Inspection on 09/07/07 for Avon House

This inspection was carried out on 9th July 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 20/04/10

Avon House 15/07/08

Avon House 23/05/06

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 Tony Lawrence Key Unannounced Inspection 9th July 2007 09:30 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.V341455.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 DS0000026012.V341455.R01.S.doc Version 5.2 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.V341455.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2006 Brief Description of the Service: Avon House is a purpose built home, managed by Craegmoor Healthcare, that provides accommodation and nursing care for up to 35 older people. The home is close to the shops and transport links of Kensington High Street. Residents’ 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, the main kitchen, a conservatory, the manager’s and administration offices. There are individual small lounges and dining areas on the first and second floors. The home has twenty-six single and four 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.V341455.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Monday 9th July 2007 from 09:30 – 16:45. The Inspector spent time talking with people living in the home, the manager and nursing and care staff on duty. The care of two people living in the home was reviewed by talking with them and staff responsible for their care and checking care records. The weekly fee for the home ranges from £850 - £950. 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. The summary of this inspection report can be made available in other formats on request. Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 6 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.V341455.R01.S.doc Version 5.2 Page 7 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 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose sets out the objectives and philosophy of the service. Admissions are not made to the home until a full assessment has been completed. EVIDENCE: The Inspector saw the home’s Statement of Purpose displayed on the notice board in the entrance hall. The Statement is specific to Avon House and accurately describes the services provided. ‘All service users have a pre-admission assessment and evaluation completed prior to admission with input from interested professionals. This forms the basis of the initial care plan’. (Extract from the provider’s Annual Quality Assurance Assessment). The Manager told the Inspector that most referrals come from the Primary Care Trust in Kensington and Chelsea. A care needs assessment is provided as part of the referral process and the Manager then visits the person referred to complete the home’s own assessment. During this visit the Inspector saw two PCT assessments and these accurately detailed the person’s care needs. The Inspector also saw the home’s own assessments for two residents. The home has completed some good work to make individual’s Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 8 care plans more ‘person-centred’ and there is clear evidence that residents are involved in their care needs assessment and care planning (see Standard 7). The home does not provide intermediate care and key Standard 6 does not apply. Avon House DS0000026012.V341455.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home involves people in the planning of care that affects their lifestyle and quality of life. Care plans are person centred and agreed with the individual resident. EVIDENCE: ‘All service users have a person centred care plan in line with the company’s policies and procedures which is initially based on the pre assessment but is then expanded upon with the involvement of the service user and their representative. All staff have attended medication training and complete updates as required’. (Extract from the provider’s Annual Quality Assurance Assessment). The manager confirmed that the home is introducing a system of person centred care planning that focuses on involving people in planning the care they receive. The Inspector felt that some very good work had been completed to introduce the system for the two people whose care was reviewed during this visit. Both of the care plan files reviewed included a care plan that included clear evidence that the resident or their representative had been involved in writing the plan. Each person’s health and personal care needs were well assessed and recorded and there was evidence that residents Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 10 are consulted about their preferences and are supported to make choices about their care wherever possible. Following a sudden death in the home in 2006 a CSCI Pharmacy Inspector carried out an inspection of the home’s medication management policy and procedures in May 2006. 10 Requirements and 2 Recommendations were made as a result of the Pharmacy Inspector’s visit. During this visit, the Inspector checked the home’s progress in implementing the Requirements made. The Inspector felt that the home had made good progress and all 10 Requirements had been met. The home uses the Boots Monitored Dosage System and all prescribed medication is delivered in individual blister packs each month. The Inspector felt that the system is working well and staff have a good understanding of the home’s procedures for the management of prescribed medication. The Inspector checked the Medication Administration Record (MAR) sheets for residents on each of the home’s three floors. A secure medication cabinet is provided on the ground floor and secure individual trolleys are provided on the first and second floors. The MAR sheets were well completed on each floor and the Inspector saw no errors or omissions on the records. The Manager confirmed that residents and their relatives / representatives are consulted about end of life care and the Inspector saw that these are sensitively recorded as part of the individual’s care plan. The Manager also told the Inspector that 4 staff are taking part in end of life training provided by the Primary Care Trust. Avon House DS0000026012.V341455.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are involved in meaningful daytime activities of their own choice and according to their individual interests and capability. The menu is varied with a number of choices including a healthy option. EVIDENCE: ‘Activities are tailored to the needs and wishes of our service users as detailed in their person centred care plan. Religious ministers visit regularly’. ‘All service users and their families complete a food preference form, the chef visits them and where necessary a nutritional care plan is commenced which is current and reviewed regularly or when required’. (Extracts from the provider’s Annual Quality Assurance Assessment). During this visit the Inspector spoke with the home’s full-time Activities Organiser who works from 09:30 – 16:30 Monday – Friday. She explained that she is able to work with individual residents each morning and run small group sessions each afternoon. Group activities include ball games; cookery; board games; exercise; ball games; quizzes and film shows. On the day of this inspection, a gentle exercise group was taking place in the main lounge. Activities are recorded in the Activity Diary and individual resident’s daily care notes. Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 12 A Church of England minister also visited the home on the day of this inspection and spent time with individual residents. The care plans reviewed by the Inspector during this visit included details of residents’ relatives and other significant people and the arrangements for contacting them. Some people’s daily care notes showed that staff support them to have regular contact with relatives and other people through visits, phone calls, letters etc. The daily menu is displayed in the main dining room. It includes a choice of main courses, including a vegetarian option. Two people living in the home told the Inspector that they usually enjoyed the food and enough was provided at mealtimes and between meals. The main dining room was a bright and pleasant room for people to eat their meals. Staff said that some people prefer to eat in their rooms or lounge areas and they are supported to do so. Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 13 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, 17 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows residents to express their views and concerns in a safe environment. The home understands the procedures for Safeguarding Adults and will always attend meetings or provide information to external agencies when requested. EVIDENCE: ‘The Company’s complaints procedure is followed through to its conclusion with all parties involved. Complaints procedure is included in the information packs given to all service users and their representatives’. (Extracts from the provider’s Annual Quality Assurance Assessment). During this visit the Inspector saw the home’s complaints procedure displayed on the notice board in the main entrance. The Manager confirmed that there have been no formal complaints since the last key inspection of the home. Staff told the Inspector that they deal with minor complaints and disagreements at the time they occur and these would be recorded in people’s daily care notes. The Manager also confirmed that a Residents’ Meeting is held every 3 months and relatives are invited to attend. All people living in the home are registered to vote in local and national elections. The Manager and staff who spoke with the Inspector had a good understanding of the local authority’s Safeguarding Adults procedures. Staff were clear about what action they would take if they suspected a residents was being abused. Since the last inspection, one member of staff has been dismissed following a Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 14 safeguarding adults enquiry that concerned a medication error. The incident was referred appropriately to the local authority Safeguarding Adults team and following dismissal the nurse was referred to the Nursing and Midwifery Council and the Protection of Vulnerable Adults Register. Avon House DS0000026012.V341455.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 25 and 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 a very pleasant, safe place to live. The bedrooms and communal rooms meet the NMS or are larger and all bedrooms have en-suite facilities. EVIDENCE: Avon House is a purpose built home, close to the shops and transport links of Kensington High Street. Residents’ 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, the main kitchen, a conservatory, the manager’s and administration offices. There are individual small lounges and dining areas on the first and second floors. The home has twenty-six single and four 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. During this visit the Inspector saw all communal parts of the home, some vacant bedrooms and other bedrooms with residents’ permission. Individual’s bedrooms are well furnished and decorated and staff have supported people Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 16 to make their rooms their own with personal possessions, photographs etc. Each bedroom has an ensuite shower, WC and wash hand basin. Communal areas are comfortable and provide a choice of spaces for residents to spend time on their own or with others. In addition to the ensuite facilities in each room, the home has a sufficient number of accessible bathrooms and toilets for residents’ use, located close to bedrooms and communal areas. The home has a small, attractive garden with raised flower beds. The manager confirmed that the home has applied for a grant to make the garden more accessible to people who use a wheelchair. During this visit all parts of the home were clean, pleasant and hygienic. Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 17 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service puts a high level of importance on training and staff report that they are supported through training to meet the individual needs of people using the service. EVIDENCE: ‘We do not employ agency staff and we meet the NVQ ratio. All care staff undergo induction and foundation training and records are kept of all training undertaken’. (Extract from the provider’s Annual Quality Assurance Assessment). When the Inspector arrived for this unannounced visit, a staff nurse and two carers were available on the first and second floors. On the ground floor a staff nurse and one carer were on duty. In addition, the home’s Manager, Administrator, catering and domestic staff were on duty. The number and deployment of nursing and care staff on duty agreed with the planned rota. The Inspector felt that the staffing levels provided were adequate to meet the needs of people living in the home. The Manager confirmed that no agency staff are used. Permanent staff can work a limited number of extra shifts to cover vacancies and there is a bank of staff known to the home who can also be used. The Inspector checked staff records and all staff working in the home have a current Enhanced Disclosure from the Criminal Records Bureau. Where convictions, cautions etc are shown on a Disclosure the Manager must make Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 18 sure that a written record is kept of actions taken to decide whether the person is safe to work with vulnerable adults and should be employed in the home. Staff who spoke with the Inspector during this visit were very positive about the training opportunities provided by the company. Information provided by the Manager was evidence that 81 of the permanent care staff working in the home have completed their National Vocational Qualification (NVQ) Level 2 training. Avon House DS0000026012.V341455.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, 32, 33, 35, 37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager has the required qualifications and experience and is competent to run the home. She works to continuously improve services and provide an increased quality of life for residents. EVIDENCE: The home’s registered Manager is a qualified nurse and she has also completed her NVQ Level 4 registered manager’s qualification training. In discussion with the Inspector she demonstrated good people skills and a clear understanding of the importance of person centred care and effective outcomes for people who use the service. The organisation is moving towards the introduction of person centred care plans for people living in the home. The Inspector felt that staff, led by the Manager, have completed some good work to introduce the new systems. During this visit the Inspector checked selected care records kept in the home, including care plans, medication and residents’ finance records. All records Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 20 were well maintained and up to date. Expenditure of residents’ finances is well recorded and the Manager confirmed that all savings are held in an interest bearing account. No health and safety issues were noted during this visit. Avon House DS0000026012.V341455.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 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 X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 X 3 3 Avon House DS0000026012.V341455.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. 1. Standard OP29 Regulation 19 Requirement Where issues arise with CRB checks, the Manager must make sure that a written record is kept of actions taken to decide whether the person is safe to work with vulnerable adults and should be employed in the home. Timescale for action 30/09/07 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 OP9 OP9 Good Practice Recommendations The GP/Pharmacist should be requested to prescribe/dispense with the full instructions for use. That storage of Controlled drugs is reviewed Avon House DS0000026012.V341455.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 DS0000026012.V341455.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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