Inspection on 25/09/07 for Avondale Lodge

This inspection was carried out on 25th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Avondale Lodge 16/09/08

Avondale Lodge 02/11/06

Avondale Lodge 17/10/05

Avondale Lodge 03/05/05

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

CARE HOME ADULTS 18-65 Avondale Lodge 419 Central Drive Blackpool Lancashire FY1 6LE Lead Inspector Mr Wesley Cornwell Unannounced Inspection 25th September 2007 09:30 Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 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 Avondale Lodge DS0000064034.V346782.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 Adults 18-65. 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. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Avondale Lodge Address 419 Central Drive Blackpool Lancashire FY1 6LE 01253 628793 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) Pro-Care Disperse Housing Ltd Manager post vacant Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 6 service users with a Mental Disorder, excluding learning disability or Dementia (MD). 2nd November 2006 Date of last inspection Brief Description of the Service: Avondale Lodge is a care home registered for 6 young adults with mental health problems aged 18 to 65 years. The home is situated in the central area of Blackpool close to the town centre. The accommodation provides 6 single rooms, which are located on the first and second floor. Toilet and bathing facilities are also located on the first floor. There is no lift available at this home. The home has a Statement of Purpose and Service User Guide providing information about the care provided, the qualifications and experience of the owners and staff and the services residents can expect if they choose to live at the home. A copy of the Service User Guide and most recent inspection report is issued to all prospective residents and their relatives/representatives to help them make an informed choice whether to move into the home. The range of fees at the home are £270.96 to £274.00 covering all aspects of care, food and accommodation. The manager provided this information on the 25th September 2007. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the homes Key Inspection. The site visit commenced at 9:30am and took place over 3 hours. Prior to this site visit the home was sent an Annual Quality Assurance Assessment form (AQAA) to complete providing information about the services they provide and the dates when maintenance equipment had been serviced. The AQAA wasn’t returned to the Commission as required by regulation and as a result the homeowner missed an opportunity to provide the Commission with written information about the quality of the service they provide. Inspection activity undertaken during the site visit was focussed on the outcomes for people living at the home. The Inspector spoke to two residents, one staff member, two Social Care Professionals, the manager and the owner of the home. Staff, care, maintenance and financial records were also examined. A full tour of the premises was undertaken with the staff member on duty. What the service does well: The homes assessment procedures were very thorough and care plans had been structured to ensure staff recognise the diverse needs of residents. Observation of practice and discussion with staff members confirmed the staff team had been provided with appropriate training to assist them in understanding and meeting the needs of residents with specific mental healthcare problems. Residents seen during the visit said they liked living at the home and could come and go as they please. One resident said, “ I have lived here for a number of years and I am quite happy”. Staff at the home are well trained and are competent to do their jobs. Observation of care practices throughout the day confirmed residents are treated with respect and dignity. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: There has been no real progress in upgrading the environmental standards in the home since the last inspection. Carpets and furnishings are old and in need of replacing. Resident bedrooms are all in need of redecoration and refurbishment. A Social Care Professional contacted felt the accommodation being provided is very poor. The Social Care Professional said, “The accommodation being provided badly needs some investment. The standards are pretty basic. The resident I support has a very small room and there is little provision for his personal belongings. His room always looks cluttered”. The owner of the home should consider reviewing staffing levels so that additional staff members can be available to support residents to pursue education and employment opportunities and undertake recreational activities of their choice. Residents spoken to during the visit said they would participate in activities if these were organised. The home is presently without a manager who registered with the Commission. The new manager said this will be addressed and he would make every effort to run the home for the benefit of the residents and improve the services presently being offered. The owner of the home should introduce effective quality assurance systems to enable residents, their relatives and other interested parties such as Health and Social Care Professionals to formally voice their views about the services being provided through anonymous satisfaction questionnaires and regular group meetings. Feedback received would enable the homeowner to review the service being provided and make improvements where shortfalls have been identified. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 7 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. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment procedures were clear to ensure the care needs of residents are met. EVIDENCE: Residents are admitted into this home through Care Management arrangements and have a full assessment of their needs undertaken by health and social services. The assessment procedure is very thorough and includes information about residents religious/cultural and relationship needs. The staff member on duty confirmed they had access to this information and could describe in detail the care needs of the residents. The staff member said they were responsible for the preparation of meals and had been informed about residents who had special dietary needs and these were being accommodated. The resident spoken to confirmed he was happy his needs were being met by the home. