Inspection on 04/01/07 for Avon House

This inspection was carried out on 4th January 2007.

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 17/10/05

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 Mrs V Gay Unannounced Inspection 4th January 2007 09:00 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 DS0000049857.V322716.R01.S.doc Version 5.2 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 DS0000049857.V322716.R01.S.doc Version 5.2 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 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) 01903 233257 01903 531313 avonhouse@ntlbusiness.com Cobham Care Ltd Mrs Amanda O`Hagan Care Home 26 Category(ies) of Dementia (24), Mental Disorder, excluding registration, with number learning disability or dementia - over 65 years of of places age (2) Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number should not exceed 26 persons at any one time. Date of last inspection 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 residents. Two semi-detached houses are joined together with a passenger lift serving both floors. Accommodation is provided in twenty-four single and one 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 Registered provider is Cobham Care Ltd. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is the first key inspection following the Inspecting for Better Lives Methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. All standards were met at the previous inspection, and seven were found to exceed the National Minimum Standards. To establish the quality of care provided by this home information was gathered by reviewing the previous report, and by using surveys. These were sent to people receiving the service, and their relatives. Due to the holiday period none have been returned in time to inform this inspection. Any received will however be held on file for future use. An unannounced inspection was carried out on the 4 January 2007 at 9am and lasted five hours. During that time the inspector toured the building, spoke with the majority of residents and spoke to staff members to gain a sense of what it was like to live and work in the home. A visitor, district nurse and hairdresser also in attendance were asked for their opinion regarding the standard of care. They gave a favourable account of the home in every respect and no adverse comments were made to the inspector. Statutory records were examined as part of the case tracking process to triangulate evidence and form a judgement. The inspector examined five files of new residents admitted since the last inspection and four new staff files. The home continues to perform well and no requirements were made. What the service does well: Avon House provides a good standard of care to vulnerable people. On arrival at the home residents were getting up, four were watching television in the lounge and others were preparing to have their hair done by the visiting hairdresser. The home, although pleasantly busy was relaxed and welcoming. Residents were alert and cheerful and happy to discuss the daily happenings with the inspector. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 6 Avon House offers the residents who live there, good care, good food and the opportunity to engage in activities. The Registered Providers visit the home regularly to monitor the standards of care. The home has a group of staff that work together as a team and enjoyed good relationship with the residents. It was not possible to engage in meaningful conversation with all the residents due to their varying degrees of dementia. However from their demeanour and interactions with the staff and each other, the inspector concluded that they felt secure and relaxed in the home. What has improved since the last inspection? What they could do better: Assessments and care plans could be developed to include more information regarding the social interests and previous history of the residents. Questionnaires received from relatives were available to the inspector. Findings from these should be audited as part of the quality assurance policy, to evaluate and develop the service further. Although staff confirmed they felt well supported and received regular training, regular supervision as stated in standard 36.2 of the National Minimum Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 7 Standards is not being recorded. Progress in respect of this will be monitored at the next inspection. 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. The summary of this inspection report can be made available in other formats on request. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Avon House DS0000049857.V322716.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prior to moving into Avon House people were given sufficient information about what the home offers, to enable them to make a choice as to whether or not they want to live there. In addition before moving into the home, people are assessed, by the manager, in their own home or hospital whenever possible, to make sure they are suitable, and invited for a trial period. People know exactly what they can expect from the home and what is expected from them. Intermediate care is not provided at Avon House. EVIDENCE: A relative spoken to on the day of inspection confirmed that he had been given information about Avon House and that he had been invited to visit the home before his Aunt was admitted. He also informed the inspector that the Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 10 Registered Manager had been very helpful in providing information and guidance about the progressive stages of dementia, to help the family understand the changes that presented. Some residents due to their mental frailty could not remember, but said that they were “very pleased they were here”. Residents told the Inspector that they thought the home was a nice place to live and that they had no complaints whatsoever about the way they were being looked after. The Inspector looked at the assessment records of five residents, and found them all to be satisfactory. The Registered Manager informed the inspector that she is looking at ways to expand the information she gains during an assessment to ensure it gives a fuller picture of the residents past life and interests. Intermediate care is not provided. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health, personal and social care needs are set out in an individual plan of care. Medication is managed safely. During the course of the inspection staff were observed to treat residents respectfully so that their dignity was preserved. EVIDENCE: The inspector examined as part of the case tracking, the care plans for five residents who had been admitted since the previous inspection, to ensure their care needs were being met. 