CARE HOMES FOR OLDER PEOPLE
Avon House 40/42 Shakespeare Road Worthing West Sussex BN11 4AS Lead Inspector
Philip Barker Unannounced 12th May 2005 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Avon House Address 40/42 Shakespeare Road, Worthing, West Sussex, BN11 4AS Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 3233257 Cobham Care Ltd Mrs Amanda OHagan Care home 26 Category(ies) of Dementia (DE) - 24 places, registration, with number Mental Disorder, excluding learning disabily or of places dementia - over 65 years of age (MD(E)) - 2 places Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: The total number should not exceed 26 at any one time. Date of last inspection 16th December 2004 Brief Description of the Service: Avon House is a home for older people with past or present mental illness registered to accommodate up to twenty six service users. It is two semidetached houses joined together arranged on two floors with the benefit of a passenger lift. It is situated in a quiet residential area of Worthing. Accommodation is provided in twenty four singles and one double room. There is a small garden at the rear of the property. The service is owned by Cobham Care Ltd and the registered manager is Mrs Amanda O’Hagan. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place from 9-30am to 1-30pm. Avon House has performed well over the past two years since change of ownership. At the last inspection no requirements were made. During the course of this inspection the inspector spoke to a few residents, staff and the manager. Records and care plans were looked at and a tour of the home was conducted. As all of the residents had some mental incapacity it was difficult to talk to some of them so the inspector spent time observing them as they went around the home. The two residents who were spoken to were very positive about the care they were getting at the home. One said that “nothing is too much trouble” and “ I feel safe and happy here as if it was my own home”. One resident had only been at the home for a short while and from observation she seemed to know where she was going and what she wanted. All records were found to be in order and up to date. The Care Plans were well written and contained most of the information needed to look after the residents. However, the inspector noted that the initial assessments were not included in the plan but were kept separately. The Registered Manager agreed to include these at admission. Staff training was ongoing and it was noted that the majority of staff were either National Vocational Qualification (NVQ) trained or were about to start the training. The training records of staff were well documented and up to date. Staff were being supervised by the Care Manager who had made detailed notes of the sessions. They were well written and gave a clear indication of the supervision session. The building was warm, clean and welcoming. There were four care staff on duty with the Care Manager, the Manager and a domestic/handyman. The cook had phoned in sick and the Care Manager was doing the cooking. At night there were two staff awake on duty. The rotas showed this to be the case. All Health and Safety issues were up to date. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 6 What the service does well: What has improved since the last inspection? What they could do better:
The home is well aware that their call bell system is old and not up to standard. Call bells need to be cancelled at the point of call and not at a central point. The owners are aware of this and have said that it will be replaced within the next twelve months. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 7 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. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 and 6 Residents and their families have the information they need to make an informed choice about where they live and are suitably assessed before placing. EVIDENCE: Each resident is given a contract when he/she enters the home. Most of the residents had family or friends who were able to act upon their behalf. One resident had no family and the home was trying to contact the social worker for help. Another resident had been accommodated for two months without receiving any financial help from the Social Care and Caring Services. The manager told the inspector that the resident was well suited to the home and that they would continue to look after her inspite of not receiving any funding. The manager assesses all residents before they join the home either in their own home or hospital. The records of these assessments were seen and found to be very detailed. The home does not take anyone in for intermediate care.
Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 The resident’s health, personal and social care needs are well met through training and supervision of the staff. EVIDENCE: Care Plans were very detailed and well presented although the initial assessments were not kept with the Care plan. The manager agreed to incorporate these assessments into the main Care plan as they were completed. District nurses visit the home when requested and records are kept of all such visits. A GP had recently visited the home and this had been written onto the care plan. Medication was stored safely and records were well kept in regard to the administering and disposing of them. Staff were well trained and the local Pharmacist regularly visited to give updates and training to staff. When looking around the home the inspector noticed staff knocking before entering rooms. Residents were called by their chosen name…some preferred their Christian name, others preferred to be addressed as Mrs. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 11 The inspector observed an incident where a resident was blocking a door and refused to move. Staff tried a number of ways of getting her to move. Eventually she agreed to move when a member of staff asked her to show her “the good picture on your television”. At no time were voices raised or staff allow their frustrations to emerge. The situation was handled very well and it was a win-win for both parties. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Residents appear happy with their lifestyle, are able to keep in contact with their family and friends and able to have some control over their daily tasks. Good home cooked food is provided. EVIDENCE: Activities are well planned in advance. The home employs the services of an Activities Co-ordinator for four afternoons a week. She uses the time for group work like Gentle exercise, dancing, singing, bingo and reminiscence. Sometimes, she works on a 1:1 basis helping a resident with some craft work or taking them out for a walk. The home had recently had an Easter Bonnet competition and lots of photos were taken so that families could see what their loved ones had been doing. At the last inspection one gentleman was able to go out on his own. Sadly he was now unable to go out unescorted as he had got lost on his last trip and had to be brought back by the Police. It was a blustery day so no-one was outside in the garden although there was evidence from benches that some had been outside when it was warmer. Family visits were important and the inspector was told that all visitors are offered refreshments. Sadly no visitors arrived during the inspection so the inspector was unable to talk to any relatives.
Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 13 The residents sat down to a meal of Steak casserole, fresh runner beans, sweet corn and mashed potatoes. There was also a choice of salad, soup or sandwiches. Dessert was a favourite with them all – White Chocolate Mousse. Some residents were unable to feed themselves so staff sat with them and they were helped. This was done in an unhurried manner. Most plates were empty at the end of the meal. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 All complaints are taken seriously and staff and residents’ families know how to complain. Staff are well aware of the Adult Protection Procedures and a Whistle Blowing Policy is in evidence. EVIDENCE: There is a Complaints Book that is empty! All staff have attended the Adult Protection training and the Procedures are in the office. There have been no Complaints made about the home to the CSCI. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 The home is well maintained, safe and clean with no nasty smells. EVIDENCE: The home is well kept and is clean and tidy. The inspector observed the cleaner doing his rounds and every room was left tidy and clean. The home has undergone considerable refurbishment since the present owners took over. This is still on going and plans are in hand to refurbish all the rooms, toilets and bathrooms. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 There are sufficient staff employed to ensure that residents’ basic needs are met. The Home has a sound recruitment policy and all checks are made. There has been considerable input into staff training. EVIDENCE: All staff have undergone Criminal Records Bureau (CRB) checks and copies that these were satisfactory were kept in staff files. Prospective staff are invited to complete an application form and attend an interview. A member of staff confirmed this to be the case. Records checked showed that application forms and two references were always completed before staff started working at the home. Staff training had been undertaken in all areas and the evidence showed that all staff were offered training relevant to their work. Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 It is apparent that the needs of the residents are paramount and that things happen for the benefit of the people living in the home. The home has no dealings with any personal finances preferring to leave that to families or other professionals. Fire procedures are up to date and the home is considered a safe environment. EVIDENCE: The home was constantly updating their practices to ensure that the residents received the best care they could offer. The home does not have any dealings with any money belonging to the residents. One resident does not at present have any one to help with her finances. The home has asked the social worker for advice. All Fire and Environmental health requirements had been met and all equipment was regularly serviced.
Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 19 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. 1. 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 Good Practice Recommendations Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 Avon House H60-H11 S49857 Avon House V223640 120505 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!
