Inspection on 17/10/05 for Avon House

This inspection was carried out on 17th October 2005.

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

Avon House 02/01/09

Avon House 04/01/07

Avon House 12/05/05

Avon House 16/12/04

Avon House 17/06/04

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

CARE HOMES FOR OLDER PEOPLE Avon House 40/42 Shakespeare Road Worthing West Sussex BN11 4AS Lead Inspector Mr P Barker Announced Monday, 17 October 2005 V246728 th 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 V246728 171005 Stage 4.doc Version 1.40 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 (CRH) 26 Category(ies) of Dementia (DE) 24 places (Both) registration, with number Mental disorder, excluding learning disability or of places dementia - over 65 years of age (MD(E)) 2 places (Both) Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 The total number should not exceed 26 persons at any one time. Date of last inspection 12th May 2005 Brief Description of the Service: Avon House is a home for older people with a past or present mental illness. It is registered to accommodate up to twenty six (26) residents. Two semi-detached houses are joined together with a passenger lift serving both floors. Accommodation is provided in twenty four (24) single and one (1) double room. The home has a small rear garden. Avon House is situated in a residential area of Worthing close to local shops, the railway station and the seafront. The service is managed by Mrs Amanda OHagan and the service is owned by Cobham Care Ltd. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place from 9-50am to 2pm. Avon House has performed well over the past two and a half 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. Relatives and visitors to the home had been sent a questionnaire by the Commission asking how they viewed the care their relative/friend was receiving. Fifteen replies had been received at the time of writing this report. The common theme to the replies can be summed up by one relative who wrote, “…there is a good nucleus of excellent staff who are qualified, helpful and responsive. The management has improved to an outstanding degree since late 2003, and it is obvious that considerable funding has been invested in equipment, re-decoration etc.” Residents appeared happy and were happy to tell the inspector that they were “looked after and cared for”. Many of the residents were sitting in the lounge and were keen to say “Hello”. 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. Initial assessments were included in the plan. Staff training was on going 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 five care staff on duty along with the manager, two domestic/handyman and a cook. At night there were two staff awake on duty. The rotas showed this to be the case. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 Page 6 The home had recently had an inspection from Environmental Health and three (3) requirements were made. These have all been dealt with including the purchase of two (2) new fridges for the kitchen. The home has an action plan for maintenance and refurbishment and have recently agreed to purchase a new call bell system that allows the carer to cancel at point of call. There were no requirements made at this inspection. What the service does well: 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. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4, 5, 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. 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. One resident is currently being assessed for nursing care as the home feel that they are no longer able to meet her needs. The home does not take anyone in for intermediate care. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, 10, 11 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. 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, and others preferred to be addressed as Mrs. There are policies and procedures for dealing with the death of a resident and all staff have received appropriate training. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 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 craftwork or taking them out for a walk. The home also employs professional entertainers and a different person came into the home every fortnight. 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. One wrote, “Always made very welcome, coffee etc.” Another said, “ I am treated like a friend rather than a visitor.” Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 Page 11 The residents at down to a meal of Sausages, mixed vegetables and mashed potatoes. There was also a choice of Cornish pasty. 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 V246728 171005 Stage 4.doc Version 1.40 Page 12 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, 17, 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 V246728 171005 Stage 4.doc Version 1.40 Page 13 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, 20, 21, 22, 23, 24, 25, 26 The home is well maintained, safe and clean. EVIDENCE: The inspector received a comment from a relative about the condition of a room. The inspector visited the room and noticed a new carpet had been fitted to the room and that the window was open for ventilation. Staff had been trained to mop up spills as soon as possible to avoid a nasty smell. The inspector wonders whether an air freshener emitting fragrance in a burst would help the situation. The home is well kept and is clean and tidy. The inspector observed the cleaners doing their rounds and every room was left tidy and clean. Rooms were well furnished and some residents had brought along with them some of their treasured possessions. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 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 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, 28, 29, 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 V246728 171005 Stage 4.doc Version 1.40 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 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) 31, 32, 33, 34, 35, 36, 37, 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 manager is currently studying for her Level 4 NVQ in Care. She then intends to obtain her Registered Managers Award. 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. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 Page 16 The home is well managed and staff are keen to assist the residents in all aspects of their life. All Fire and Environmental health requirements had been met and all equipment was regularly serviced. Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 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 4 14 4 15 3 COMPLAINTS AND PROTECTION 4 3 3 3 3 3 4 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 3 3 3 4 4 3 3 3 3 3 Avon House H60 H11 S49857 Avon House V246728 171005 Stage 4.doc Version 1.40 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. 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 V246728 171005 Stage 4.doc Version 1.40 Page 19 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. 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