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of residents health and personal care is taken seriously and closely monitored to ensure they are met. EVIDENCE: Individual records are kept for residents with a plan of care, which had been generated through Care Management Assessment arrangements, setting out the action that needed to be taken by support staff to ensure all aspects of health, personal and social care needs of the residents were met. The care plan of one resident had recently been reviewed by a Social Care Professional and had been updated to reflect the changing needs of the resident. The staff member on duty confirmed he had been involved in the review process with the resident and they were both in agreement with the level of support to be provided. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 11 The daily records of two residents described the level of support and assistance being provided by the staff team with their daily living routines. One resident said they liked living at the home and were happy with the level of support being provided. Observation of care plan records confirmed the home has clear risk assessment management strategies in place for dealing with potential risks to residents. The home has a good record of dealing promptly with any unexplained absences of residents according to written procedure and ensuring all appropriate organisations are kept fully updated. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Education and employment opportunities are not being promoted to ensure the residents have opportunities for personal development. EVIDENCE: Observation of care plans and discussion with residents confirmed opportunities for the personal development of residents are not being encouraged. There was no evidence that educational or employment opportunities had been discussed with residents and where appropriate explored. Activities are not being organised and there appeared to be no structure to daily living within the home. One Resident spoken to said he liked living at the home but sometimes gets bored. The resident said, “I haven’t been anywhere recently and haven’t been up to much. I might go to the shops later”. Social care professionals supporting residents in the home said there was no motivation for residents to undertake activities. One Social Care Professional said, “I know it is difficult to motivate the resident I support but I Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 13 would like to see additional staff employed to support residents with recreational activities where appropriate and to healthcare appointments”. The owner and manager of the home need to give serious consideration to devising a personal activity plan for each resident identifying educational, employment and social opportunities. The plan should be agreed with each resident and include information about the day and time the activities are to be undertaken, venue, meal provision, transport arrangements and support to be provided. This will enable residents to enjoy a full and stimulating lifestyle. One resident said he was happy with arrangements in place for receiving his visitors and was encouraged to maintain contact with his family and friends. Social Care Professionals said they were able to see residents in the privacy of their own room whenever they visited and always found the staff friendly and welcoming. The residents spoken to confirmed they were happy with the routines within the home and could come and go as they pleased and go to bed and get up when they wanted. The residents said they were provided with the choice of spending time on their own or in the lounge areas and the staff respected their privacy. Residents spoken to confirmed they are consulted about the homes menu. Food is purchased for the week and then residents can choose daily what they would like to eat. Residents were observed having open access to the kitchen to prepare snacks and drinks. All residents spoken to said they liked the food being provided and enjoyed assisting staff with the preparation of meals. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Promotion of health is taken seriously and personal support is provided in a flexible and sensitive manner. EVIDENCE: Discussion with residents confirmed they were happy with the level of support they received and said they were encouraged to be independent and attend to their own needs. The staff member on duty confirmed residents have responsibility for their own personal care needs and choose when to go to bed and get up, have a bath and change their clothing. Observation of care plans confirmed residents have access to healthcare services both within and outside the home and their healthcare needs are monitored and appropriate action taken when required. Medication practices observed were safe and good records had been maintained. The staff members responsible for the administration of medicines had received training to ensure they had basic knowledge of how medicines are used and how to recognise and deal with problems in use. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. EVIDENCE: The home has a detailed complaints procedure, which is made available to all residents on admission to the home. Residents spoken to were aware of how to make a complaint and felt these would be listened to and acted upon. At the time of this visit no complaints had been received by the home or referred to the Commission for Social Care Inspection. The home has a procedure in place for dealing with allegations of abuse. The staff member on duty had a good understanding of the procedures to be followed in the event of any allegations or suspicion of abuse or neglect. The staff member said abusive practices and how to recognise these had been covered during training provided by the home. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of a planned maintenance and renewal programme for the redecoration and refurbishment of the home does not ensure residents live in a comfortable, homely environment. EVIDENCE: There has been no real progress in upgrading the environmental standards in the home since the last inspection. Carpets and furnishings are old and in need of replacing. Resident bedrooms are all in need of redecoration and refurbishment. The environment throughout the building is dark and gloomy and would benefit from an on going refurbishment programme to upgrade the fabric and decoration of the premises and improve the comfort of residents. A tour of the building confirmed resident bedrooms had been personalised with their own belongings. However, most of the bedrooms are small and have inadequate storage space and as a result rooms are cluttered. Each bedroom Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 17 had been fitted with a lock and the resident issued with their own key ensuring their privacy was being promoted. Hot water temperatures throughout the home were checked and found to deliver water at a safe temperature in line with health and safety guidelines. The building generally looks neglected and would benefit from a complete refurbishment to improve the comfort and living standards of the residents. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes recruitment procedures are robust and these provide safeguards for the protection of residents. EVIDENCE: Staffing levels were sufficient for the number of residents living at the home. Residents spoken to confirmed they attended to their own needs and said staff members were always available if needed. However, the owner was asked to consider reviewing staffing levels so that additional resources could be available to assist residents pursuing education and employment opportunities and individual activities of their choice. The manager said this was something he had discussed with the homeowner and they are looking into employing additional staff members to support residents with their personal development and help to improve their quality of life. Records show over 50 of staff members have achieved National Vocational Qualifications (NVQ) ensuring residents are in the safe hands of a qualified and competent staff team. Discussion with staff and examination of records confirmed training had been provided to ensure they had a clear understanding of the specific care needs of residents accommodated at the home. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 19 The home has a small staff team and there has been no new employees recruited since the last inspection. Examination of records during previous inspections showed good systems were in place for obtaining relevant documentation for staff members employed by the home ensuring the protection of residents. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of quality monitoring systems does not provide residents with the opportunity to express their views about the service being provided. EVIDENCE: The acting manager of the home holds a relevant social work qualification and has significant management experience in a residential care setting. The manager said he is in the process of completing an application form to apply to be registered with the Commission for Social Care Inspection and has also applied to enrol for a relevant management qualification to ensure the home is being run by a qualified and competent person. An annual quality assessment of standards is undertaken within the home by a professionally recognised organisation who completes an audit of the care Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 21 being provided and seeks the views of residents and their relatives. Residents spoken to were very positive in their comments about the staff team who were described as being friendly, approachable and very helpful. However, the home does not have in place its own quality assurance systems to seek the views of residents, their relatives and other interested parties such as health and social care professionals about the quality of service being provided. The owner of the home should ensure residents are provided with the opportunity to formally voice their views about the services being provided through anonymous satisfaction questionnaires and regular group meetings. A Social Care Professional said they would welcome the opportunity to formally provide feedback about the services being provided and make suggestions where improvements could be made. The Social Care Professional said, “The accommodation being provided badly needs some investment. The standards are pretty basic. I would also like to see additional staff employed to support residents with recreational activities where appropriate and to healthcare appointments”. Inspection of maintenance records confirmed facilities and equipment was being maintained as required by health and safety legislation to provide a safe environment for residents and staff. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 X 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 3 X Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? 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 YA37 Regulation 8 Requirement Timescale for action 25/12/07 2 YA39 24(1) (2) The registered provider must ensure the person in day to day control of the home is registered with the Commission and that an application for registration is submitted to the Commission for Social Care Inspection. 16/10/07 The registered provider must ensure the homes Annual Quality Assurance Assessment form is completed and returned to the Commission providing up to date information about the service being provided. This will assist the Commission to develop a picture of the service being provided and target inspection activity. 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 YA23 Good Practice Recommendations The registered person should produce a programme for the DS0000064034.V346782.R01.S.doc Version 5.2 Page 24 Avondale Lodge 2. 3. 4 YA12 YA14 YA39 routine maintenance of the fabric and decoration of the home. People who use the service should be supported to pursue education and employment opportunities. People who use the service should be encouraged to engage in recreational activities of their choice. The registered person should ensure the home has effective quality assurance systems in place enabling residents, their relatives and other interested parties to express their views about the service being provided. Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Avondale Lodge DS0000064034.V346782.R01.S.doc Version 5.2 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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