Inspection on 09/01/09 for Avoca Care Home

This inspection was carried out on 9th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Avoca Care Home 52 Mosspits Lane Liverpool Merseyside L10 9LQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lorraine Farrar     Date: 0 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Avoca Care Home 52 Mosspits Lane Liverpool Merseyside L10 9LQ 01514744132 01514744132 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Potensial Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 7 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 7 The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of people who can be accommodated is: 7 Date of last inspection Brief description of the care home Avoca is owned and operated by a company called Potensials. They provide care and support services to people across the country. It is registered to provide support and accommodation for seven adults who have learning disabilities. The house is an end terraced based in a family area of Fazackerly. It is within reasonable distance of local shops, facilites and public transport. Accommodation consists of a shared lounge, dining room, domestic kitchen and laundry. In addition there is an upstairs bathroom with accessible shower and bath and a downstairs shower room with seperate toilet. Everyone living at Avoca has their own en-suite bedroom that they can personalise as Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home the choose. Outside an enclosed rear garden provides seating areas. Some parking is availalbe on the drive with additional parking on the street outside. Staff work at Avoca twenty four hours a day to support the people living there. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We gathered evidence for this inspection in a number of different ways. Before we visited we sent the manager a self assessment form which gave us information about things like health and safety and staffing. It also gave us information about where the manager thinks Avoca supports people well and where she thinks they can improve. We also looked at any information we have received about Avoca since it was registered in August 2008. We used all this information and the self assessment form to help us plan our site visit and write this report. We made an unannounced site visit to Avoca on the 9th January 2009. We were there for over six hours and spent time reading records and looking around the house. We Care Homes for Adults (18-65 years) Page 6 of 31 looked at the support three of the people living at Avoca receive. This included support with their daily lives, money, medication, activities and the environment. While we were there we talked with all of the people who live there and with five members of staff including the new manager. This helped us to find out what it is like to live at Avoca and if people get the support they need and choose. It costs between four hundred and sixty one pounds, thirty three pence and seven hundred and sixty three pounds and sixty seven pence each week to live at Avoca. What the care home does well: What has improved since the last inspection? What they could do better: Peoples care plans need to be re-written. Staff need to make sure that they sit with the person and get their views on what should be in their plan. Care plans are not always up to date. Some information is not filled in clearly. This will help to make sure people have a say in the support they receive. It will also help to make sure that any changes to their support needs are quickly noticed and acted upon. People should get more support to be involved in the running of their house. They should be supported to go for the food shopping and to learn household tasks. More support should be offered to people to take part in their local community. Things like going to local events and clubs. This will all help people to have more control over and interests in their everyday lives. Care Homes for Adults (18-65 years) Page 8 of 31 In the dining room there is paperwork pinned to the wall. This makes Avoca look less homely. Some of the information may be private and people might not want it on the wall for visitors to read. Small electric items in the house, such as shavers and kettles have not been tested recently. These need to be tested every year to make sure that they are still safe to use. The way staff record medication needs to be better. Staff need to make sure that they sign under the right date. They also need to make sure that all the medication in the cupboard is still in use. This will help to lessen the risk of a mistake happening. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient information is obtained about and provided to people considering moving into Avoca. This helps everyone to decide if Avoca is the right place for the person to live. Evidence: The people who live at Avoca told us that they like living there, with one person explaining, it suits me here. As nobody new has moved into Avoca for several years it was not possible for us to practically assess the support the home would offer to them. However we discussed this with the manager, who explained that she would follow the companies policy. This would include obtaining as much information as possible about the persons support needs and their choices. She explained that in order to do this she would arrange to obtain initial information from social services. Staff would then meet with the person and others who support them, including their family. After an initial assessment they would be invited to visit Avoca on several occasions and stay overnight if they wished. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: This would provide them with the opportunity to meet the other people living there and also to see how the home operates. The manager also explained that she would send the person information about the services provided at Avoca. This all helps the person to decide if Avoca is the right place for them to live. It also helps staff to plan how they can support the person successfully if they move in. