Inspection on 03/08/06 for Avenue The (1)

This inspection was carried out on 3rd August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Avenue The (1) 07/07/09

Avenue The (1) 26/07/07

Avenue The (1) 02/02/06

Avenue The (1) 19/10/05

Avenue The (1) 27/01/05

Avenue The (1) 29/09/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Avenue The (1) 1 The Avenue Knaresborough North Yorkshire HG5 0NL Lead Inspector Mrs Irene Ward Key Unannounced Inspection 3rd August 2006 09:00 Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 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 The (1) DS0000007885.V306562.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 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 The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avenue The (1) Address 1 The Avenue Knaresborough North Yorkshire HG5 0NL 01423 856576 01423 541889 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) Henshaws Society for Blind People Mr David Anthony Houston Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for a maximum of 5 Resident with Learning Disabilities all of whom have an additional Physical Disability Date of last inspection 2nd February 2006 Brief Description of the Service: 1 The Avenue is operated by Henshaws Society for Blind People and is registered to provide residential care for 5 younger adults aged under 65 years who have learning disabilities with an additional impairment. The house is situated within walking distance of Knaresborough town centre. There are local amenities close to the home. It is a large three storey detached house with a gardens to the front and side of the property. All bedrooms are designed for single occupancy. The weekly fees on 4th July 2006 range from £671 to £729.68 and do not include costs for hairdressing, chiropody, toiletries and transport to leisure activities. This information was supplied to the Commission For Social Care Inspection via the pre-inspection questionnaire received on the 4th July 2006. Service users/relatives and other interested parties are able to have access to inspection reports as they are displayed in the main entrance of the home. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit carried out on the 3 August 2006. This visit was carried out by two Regulation Inspectors and started at 09.00 hrs and finished at 13.30 hrs with 2 hours preparation time. A visit was also carried out to the offices of Henshaws Community Housing to look at staff files that are held centrally there. The home returned the requested information before this site visit, and surveys were sent out to relatives and other professionals who had contact with the home. Comment cards were received from two relatives and three health and social care professionals. The site visit comprised of a full inspection of the premises, which included some service users private accommodation. The care records of five service users were looked, which included service users assessments, care plans and medication records. Staff rotas and health and safety documentation were inspected. Time was spent observing activity in the home and interaction between two service users who were in at the time of the site visit, and staff. Time was also spent talking to members of staff on duty. The focus of the inspection was a number of key standards, inspecting the case records of service users in detail to establish if they corresponded with service users experiences in the home. The registered manager was not on duty. The senior support worker was available throughout the morning. There were no requirements outstanding from previous inspections. No requirements were made. One recommendation was made regarding the auditing of medication. The last unannounced inspection was carried out on the 2nd February 2006. What the service does well: The way in which information is gathered and kept about service users means staff can provide support in a way that service users need and prefer. It also means staff have in depth knowledge and understanding about each individual service user and so encourage service users to develop skills and experiences safely. Staff are clearly committed to providing good standards of care for service users so that service users were well looked after. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 6 Care planning centred around the personal wishes and preferences of service users’ on how they wished to live their lives. Service users’ had access to a range of activities to enable them to pursue their social and leisure interests. Comments received via surveys from relatives and health care professionals were positive such as “ my daughter is very happy at 1 The Avenue. I find all the staff very caring”. Another comment received said, “ In my opinion the staff are highly trained in communicating with this client group”. What has improved since the last inspection? 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. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 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 The (1) DS0000007885.V306562.R01.S.doc Version 5.2 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): 1,2,3,4 and 5 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Service users needs are properly assessed prior to admission. EVIDENCE: No changes have been made to the Statement of Purpose or the Service user Guide. Both these documents are available on audiotape, Braille and large print. There have been no new admissions since the last inspection. One service user who was admitted prior to the last inspection was given the opportunity to visit the home and spend evenings with other service users prior to moving in. This was a temporary arrangement to see if he settled in as the other service users all have different ways of communicating. In discussions held with the service user it was clear that he had settled into the household. All service users are admitted following a local authority care management assessment and the home’s pre admission assessment. The assessment includes all aspects of the service users lives and how they want support to be provided for them. Completion of the document includes Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 9 meeting and gathering information from the service user, family and other professionals and is particularly useful for those service users who have complex needs and /or difficulties with communication. Five service users’ care records were inspected and these all contained an initial assessment and care plan which clearly detailed the specific individual needs of the service users’. Each service user had an individual statement of terms and conditions or licence agreement, which had been agreed between the home and the service user. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. The care provided to service users’ was good and encouraged service users’ to make their own decisions about how they lived their lives. EVIDENCE: Whilst staff were supporting service users during the morning it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. Staff were seen using makaton/ finger spelling and physical prompts to support service users. Staff discussed individual needs and demonstrated their knowledge in making sure service users have as much choice and control over their lives. Particularly with regard to supporting service users who have different communication abilities, as all five-service users who live in the home all communicate differently. One service user also interviews prospective employees. The care plans of all five service users’ were looked at. These detailed how needs had been assessed and what actions were needed to meet the identified Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 11 needs. Individual risk assessments, which were clear and well detailed, had been carried out to promote independence and safety and these were agreed with the service users. The care plans contained detailed information about service users, which helped staff to know about the service users’ preferences about how they wished to live their life. Through discussion with staff and the contents of the care plans it was clear that service users are able to make clear choices. Service users plans are written with service users, reviewed regularly and audited monthly by the homes manager. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 12 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): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ enjoy a range of activities to meet their social and recreational needs. EVIDENCE: Service users have the opportunity to attend specialist day centres and work placements such as working in the admin office at the Arts and Crafts Centre. They also have days at home to participate in personal shopping, laundry and household tasks. Service users had opportunities to pursue other interests outside of the home. Various activities are enjoyed by service users from going out for picnics, belonging to a walking club, to going to Alton Towers. Two service users are going on a planned holiday to Reighton Sands. One service user has a versabrailller in their room, which is like a computer telephone that helps them to communicate with relatives and friends. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 13 Menu’s are in different formats such as picture formats. One-service user was writing his shopping list for the meal he was going to cook that day. Service users’ planned their own menus in advance. . Service users’ were supported by the staff to prepare and cook their own meals where this was part of the care plan. Staff have completed the food hygiene training. One comment was received via the surveys from relatives regarding the meals at the home and it was that “ Supervision of clients nutritional intake/healthy regular balanced meals would improve the service for clients”. This was fed back to staff on the day of the site visit. Staff agreed that it was difficult, as service users would always choose the less healthy options. However staff were able to give examples as to how they were able to promote and encourage service users to try the healthier food as staff also felt it to be important to ensure that the nutritional needs of service users is being met. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 14 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): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ received good support and had access to specialist services when required to ensure that their needs were met. EVIDENCE: Staff aimed to promote the independence of the service users’ and to provide support in a sensitive manner. Service users’ preferences as to how they wished to be supported were recorded within individual care plans. Each service user had a GP and access to chiropody, dental and optical services and referrals were made to specialist services as appropriate. Daily record entries reflected the care that was being provided. The home has the Dossett box system in place, however the home is considering replacing this system with the Boots blister pack. There is a policy in place for the storage and administration of medication. The Medication Administration Records were up to date although there was a discrepancy with quantity of one service users medication. No records of any internal audits or checks had been carried out. No running total was maintained. The home was advised that medication should be audited and a record maintained of medication held in stock, so that the quantity of medication balances. This was Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 15 agreed by staff to be done although this problem will be addressed when the new medication system is introduced. Medication was securely stored in a locked cabinet. Staff have received training regarding medication and obtained Competence in Administration of Drugs certificates that are held on individual staff files. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have access to an effective complaints procedure and are protected from harm. EVIDENCE: Service users are provided with a complaints procedure, which is produced in different formats such as Braille, large print or tape. Because of the complexity of service users needs and difficulties with communication it is unlikely that a service user would make a complaint in the usual manner. Staff, therefore, need to have the skills to interpret service users behaviours and have additional communication skills such as signing and finger spelling to determine whether they are unhappy about something. No formal complaints have been received by the home or the Commission for Social Care Inspection. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. Staff receive training in adult protection issues during induction and further training organised by the organisation. Staff had training in the Protection of Vulnerable People and certificates were held on individual staff files. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 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): 24,25,27, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users live in a clean, comfortable and safe home. EVIDENCE: The home provides spacious accommodation for service users. This includes a lounge, dinning room, and kitchen and utility room all on the ground floor. The home is clean and comfortable. It is decorated and furnished to a very good standard. A new suite had been bought for the main lounge. The décor and furnishings reflect a “young persons” type of household and one of the bedrooms seen was individually decorated. The home has sufficient bathrooms and toilets that were clean and well maintained. A range of maintenance checks is completed on a regular basis to make sure that the house is safe and secure. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 18 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): 32,34 and 35 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Sufficient staffing levels, proper recruitment procedures and comprehensive staff training meant that service users’ needs were met and their interests were safeguarded. EVIDENCE: Staffing levels were sufficient for meeting the needs of the service users’. The duty roster showed that there were two members of staff on duty on that day. There was one relief staff member on duty with two service users until another member of staff came on duty. The second member of staff was assisting service users with their shopping. In discussions held with both staff it was clear that all staff including relief staff are comprehensively trained and have the skills that are required to meet the needs of service users, especially those service users who have other ways of communicating rather than verbally. One survey received from a senior practitioner with an Adult Sensory Team said, “In my opinion the staff are highly trained in communicating with this client group”. When service users are at home and at peak times such as evenings and weekends staffing is increased. The staff roster is done to accommodate what Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 19 service users are doing. This makes sure that service users social activities are not compromised. At night there is one person doing sleep-in duties. The organisation has on-call arrangements in place in cases of emergency a roster was displayed on the office wall. The staff files of three members of the staff team were looked at including those of one recently appointed member of staff. These showed that all the necessary pre-employment checks had been carried out prior to the new workers starting in post. Comprehensive training is in place for all staff and varies from Health and Safety, Emergency First Aid in the Workplace to Attitudes and Values, Visual Impairment and Protection of Vulnerable Adults. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 20 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The management of this home ensures service users best interests are promoted and reflected in the service provided. Service users health, safety and welfare are protected. EVIDENCE: The registered manager was not on duty at the time of the site visit, as he is on paternity leave. Therefore no supervision records were looked a on this occasion. However staff confirmed that in the event of them requiring any management support they would contact the service manager who is always contactable. The organisation has an effective quality monitoring system in place. The Service Manager, who carries out regular visits, completes a report on the conduct of the home, which is forwarded on to the Commission for Social Care Inspection. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 21 Records were seen which confirmed that equipment is maintained; gas and electricity supplies in the home are safe and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Staff receive regular training with regard to all health and safety matters. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard YA20 Good Practice Recommendations The registered provider should ensure that medication is audited and a record maintained of medication held in stock, so that the quantity balances. Avenue The (1) DS0000007885.V306562.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 The (1) DS0000007885.V306562.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. 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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