Inspection on 23/05/06 for Avon House

This inspection was carried out on 23rd May 2006.

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

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

Other inspections for this house

Avon House 20/04/10

Avon House 15/07/08

Avon House 09/07/07

Avon House 13/12/05

Avon House 19/01/05

Avon House 17/05/04

Similar services:

Ashlong House

Spring Lane Care Home

Avenues (The) (Neave Crescent)

Barrington Lodge Nursing Home

Beacon House Nursing Home

St Mary`s Convent & Nursing Home

1-3 Frederick Gardens

The Royal Star and Garter Home

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

CARE HOMES FOR OLDER PEOPLE Avon House Allen Street London W8 6BL Lead Inspector Peter Montgomery Unannounced Inspection 10:30 23rd May 2006 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.V288368.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.V288368.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.V288368.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 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.V288368.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 over two days on Tuesday 23rd. and Thursday 25th. May 2006. The inspector was accompanied by the Pharmacy Inspector who completed a comprehensive audit of medication systems, including records, storage and administration. Communal areas were viewed, and individual service users records and communal records compiled by staff were reviewed, as were the homes policies, and these were used to inform the report. The inspectors were able to talk with service users, staff members and the manager. At the end of the inspection the inspectors provided feedback to the manager. What the service does well: What has improved since the last inspection? What they could do better: Service user participation in care planning has improved, but staff still need to identify more realistic objectives in the support plans. The management team should also consider alternative seating arrangements to that existing in the communal ground floor lounge which is very cramped and over crowded. Avon House DS0000026012.V288368.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.V288368.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.V288368.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): 1,2,3,4,5,6 The homes Statement of Purpose and Service user Guide are adequate, although clearly these documents have not been updated for some time. Prospective users reading these documents would be aware of basic services available in the home. Quality in this outcome area is adequate, this judgment had been made using available evidence including a visit to this service. EVIDENCE: The homes Statement of Purpose and Service User Guide contain sufficient information to aid service users gain some understanding of services and facilities in the home. Core objectives are clearly stated, although - given changes in the home - this information is somewhat out of date. Records and individual assessment information demonstrated service users have been admitted into the home with an assessment of how their needs should be met, although this is not very clearly stated in support plans. A number of people who live in the home were spoken to during the inspection, and all stated they considered their needs were generally being met. Avon House DS0000026012.V288368.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 Support plans have recently been introduced in place of care plans, and are intended to ensure reviews and agreed outcomes are in place to ensure staff adequately identify and meet service user needs. Quality in this outcome area is good, this judgment had been made using available evidence including a visit to this service. EVIDENCE: The records for six-service user on each floor were looked at and each contained a plan identifying of the persons care needs, and how they were to be met by staff. There was evidence they were being reviewed regularly in consultation with appropriate care professionals, although some of the objectives were not clearly – or realisticaly – addressed, and this needs to be resolved. In addition some were difficult to read. Service users are supported to make decisions and take risks as part of their independent lifestyle, and each person’s file contained an assessment of any areas where there was considered to be a risk and how these risks were to be addressed. Service Avon House DS0000026012.V288368.R01.S.doc Version 5.1 Page 10 users have been involved in the development of the care plan and agreed their objectives, and the range of activities planned. A full audit of medication systems, including records, storage, administration and training was undertaken by the Pharmacy Inspector, and these systems were considered good. Avon House DS0000026012.V288368.R01.S.doc Version 5.1 Page 11 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 Community links have been established or developed to support and enrich service users social needs. At the present time service users benefit from a more varied and stimulating range of activities and outings of their choice. Quality in this outcome area is good, this judgment had been made using available evidence including a visit to this service. EVIDENCE: There is evidence of a varied programme of activities, facilitated by the activity coordinator and that staff accompany service users on outings where appropriate. Evidence throughout the home, plus feedback from service users, confirmes that most considered activities good, particularly for those with specialised needs. There are also seasonal events such as barbeques etc. and a greater number of service users thought individual activities - such as visits to the shops or a café, had improved. The variety and quality of the meals provided are imaginative and include both vegetarian and ethnic choices demonstrated that choice and individual preferences are well catered for in the home. Many residents spoken to said how much they enjoyed their meals. Avon House DS0000026012.V288368.R01.S.doc Version 5.1 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 the following standard(s): 16,17,18 The home has a well-developed complaints system, there is considerable evidence that service users views are listened to and acted upon. Quality in this outcome area is good, this judgment had been made using available evidence including a visit to this service. EVIDENCE: All service users are given copies of the complaints procedure (in the service user guide) 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 feel able to discuss concerns with staff. No complaints have been recorded at the home since the last inspection, although there have been minor concerns raised with senior staff. These were satisfactorily concluded within specified timescales. Avon House DS0000026012.V288368.R01.S.doc Version 5.1 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 the following standard(s): 19,20,21,22,23,24,25,26 The quality of furnishings, fittings and décor is good. There is evidence of regular maintenance and planned improvements. The home provides service users with a comfortable and homely environment. Quality in this outcome area is good, this judgment had been made using available evidence including a visit to this service. EVIDENCE: Furnishings, décor and standards of cleanliness throughout the home are good, and facilities are well maintained. Each of the three upper floors provide a “group living area” comprising of a small lounge and a kitchen. All of these areas are being redecorated. I addition there are ensuite single bedrooms and specialist bathing and w.c. facilities. Unfortunately as everyone sits in the main ground floor lounge this is very over crowded. This issue has been highlighted in previous reports, and it is suggested again that the management team consider a better way of using the communal facilities available throughout the home. Externally the attractive gardens have been replanted. Avon House DS0000026012.V288368.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): 27,28,29,30 Service users benefit from an experienced team of staff at the home, good progress has been made in addressing individual staff supervision and formal training needs. Quality in this outcome area is good, this judgment had been made using available evidence including a visit to this service. EVIDENCE: Staff competencies and their friendliness was commented on by service users, a number of whom have worked at the home for a number of years and have built up a good knowledge and understanding of the needs of each service user. Staffing levels comprise of a registered nurse and two support workers on each floor during the day. Support staff have undertaken training in essential areas, such as food hygiene, health and safety, and first aid in the last year, and most recently in support/care planning. NVQ Level 2 training uptake by care staff remains very good, with the majority of staff having completed this training. This commitment to staff development and training by the organisation should ensure service users receive an appropriate standard of support and care from the staff at the home. Avon House DS0000026012.V288368.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 A satisfactory development plan for the home is in place and the manager is well supported by the organisation. All staff are aware of their roles and responsibilities. Quality in this outcome area is adequate, this judgment had been made using available evidence including a visit to this service. EVIDENCE: All senior staff are registered nurses, management systems have been improved with the recent appointment of a deputy manager to the team. Staff supervisory systems appeared adequate to achieve and monitor good standards of care practice. Staff stated regular meetings with residents are scheduled to determine their views, and access to external advocates is provided as required. All statutory records were reviewed, and all were well maintainedincluding care plans, risk assessments, staff rosters etc. These records were generally detailed and accurate, and record keeping overall Avon House DS0000026012.V288368.R01.S.doc Version 5.1 Page 16 demonstrated the home is being run responsibly with essential checks being made and acted upon. Avon House DS0000026012.V288368.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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 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.V288368.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. 1 Standard OP15 15 Regulation 7 Requirement Care plans must be improved to ensure individual objectives accurately reflects service users needs, and these can be achieved by staff. Timescale for action 24/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying ut. No. 1 Refer to Standard OP19 19 Good Practice Recommendations It is recommended better use of communal seating arrangements and facilities in the home are considered. Avon House DS0000026012.V288368.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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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