CARE HOMES FOR OLDER PEOPLE
Avon House Allen Street London W8 6BL Lead Inspector
Peter Montgomery Unannounced Inspection 13th December 2005 10:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Avon House Address Allen Street London W8 6BL 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) 020 7937 3307 020 7795 6288 avon.house@craegmoor.co.uk London Parkcare Limited Grace Corriea Care Home 35 Category(ies) of Physical disability (35) registration, with number of places Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: Avon House is a largely modern home which has been significantly extended in the recent past. The home is located near Kensington High Street, and currently provides accommodation for up to 35 older people. Service users bedrooms are located on all three stories in the home, with lift access to the upper floors. On the ground floor there is an open plan lounge, a large dining room, conservatory and the managers and administration offices. The main kitchen and laundry are also located on this floor. There are individual small lounges and dining areas on the first and second floors, and a total of twenty five single and five double bedrooms, all with en suite facilities. To the front of the home there is limited off street parking, and a small garden to the rear. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 13th. December 2005. Communal areas were viewed, and the people who live in the home, plus staff on duty were spoken to. Individual service users records and communal records compiled by staff were reviewed, and these were used to inform the report. What the service does well: What has improved since the last inspection? What they could do better:
It is considered service users, especially those with more specialised needs, would continue to benefit from a wider range of social activities. The extent of service user involvement in careplanning will also be reviewed in subsequent inspections. As stated above, environmental standards are considered adequate, with one large lounge and a conservatory on the ground floor, and several smaller lounges on the upper floors. However the majority of service users use the ground floor lounge exclusively, resulting in a very cramped and congested area, which is also compounded by service users sitting in the corridor. It is recommended staff and service users review these arrangements, and consider more appropriate ways of utilising facilities throughout the home.
Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 6 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 DS0000026012.V274376.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): x These outcomes were not reviewed at this inspection EVIDENCE: These Standards were not assessed at this inspection. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7,8,9,10,11 The information contained within the care planning system currently being implemented provide staff with the information they need to satisfactorily address the needs of service users. EVIDENCE: The records for service users were looked at demonstrated that there was a more comprehensive plan of care/action, which identifies the needs of service users and how they were to be met by staff. In addition they were being reviewed more regularly, in consultation with appropriate care professionals. The current care planning system is being replaced by the new care plan format, and the advantages of this system was discussed with the new deputy manager. He confirmed all staff were receiving training in using the new format, and this should be completed early in the new year. It was too early to judge how successful this system will be, however these systems will be reviewed in detail at the next inspection. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 12,13,14,15 The home has made some progress to meet the expectations and preferences of service users, people using the service are able to exercise a limited choice and control over their diet. EVIDENCE: There is a published programme of activities and outings posted in the home, which have been drawn up by the activities coordinator, with a particularly good choice in music and entertainment activities. It has been noted in previous inspections that service users have stated they would enjoy a greater variety of activities being on offer - particularly for those with more specialised needs, a frequent comment being there could be more activities for residents in the daytime and at weekends - such as individual outings to shops and cafes, which would need to be facilitated more by care staff. It is recommended the manager investigate ways to achieve this, perhaps by identifying a member of the care staff team to liase with the activities coordinator to facilitate individual outings and activities. Service users were complimentary of meals and choice provided. Seasonal changes to the menu and more frequent service user consultation has resulted in notable improvements in menu planning. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 16,17,18 The home has a well established complaints system, there is evidence that service users views are listened to and acted upon. EVIDENCE: The service user guide provides a variety of information relevant to the home, in addition to the complaints procedure. All service users are given a copy when they are admitted into the home, and a record of all complaints made in the home is retained on file by the manager. Service users spoken to are generally aware of the complaints process and all stated they could discuss concerns with staff. Complaints that have been reported since the last inspection have been satisfactorily concluded within specified timescales. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 19,20,23,25 There have been minor changes to the décor and furnishings in the home in the last year; service users live in a pleasant environment. EVIDENCE: Facilities, furnishings, décor and standards of cleanliness throughout the home are well maintained. The home has been significantly extended over recent years to provide the present level of accommodation. Facilities are arranged over the first, second and third floors. Each floor has a small lounge and kitchen area, although most service users take their meals in the large ground floor dining area, and sit in the one large lounge. As stated in the summary this means that the lounge is rather congested, with wheelchairs and furnishings posing a potential risk to health and safety. It is recommended staff and service users review these arrangements, and consider more appropriate ways of utilising facilities throughout the home.
Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 13 Resident’s bedrooms are all well decorated with some personal furnishings and memorabilia. Service users comments demonstrated they were satisfied with the standard of accommodation in their rooms. Communal areas are all well decorated and maintained Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): x These outcomes were not reviewed at this inspection EVIDENCE: These Standards were not assessed at this inspection. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37,38 The manager has a development plan for the home and is well supported by senior staff. All staff are aware of their roles and responsibilities. EVIDENCE: The manager and all senior staff in the home are registered nurses. Organisational policies and procedures require staff to maintain appropriate professional standards for the home and feedback from users of the service was positive. Staff on duty stated regular meetings with residents are scheduled to determine their views, and access to external advocates is provided as required. A number of records were looked at, including care plans, risk assessments, staff rosters etc. These records were generally detailed and accurate, and record keeping overall demonstrated the home is being run responsibly with essential checks being made and acted upon. Given that new care plans formats have recently been introduced – and the majority have not been completed for all service users - these records will be examined in greater detail at the next inspection.
Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 16 Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 x x 3 x 3 x STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 18 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 2 Refer to Standard 12 19 Good Practice Recommendations It is recommended care staff liase with activity staff to provide further support in facilitating specialist activities for those service users requiring individual aid. Rather than the majority of service users using the main lounge, it is recommended some thought is given to the better use of seating areas for service users. Avon House DS0000026012.V274376.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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