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs and choices of the people living at Avoca are currently recognised and met. However a lack of clear care planning could impact on this in the future. Evidence: Individual care files are in place for all of the people who live at Avoca. However these are large files and contain some information dating back to 2002. This could make it difficult to find up to date information about the person and their support needs in a timely manner. We looked at care plans for three of the people living at Avoca and found the contents to be variable. For example one person had a well completed health action plan, that they had signed and that gave clear information. However another persons plan contained the same document but it had not been completed. Care plans were in place for supporting people with their medication, money, diet, individual health needs, going out and personal care and provided some guidance for staff. Although these had Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: been reviewed regularly the reviews do not contain facts, instead stating the plan continues or is being met. This does not provide sufficient evidence that the persons needs or choices remain the same nor does it evidence the steps staff have taken to support them, since the last review. Some plans contained evidence that the person was involved in writing them, others did not. However the manager showed us a document that she intends to use as a monthly plan review between the person and their key worker. We saw one of these completed and this recorded good discussions between the person and their key worker. Once fully in use these documents will provide people with a formal way to express their views on the support they receive and any changes they would like to make. Care plans did contain a series of assessments and risk assessments for the person. These included health assessments such as for pressure areas and nutrition and had all been reviewed regularly. Risk assessments were in place for supporting the person with areas such as their money, and medication. Some of these had been recently reviewed with the person others had not. Throughout our visit we noted that staff have a good understanding of peoples support needs and their choices. However a lack of clear, reviewed care plans may mean that people do not consistently get the support they need, or that any changes to their needs and choices are not noted and acted upon as quickly as they could be. The people living at Avoca told us that they make their own decisions, with one person explaining, they ask what you want, you get it. Throughout our visit we noticed that the people living there decided how to spend their time, and what they wanted to do. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Avoca are supported to live a lifestyle of their choosing. This could be further expanded to involved them more in the everyday running of their household and in their local community. Evidence: The people living at Avoca spend their time in different ways. Some people go to local colleges or day centres, others spend their time at home engaged in activities of their choice. Some people told us that they go out independently, with one person explaining staff have given him an identification card to carry for safety. Another person explained that sometimes , I go for messages and other times he goes to church or out and about to see friends. Records showed that people get some support from staff to go out and about, for example for a meal and one person we spoke with, explained he had been on holiday with staff in the past year. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: In her self assessment form the manager explained that they plan to offer people more support with community activities. During our visit she explained that they intend to support people to look at local facilities, events and clubs and support them to attend if they wish. We noticed that people choose where to spend their time at home. Some people spent time in the lounge chatting with each other, whilst others used their bedrooms to watch TV or listen to music. The people living there explained that they can have visitors whenever they want and this was confirmed in records that showed peoples visitors coming to the house. The people living at Avoca are not very involved in the everyday running of their household. For example one person told us that staff do his laundry although, I could do it if I wanted to. Similarly staff go shopping for the bulk of the food, although the people living there may go locally for smaller items. More support for people to become involved in the everyday running of their household may provide them with an increased opportunity to learn new skills and become more independent. People did tell us that they have a choice of food and can make a drink or snack when they want one. One person told us he chooses his food, they give you what you ask for. Whilst another explained he makes his own cup of tea and lunch, staff make tea and if I dont like it tell them. Have something else. Menus confirmed that a variety of meals are made and we saw sufficient supplies of food available in the home. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living at Avoca are supported to meet their health and personal care needs and choices. Practices around medication recording should be improved to ensure they are managed safely at all times. Evidence: The people living at Avoca told us that they get support from staff with their health and personal care when they need it. During our visit it was evident from meeting the people living there that they had received support to look after their appearance, if needed. People told us that routines in the house are flexible and they can get up or go to bed as they choose, one person explained, we dont get told to go to bed. This was further evidenced in the records that we read. People also told us that they get support from staff to look after their health. One person told us that if they were unwell, staff get the doctor. Staff go with me another person confirmed this adding, they do their best. Records showed that people receive support to make and attend regular health care checks such as with the chiropodist and optician as well as more specialist health appointments with Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: consultants. They also showed that staff are skilled at recognising and dealing with any health emergencies people may have. For example records showed that staff had noted one person displaying possible signs of pre seizure behaviour and had discussed it with them and monitored them more closely. In discussions with the staff team they displayed a very good understanding of how to support people with their health and also of signs to look out for that may indicate they were becoming unwell or may have a seizure. This