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. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 12 It was confirmed by many of the residents whom the Inspector spoke with on the day of inspection that their varying needs were being met. Residents said they “couldn’t fault anything about the home”. Another resident said, “ I prefer this home as they allow me to stay in my own room”. Another resident said she appreciated the cleanliness of the home and that everything was so nice”. The manager confirmed to the Inspector that staff members administering medication had all received the appropriate training, records supported this to be so. No resident, due to their mental frailty manages their own prescribed medication. The inspector was pleased to see that staff knocked on resident’s doors and awaited an invite before walking in. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are helped to make their own choice as far as possible taking into account their mental frailty. Residents said their families were made to feel welcome when they visited. The mealtimes are well managed and the food is well presented and varied. EVIDENCE: There is a range of activities for those who wish to participate, and residents are encouraged to maintain contact with their family and friends wherever possible. All residents seemed to enjoy their food, and the company of others. The atmosphere was relaxed and residents were happy talking to each other over lunch. The main meal of the day was fish pie and a selection of vegetables. The meal appeared appetising and was generous in quantity. Several residents said the food was always very good. The cook was aware of the likes and dislikes of Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 14 the residents. Alternatives to the main meal were being provided as appropriate. Staff assisted residents who required help with feeding in a sensitive manner. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are listened to and given time and attention when they are worried or concerned. Regular training sessions for staff, plus policies and procedures regarding abuse, ensure that, as far as is possible, the people who live at Avon House are protected from bad practice. EVIDENCE: The procedures for the recruitment of staff are thorough and provide the necessary safeguards to offer protection to the residents living in the home. The Commission has received no complaints since the previous inspection, and none had been recorded in the home. The Registered Manager said she would promptly deal with any sign of dissatisfaction. Staff members have gained or are participating in training leading to a National Vocational Qualification level 2 or 3 and are therefore aware of what constitutes bad practice. A copy of the West Sussex County Council Multi Disciplinary Adult protection Policy available in the home Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained, safe and clean. EVIDENCE: The inspector toured the building. All areas of the home used by residents are clean, nicely decorated and furnished in a manner that appears “homely”. All residents have comfortable clean rooms, which have been personalised with many of their own possessions. The inspector observed the cleaners doing their rounds and every room was left tidy and clean. Risk assessments have been undertaken by an external consultant to ensure the safety of residents and to enable them to enjoy a fulfilled life. The deputy manager confirmed, and records supported that all staff receive regular fire training to ensure that they know what action to take in the event of a fire. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 17 Hoists and specialised equipment is available for one resident, the other residents are all currently mobile. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is 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: Adequate staffing is provided to meet the needs of the residents. Staff members are trained and competent to do their jobs. 52 of the care staff are now trained to National Vocational Qualification level 2 or 3 and have therefore exceeded the National Minimum standard. Staff interviewed said they were given ample opportunities to attend training in all relevant topics. The home continues to review their practices to ensure that the residents received the best care they could offer. There are robust recruitment procedures in place. All care staff has a Criminal Records Bureau enhanced checks to ensure they are suitable to work with vulnerable people. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager has obtained National Vocational Training level 4 and the Registered Manager Award since the new providers took over the home. It is apparent that the needs of the residents are paramount and that systems are in place 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 and Environmental Health Officer standards are up to date and the home is considered a safe environment. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 20 EVIDENCE: 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 is regularly serviced. The Registered Manager has worked at the home as a deputy for several years and is therefore experienced in caring for this client group. The manager confirmed that she had a good rapport with each of the resident’s relatives. Questionnaires are sent out as part of the Quality Assurance policy. It was agreed that this could be developed further to provide a quality audit of the home, for future inspections. No resident is able to look after his or her own money; this is usually undertaken by a family member or solicitor acting on their behalf. Records showed that staff meetings, handovers, and newsletters are arranged to ensure staff have a clear understanding of their role and the expectations of the registering authority. A programme of training, which includes health and safety, moving and handling, food hygiene, dementia training and safeguarding adults, is ongoing for all staff. An external consultant provides this training and a record of the programme arranged for 2007 was available to the inspector. Staff members were cheerful, pleasant and helpful during the inspection. Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 21 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 X 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 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X 3 2 X 3 Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Avon House DS0000049857.V322716.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 DS0000049857.V322716.R01.S.doc Version 5.2 Page 24 - 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. 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