Inspection on 04/05/06 for Blenheim Avenue Care Home

This inspection was carried out on 4th 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

Blenheim Avenue Care Home 14/08/07

Blenheim Avenue Care Home 17/11/05

Blenheim Avenue Care Home 26/04/05

Blenheim Avenue Care Home 08/12/04

Blenheim Avenue Care Home 05/07/04

Blenheim Avenue Care Home 29/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Blenheim Avenue Care Home 9 Blenheim Avenue Mapperly Nottingham NG3 6GD Lead Inspector Andrew Sales Unannounced Inspection 4th May 2006 10:00 Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 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 Blenheim Avenue Care Home DS0000008633.V293237.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 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. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Blenheim Avenue Care Home Address 9 Blenheim Avenue Mapperly Nottingham NG3 6GD 0115 9555221 0115 9555221 mlesleyr@ncha.org.uk www.ncha.org.uk NCHA 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) Lesley Rawlinson Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents shall be within category LD Date of last inspection 17th November 2005 Brief Description of the Service: Blenheim Avenue Care Home is a detached bungalow located within the residential area of Carlton. There are some local shops and amenities nearby. The home is registered to provide care and support for four adults with a learning disability who all have additional physical disabilities. There are new adaptations and equipment in the home enabling full and flexible assistance to residents with physical disabilities and who use wheelchairs. The accommodation comprises of four single bedrooms, a lounge/diner, and a bathroom/shower with toilet, separate toilet suitable for wheelchair users, kitchen and a laundry room. The office is in the loft conversion, which also acts as a sleep in room for staff. There is an attractive garden to the back of the bungalow, which is accessible to wheelchair users. This is a partnership home, which is managed by the Nottingham Community Housing Association. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was conducted by A.J. Sales on 4 May 2006. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for residents and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The preferred method of inspection used is usually ‘case tracking’ which involves selecting residents and tracking the care they receive through review of their records, discussion with residents where possible, discussions with the care staff and observation of care practices. Due to communication issues this was not able to be fully utilised. Of the four residents, two were out when the inspector visited and the remaining two went out early on, during the inspection. The inspector was introduced to the two resident briefly and was able to make some observations of interactions with staff prior to them going out. What the service does well: The manager and support staff have a very good understanding of the needs of the residents living at the home and care plans record the needs of residents clear detail. Risk assessments are also very informative for staff, which is important for promoting the safety and independence of residents. There are good methods of communication between staff, which means that staff are up to date with when residents needs have changed and when tasks need doing. Staff who spoke with the inspector are clearly committed to promoting the quality of life of residents. The manager ensures that specialist professionals are called upon for their input on how to best meet the needs of people that live at Blenheim Avenue. Staff support residents to maintain contact with family and friends. The structure and culture within the home is that of putting resident’s needs and independence first. The staff group ensure that residents are actively engaged in getting out and getting involved in day to day events and activities. There is an appropriate complaints procedure in place and staff are encouraged to act on behalf of residents to enable residents to access this procedure. Staff demonstrated an understanding of their responsibilities in protecting residents from abuse. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 6 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. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 7 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 Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. 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.” Residents are fully assessed before moving in to the home. Care planning is thorough and enables clear action plans to be developed for residents to fulfil their own potential. EVIDENCE: The records of two resident’s files were checked as part of this inspection. Both of these contained an extended social work assessment, which had been obtained prior to their admission. All files contained assessments conducted by the manager, or deputy manager. All of the assessments were comprehensive and contained sufficient information to enable staff to ensure that they could meet the residents assessed needs. There were detailed action plans for support staff. The plans are computerised within a large secure database, paper copies were observed. Staff spoken with explained how they used information on these plans and how they were regularly updated to reflect changes in residents needs, preferences and behaviour. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” All residents have assessment plans detailing their support requirements, preferences and areas of risk. Residents are supported to make their own decisions where possible and balance their decisions with appropriate risks. EVIDENCE: Staff spoken with demonstrated a good understanding of the individual needs of the resident group and it was evident that the resident plans are utilised effectively in order to meet the needs of residents and that changing needs are identified and recorded. Records are held both on the computer system and on a paper file, which means that the care plans are accessible at all times. Care plans are reviewed every 90 days and the computer system actually prompts this. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 10 Visual Communication needs were identified clearly in resident plans seen. tools such as pictures and photographs are used to enable residents to make choices and decisions about their lives. Staff spoken with gave examples of residents choosing activities, holidays and meals. Care plans and staff provided clear evidence of how residents interests are put first. Support is flexible enough to enable residents to make spontaneous decisions about what they did and where they wanted to go. On the day of the inspection the remaining two residents decided to go out for a pub lunch. Care plans detail individual needs and balance the risk involved for that resident in day to day living activities. Residents are supported to go out regularly to engage in variety of different activities. Residents have little or no comprehension of their resident plans and assessed needs. The manager reports that the consent and involvement of relatives is sought although not all the residents have family that want to be involved. There is evidence that the residents or other appropriate representatives / advocates have been consulted about how residents are supported with signatures also obtained. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17. “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” Current resources are managed well in order to provide some meaningful and therapeutic activities for residents and meals offered are healthy and varied. Daily routines within the home ensure that the rights of residents are respected. EVIDENCE: On the day of the inspection two residents were already out with staff. The inspector was introduced to the remaining two residents, who later also went out with staff for a pub lunch. Care plans and support staff described the list and range of activities that residents have access to it is clear that their individual recreational and social needs are well promoted in the home and the wider community. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 12 The home is expecting delivery of its own vehicle within one week. Staff described what an enormous improvement this will make to the residents every day life, in terms of attending social events and medical appointments. Also for longer term activities like holidays, which are already frequent events. It was evident from discussion with staff and also by looking at the relevant care plans, that residents’ contact with their family and friends is promoted. The inspector was shown the kitchen where meals were made with some involvement of residents. Residents are able to make choices on the day over what to eat, which creates a far less institutional feel. The garden area was also observed. Residents were observed relaxing in extremely pleasant surroundings. The manager and staff demonstrated items of craftwork completed by residents, which is now used to decorate garden walls. Separate areas have been developed to provide sensory stimulation, privacy and relation and other areas have been dedicated to fruit trees and herb gardens, which the home uses for cooking. Staff described how one resident came to live at the home, was severely withdrawn and underweight. They described how they had worked with his family to provide culturally appropriate meals that he enjoyed. They went on to describe how he had developed his own methods of communication with them and what great steps he had made in terms of confidence and self esteem. They said the family had also had acknowledged this with pleasure. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents’ health care needs are well met and careful consideration has been given to ensuring that the essential and appropriate equipment has been installed. The system for medication administration promotes the safety of residents. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 14 EVIDENCE: Detailed plans for health, personal and social care needs were seen on resident plans and staff spoken with all demonstrated an awareness of individual residents needs and preferences. There is evidence that the staff team is well established and trained and the collective experience of all the team ensures the residents are treated in a manner that is appropriate for them. There is evidence on care plans that physiotherapists and occupational therapists advice has been obtained on how to best meet the needs of residents and where possible this has informed changes to care plans and the way support to residents is given. Health care plans were observed and found to be detailed with health care appointments and outcomes seen recorded on daily notes. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents are safeguarded by the homes complaints and adult protection procedures. EVIDENCE: There have been no complaints made by either residents or their relatives / representatives over the last year. There are policies and procedures available at the home concerning adult protection issues including responding to suspicion of abuse/neglect, dealing with physical and verbal aggression and management of resident’ finances. Financial records were observed and found to be accurate and well maintained, providing an audit trail for all transactions conducted on resident’s behalf. Two staff interviewed said they had received training in adult protection issues and were fully aware of their responsibilities to safeguard older people. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,29,30. “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” The home was clean and tidy at the time of this inspection. The home is generally well maintained, domestic and personalised by individuals living there. Residents live in comfortable surroundings. EVIDENCE: The home was observed to be extremely domestic and comfortable. The layout lends the home a non-institutional atmosphere and is well maintained. Adaptations for hoist tracking and to the bathroom were discussed as part of a major refit at the last inspection. Prior to that, multi-disciplinary meetings have been taking place to ensure that what is provided is suitable for all residents and an occupational therapist has been responsible for identifying the appropriate equipment. Minutes of meetings show that an advocacy service have been involved on behalf of residents. Whilst these major adaptations were being completed, residents and staff were relocated to another residence. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 17 The manager showed the inspector the new facilities, recently completed. Overhead tracking for electric hoists now enable residents to transfer to more areas of the home in greater comfort and safety. The bathroom is now fully equipped with a fixed shower and a mobile bath and shower combined. This equipment is highly effective and enables staff and residents to find the most effective and enjoyable ways for residents to bathe. The manger demonstrated how this device can support individuals with very complex needs safely and with minimum effort for staff. Revised risk assessments were observed as part of the changes. All equipment is stored safely not causing obstructions or hazards. The home was clean throughout. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Staff are recruited and employed in suitable numbers. There are sufficient staff records at the home. Staff are trained in mandatory subjects required by this standard and for care specific support. Residents are safeguarded by the homes recruitment practices. EVIDENCE: Both staff members spoken with, demonstrated a sound understanding of their roles and responsibilities and a great insight into the methods of promoting independence whilst supporting residents. Both of the staff spoken with during the inspection feel that training is very good at Blenheim Avenue. They said all of the necessary mandatory training is provided and there is the opportunity to go on other courses if it enables staff to carry out their roles more effectively and efficiently and will ultimately benefit the residents. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 19 The manager reports that all staff records including Criminal Records Bureau (CRB) disclosures and references are held at the home. These were observed on staff files examined. There was evidence on staff files of supervision sessions taking place. Staff said they felt well supported by the manager in all aspects of their work and with other issues as well. The manager introduced the inspector to the deputy manager. Some of the management responsibilities are now shared or delegated. From the comments and observations made, the staff team are held in high esteem amongst the residents for their commitment, attitude and support. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42. “Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.” The manager is highly thought of and has created a home where resident’s well being and dignity is a priority. The resident’s interests are key to any decisions made at the home. Resident’s wherever possible are consulted over issues in the care home and their safety and well being are put first. Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 21 EVIDENCE: Staff said they felt the home was well run and the management team were always on hand for support and advice. Staff spoken with, confirmed that they felt supported by the manager and that they are approachable to discuss any issues. The owner/manager of the home is a registered nurse. She has some years of experience and knowledge to manage a care home. Staff spoken with spoke highly of the manager and deputy manager and stated they felt well supported within their job role. The manager explained how there are internal audits held approximately three to four times per year and other initiatives for quality assurance are used by Nottingham Community Housing Association such as ‘Better Lives’, ‘ Promoting Person-Centred Services’ and the Nottinghamshire document ‘The Quality Tree’. Advocates are accessed to represent the views of residents for identifying ways to develop the service. Risk assessments were observed on individual files and are in place for the building and individual residents. Records were observed for the appropriate testing and servicing of the following systems and appliances. • • • • • • • Electrical appliances Lifts Hoists Gas Fire alarms Fire equipment Water supply Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 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 4 25 X 26 X 27 X 28 X 29 4 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 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 X 3 X X 3 x Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 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. 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 Blenheim Avenue Care Home DS0000008633.V293237.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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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