all helps to ensure the people living at Avoca remain as healthy as possible. None of the people living at Avoca currently manage their own medication and they told us they do not wish to do so. One person explained, I am happy with that and another that staff look after his tablets, and make sure he has them on time. Medication is stored correctly and staff have received training in managing medication safely. However we noted that the sheets staff sign when they give out medication did not correspond with the actual dates they were given. This may mean that an accurate audit of medication cannot be carried out and therefore mistakes may not be noted and acted upon as quickly as they could be. We also noted that some medication stored in the cupboard and prescribed for use as needed was no longer listed on the persons medication sheet as prescribed. This could lead to the person either not being given as needed medication that is still prescribed or it being given when no longer prescribed. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Avoca feel safe living there and have confidence that any concerns or complaints they had would be taken seriously and acted upon. The documentation of how peoples money is managed does not always evidence that it is managed in their best interests. Evidence: The people living at Avoca all know who they would talk to if they had any concerns or complaints and were confident that staff would help them. One person told us, staff ask if there is anything on your mind. I tell them, they try to make me happy. Another person explained they would tell, whos in charge. They help The manager told us in her self assessment form that the staff working at Avoca have all had training in adult protection issues and we saw evidence of this in the staff files we looked at. In discussions with some of the staff who work at Avoca they displayed a clear understanding of adult protection issues, the signs they would look for and the actions they would take. The awareness staff have along with the fact that the people living there are confident they will be listened to and their concerns acted upon helps people to feel safe whilst living there. No concerns, complaints or protection issues have been raised about Avoca since it was registered in August 2008. Potensials act as appointee for the benefit money of most of the people who live at Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: Avoca. We checked samples of records and amounts held in the home for people and found that these tallied with clear records kept of monies spent. However a copy of the companys policy on managing peoples money was not available in the house. Bank statements showed that people have been supported to have bank accounts in their own name. However no explanation was available as to how people are supported to manage and check these. Similarly no explanation was available as to how the organisation manage peoples benefit money or what accounts it is paid into. This would help to ensure that people are supported to manage their money safely and well. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Avoca provides people with a comfortable, family type home to live in that is adapted to meet their needs and choices. Evidence: Avoca is an end terraced house located in a family area of Fazackerly and fits in well with other houses in the local area . It therefore supports the people living there to live as ordinary a lifestyle as possible within their local community. Everyone living at Avoca has their own en-suite bedroom. One of the people living there told us that he has, a lovely room and finds that it is always warm enough. We noticed during our visit that peoples are able to personalise their bedroom as they wish in accordance with their hobbies and interests. In addition to the en-suite toilets in bedrooms Avoca also provides an upstairs bathroom with bath and accessible shower and an accessible shower downstairs. Grab rails are available to help people with their mobility if needed. The people living at Avoca share a lounge, dining room, domestic kitchen and laundry room. Outside there is a small front garden with enclosed rear garden area with Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: seating. Parking is available on the street at the front of the house. All areas of the house are warm and comfortable with a domestic feel to them. In addition we noted that the home is clean and well maintained. A seperate laundry room provides washing and drying equipment and staff have access to disposable gloves, bags and aprons to help prevent a possible outbreak of infection. In the dining room printed pen pictures of the people living there were hung on the wall, along with a very large notice board with various information pinned to it. This may breach peoples right to confidentiality it also detracted from the domestic feel of the rest of the house. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Avoca are supported by an experienced staff team who are able to recognise and meet their support needs and choices. Evidence: The people who live at Avoca told us that they like the staff team and get support from them when needed. One person told us, I like the staff, they do a good job looking after us. I am pleased about that. Whilst others told us staff are, all right, they help with everything and all right, they do the work. No new staff have started working at Avoca since Potensials took over in August 2008. However staff files for existing staff showed that records of checks such as references and Criminal Records Bureau (CRB) checks are on file. The manager told us in her self assessment form that, stringent recruitment procedures are in place and would be used. This helps to ensure that staff are suitable to work with people who may be vulnerable. Staff we spoke with had a very good understanding of the people who live at Avoca. They were able to explain the different support and health needs peoples have as well as their likes and dislikes and their chosen lifestyles. We observed during our visit that Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: staff have built good relationships with the people living there, who clearly felt comfortable in their company. Currently thirty three percent of the staff team hold a national qualification in care (NVQ) however all of the other staff are currently working towards obtaining this. Records showed that staff have had other training in various aspects of supporting people. These ranged from health and safety and fire awareness to health issues and the protection of vulnerable adults. Staff told us that Potensials organises training for them and they are confident that if they requested training based on the needs of the people living at Avoca, this would be provided. We saw records of future training booked for staff and the manager explained there are plans for all staff to undertake a nationally recognised award in supporting people who have a learning disability. The training staff have had and that is planned helps to ensure staff are as up to date as possible in how to support people safely and well. