints procedure is on display in the home. Staff go through the complaints process with all new residents and residents are reminded of their right to make a complaint within or to those outside the home at residents meetings. Residents told the inspector that they had no concerns or complaints to make at the time of this visit. Residents also expressed confidence in the staff and manager to “sort out” any complaints. All staff have received training on the protection of vulnerable adults. The home has its own procedures and keeps a copy of the local authority procedure. This ensures that staff are aware of the actions they must take should there be any allegations or suspicions of abuse. The manager provides staff with guidance on dealing with and understanding verbal or physical aggression. To ensure that all parties are aware of any agreements, the manager must ensure that where arrangements have been made for a resident to contribute towards their fees this is clearly set out in the admission documentation, the care plan and the formal review of the placement. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 16 Residents can deposit small amounts of cash in the home for safekeeping. Individual records are kept of all money deposited and withdrawn for each resident. Staff support residents to manage their budget. The records seen were up to date and accurate. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 17 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, 26, 28 & 30 Residents are provided with a homely comfortable environment. Residents were happy with their individual bedrooms. The home is clean and tidy. EVIDENCE: This is a domestic style home which is comfortably furnished. Residents have access to two lounge areas and another seating area at the back where they can smoke. Meals are taken in the dining area. The home has a separate laundry which is accessible to residents and a small kitchen. A well maintained garden with a patio area and aviary is available to the rear of the home. Residents gave very positive comments on their bedrooms which were seen to be bright, airy warm and well ventilated. Residents confirmed they can have a key to their bedroom if they wish. Bedrooms were seen to reflect the individual interests of residents. Residents have personalised their rooms with books, ornaments and pictures. All areas of the home seen on this visit were well maintained, clean and tidy. Residents confirmed they assist with some of the domestic tasks in the home. All staff have received training on infection control. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 18 Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 19 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): 32, 33, 34, 35 & 36 Residents gave very positive comments on the staff group. Sufficient staff are available on duty to meet the needs of the residents in the home. The checks carried out on staff assist in protecting residents. Staff are offered regular training opportunities. EVIDENCE: All residents spoken to gave positive comments on the approach and attitude of the staff group. Staff were viewed as reliable, approachable and honest. The manager who is a qualified mental health nurse provides the carers with training in mental health issues which assists staff in understanding and meeting the needs of the individuals in their care. One member of staff has completed NVQ level two training. One staff member is in the process of completing this training. Another member of staff is in the process of completing NVQ level three training. This training ensures that residents are supported by a well informed and qualified staff group. Six care staff and the registered manager make up the staff team. A minimum of one member of staff is on duty at any one time in the home. The staffing levels vary according to the activities of individual residents. At the time of this visit one carer and the registered manager were on duty in the home. All staff are over the age of eighteen. Staff turnover and sickness is low and no Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 20 agency staff are used in this home. This ensures that residents are provided with continuity of care and are supported by staff they are familiar with. Appropriate checks including Criminal Records Bureau checks are carried out on all members of staff before they start working in the home. These checks assist in ensuring the protection of residents. All staff receive regular one to one supervision from the home manager which ensures that staff are well supported and provided with guidance on their working practice. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 21 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, 39 & 42 Residents benefit from a well managed home. A record of the monthly visit by the home owner is not supplied to the Commission. Further work needs to be done on the quality assurance systems to ensure that the views of residents are taken into account in the development of the home. Staff make regular checks on the building and service to ensure that health, safety and welfare of residents, staff and visitors to the home. EVIDENCE: Residents are given the opportunity to discuss issues at regular residents meetings. A record of the minutes of these meetings is kept in the home. Individual issues can be discussed when care plans are set up and at the review meetings. As this is a small home residents have the opportunity to meet with the manager on a day to day basis. The home owner must ensure that copies of the report produced following monthly visits to the home are supplied to the Commission. Arrangements are in place for residents, visitors and other professionals to receive questionnaires seeking their views on the home. The manager and Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 22 owner must ensure that an annual review of the service taking into account the feedback from questionnaires is carried out. The results of residents questionnaires must be published and made available to prospective residents. A copy of the report compiled following the annual review must be provided to the Commission. Monthly health and safety checks are carried out on the home. Regular checks are carried out on the fire alarm system along with fire drills for staff and residents. Staff are provided with training on first aid and food hygiene. These checks and the training assists in assuring the health, safety and welfare of residents. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 23 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 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 2 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Avenue Lodge Score X 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 3 x DS0000027251.V266663.R01.S.doc Version 5.0 Page 24 yes 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 YA23 Regulation 17(2) Schedule 4 (8) Requirement The Registered Persons must ensure that where arrangements have been made for a resident to contribute towards their fees this is clearly set out in records held in the home including formal reviews of the placement. The Registered Provider must ensure that copies of the report produced following a monthly visit are supplied to the Commission. The Registered Persons must provide to the Commission a copy of the report produced following the annual review of the service. Timescale for action 10/01/06 2 YA38 26 10/01/06 3 YA39 24(2) 10/01/06 Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 25 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 YA14 Good Practice Recommendations The Registered Persons should ensure that as part of the basic contract price residents are provided with the opportunity for a seven day holiday away from the home. Avenue Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Lodge DS0000027251.V266663.R01.S.doc Version 5.0 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!