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management systems at Avoca are improving to benefit the people living there. However healthy and safety checks are not always prioritised which may affect safety within the home. Evidence: Ms Julie Green has been the appointed manager of Avoca since November 2008. She is experienced in working in a management capacity and with adults who have learning disabilities. Ms Green has started the process of obtaining the necessary checks to register with ourselves as the manager at Avoca. This process helps to ensure that managers are suitably qualified and experienced to manage a care home. Ms Green works at least two days per week at Avoca and spends a further two days per week at its sister home nearby. In order to provide further management support a deputy manager is also based at Avoca. Staff told us that they find the manager fair and approachable and feel she is considerate of the people who live at Avoca. In discussions with her we found that she has identified areas of improvement that could Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: be made to the service and is clear about how these will be planned and delivered. At the same time she displayed an awareness of the need to include the people living at Avoca and staff in future plans and the need not to introduce too many changes at the same time, which could overwhelm them. The manager told us in her self assessment questionnaire that since Potensials took over they have introduced a series of checks within the home. We saw samples of these that included checks of care plans and of health and safety . These checks, if followed up, provide a good way to quickly identity and act upon any issues that may arise. No evidence was available that the views of the people who live at Avoca are formally obtained and taken into account regarding future planning, although the manager was able to explain how she intends to do this in future. This would help to provide people with the opportunity to have a real influence on the way their home is run and to plan improvements they would like to see. A series of certificates and records showed that most health and safety checks are carried out regularly. This included checks on water temperatures and on the gas supply. However no record of the last time portable electrical appliance testing (PAT) took place was available. The monthly health and safety report for December noted. Still need PAT testing ASAP. However at the time of our visit no date for this had been arranged. In not ensuring all checks are carried out regularly in line with good practice guidance, the organisation are not taking all reasonable steps to ensure that Avoca is a safe place to live, work and visit. Care Homes for Adults (18-65 years) Page 26 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Clear up to date care plans must be compiled for all of the people who live at Avoca. This will help to ensure that their support needs and choices are recognised and can be met 27/02/2009 2 9 15 Risk assessments must be reviewed and updated if needed regularly. This will help to ensure that any risks to the person are recognised and can be minimised. 27/02/2009 3 20 13 Action should be taken to 02/02/2009 ensure that records of medication administered are completed on the correct date. Any medication stored in the home and not recorded on medication sheets must be investigated. If in use action must be Care Homes for Adults (18-65 years) Page 28 of 31 taken to record this. If no longer in use they must be disposed of safely. This will help to lessen the risk of errors occurring. 4 23 20 A copy of the company 27/03/2009 policy on managing service users money must be available in the home. An explanation must be available as to the support people are offered with their benefits money and bank accounts. This must include which account the money is paid into and if not paid direct to the person then an explanation of how soon it is transferred. This will help to ensure that people are supported to manage their money in a way that is both safe and in their best interests. 5 42 13 Testing of portable electric appliances must be carried out. This will help to make sure Avoca is a safe place to live, work and visit. 06/02/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Old information stored in care plans should be removed and stored elsewhere if it is no longer applicable to the persons Page 29 of 31 Care Homes for Adults (18-65 years) current support needs. This will help to ensure that current information can be easily found. 2 14 Plans to support people to increase their participation in local community events, clubs and activities, including household shopping, should be followed. This will support people to have new experiences, become more involved in their local community and in the everyday running of their lives. More support should be offered to the people living at Avoca to become involved in the everyday running of their household. This will provide them with opportunities to increase their lifestyle skills and gain further independence. An internal audit of medication should be introduced and carried out regularly. This will help to quickly identity any issues that may arise and address them. Consideration should be given to removing notices and pen pictures from the dining room walls. This will help to ensure peoples confidentiality is maintained. it will also help to provide people with a more domestic environment to live in. The views of the people living at Avoca should be formally obtained regarding the service they receive and any future changes they would like to see occur. This will provide them with a formal way to influence how their home operates. 3 16 4 20 5 24 6 39 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - 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!