Inspection on 14/07/05 for Cumberland Avenue Residential Home

This inspection was carried out on 14th July 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Cumberland Avenue Residential... 06/10/08

Cumberland Avenue Residential... 06/12/06

Cumberland Avenue Residential... 16/02/06

Cumberland Avenue Residential... 31/01/05

Cumberland Avenue Residential... 11/08/04

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

CARE HOME ADULTS 18-65 Cumberland Avenue Residential Home 31 Cumberland Avenue Bury St Edmunds Suffolk IP32 6TG Lead Inspector Jane Offord Unannounced 14th July 2005 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 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 Stationary 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. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Cumberland Avenue Residential Home Address 31 Cumberland Avenue, Bury St Edmunds, Suffolk, IP32 6TG Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01284 725972 None None Royal Mencap Society Mrs C Smith Care Home 6 Category(ies) of Learning Disabilities (6) registration, with number of places Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31/1/05 Brief Description of the Service: 31, Cumberland Avenue is a six-bedded care home for adults with learning disabilities. It is located in a residential part of Bury St. Edmunds and is situated in a quiet road with access to green areas nearby. The home is close to local shopping facilities and a short car or bus journey from the centre of Bury St. Edmunds and all the resources offered there. The home consists of a large purpose built house, which is leased from Suffolk Housing Association by Mencap who provide the staffing and administration. The home was first registered in 1994 and provides spacious and modern accommodation for the residents. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a weekday, late afternoon and early evening. The inspector was given access to residents’ personal files, finances, Medication Administration Records (MAR sheets), staff training certificates, some policies and risk assessments. The registered manager was off duty at the time of inspection but spoke by telephone with the inspector to clarify some issues. The care staff on duty were welcoming and helpful. The residents spoken with were open and relaxed talking to the inspector. Most areas of the home were visited including four residents’ bedrooms. The overall impression was that this was the home of the residents and they were able to choose how they spent their time. The staff were there to support the choices of the residents. What the service does well: What has improved since the last inspection? Since the last inspection self-closing fire door mechanisms have been fitted to doors throughout the house as required. The manager told the inspector on the telephone that the smoke alarms had been checked the previous day by the fire officer for correct siting. The fire officer had said that all smoke alarms were appropriately sited for the building. The upstairs windows that are accessible to residents have been fitted with safety closing devices to prevent any accidents if windows are opened wide. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 6 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. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 standard(s) None of these standards was inspected this time. EVIDENCE: Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9, People who use this service can expect to be consulted about the running of the home and be supported to make decisions and take risks to maintain a lifestyle of their choice. EVIDENCE: There was evidence in the personal records that the residents all pursue a variety of daily activities during the week. These included time at The Bury Resource Centre, Wood ‘n Stuff and a selection of other training centres. The records showed that residents were offered new courses and choices at different times of the year. One resident was not benefiting from a particular activity and there was evidence that their wishes were taken into account and the activity changed for something they preferred. The residents talked of things they had done during the day and showed off drawings and woodwork pieces they had made. There were photos in the records of residents participating in activities with companions from the centres. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 10 Some of the risk assessments seen were for residents to travel safely, awareness of road safety, risk of sunburn during outdoor activities and the use of sharp knives to prepare food. Staff said that residents chose their own meals for a week, on one day, and the shopping was done to facilitate their choices. Menus seen indicated that on some days each resident had a different meal for tea. The bed linen and towels are sometimes chosen from a catalogue and residents choose their own duvet covers. Sometimes a resident would like a particular theme and staff assist them to find that. One resident had chosen a ‘Jungle Book’ bed linen set and another had an Ipswich Town one. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16, 17 People who use this service can expect to be offered opportunities in the local community for personal development with others of a similar age. They can expect that their right to contact with family and friends is respected and they will be offered a healthy diet of their choice. EVIDENCE: The residents all access day services offering different activities five days a week. Their personal files show there has been a selection of activities to choose from varying from computer courses, (one resident wanted to learn to write their name on a computer) to food preparation. There were certificates of achievement in the files for completed courses. One resident had some trophies in their room relating to sports achievements gained some time ago but still displayed with pride. Some residents have a befriender who will go with them to local facilities such as a pub, Abbey Gardens or shopping. One resident has a significant sight problem and has contact with a group offering support to visually impaired people and access to talking books. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 12 The personal files seen all documented family members of the residents, their names, relationship to the resident and contact details. There was documented evidence that residents see family members, some more frequently than others. On the day of inspection one resident went to the pub with family who had been staying locally but usually live in the north of England. One resident is engaged and the importance of the relationship is recognised in the records and provision is made to give the couple time to themselves. The staff talked about residents who have recently been bereaved and what has been done to help them manage during a difficult time. Residents have been given the opportunity to choose flowers for the funeral and attend if they wished. They have been supported to visit the grave of their relative as often as they needed to. Routines in the home include rotas for the residents to perform housekeeping tasks to their individual abilities. One resident was enthusiastically hoovering during the inspection. Residents are encouraged to help with meal preparation. One resident who particularly enjoys peeling vegetables has recently had a peeler purchased as there has been a problem with their finger joints making it difficult to manage a knife. Although all the doors in the home were open on the day of inspection due to excessively hot weather, staff were observed asking residents if they wanted doors closed before having a conversation with them. There were individual named pigeonholes in the sunroom for residents’ post. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 standard(s) 18, 19, 20, 21 People who use this service can expect to have their final wishes respected and receive care and support for their health needs in the way they would choose. EVIDENCE: Personal records show evidence of appointments with health professionals. There were appointments with GPs, Opticians, hospital out patients and Occupational Therapy assessments. On the day of inspection a physiotherapist was attending one resident and records showed that the resident had regular physiotherapy input. The physiotherapist had left written instructions for the staff about their handling of the resident. The resident was about to try a new mattress for comfort and the physiotherapist had left a photo of the resident on the mattress in the correct sleeping position for reference for the staff. Personal records showed evidence that female residents had received breast care checks in line with Government health recommendations. One resident had had to undergo surgery recently and the records detailed appointments both pre and post operatively. The resident talked about the hospital stay and said that they had not been afraid, as ‘everyone was good’. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 14 Individual preferences for personal care are explained in the care plans. One resident is wheelchair dependent and has details in their care plan, compiled with the physiotherapist, of the correct way to move them and offer assistance to encourage as much independence as possible. The inspector did not discuss with residents their final wishes but the personal records seen all had those details completed. Discussions with the staff about bereavements suffered by some residents and the way the situations have been managed indicate that the death of a resident would be handled with sensitivity. Medication Administration Sheets (MAR sheets) seen were completed correctly. Residents on ‘as required’ (PRN) medication had individual protocols drawn up to ensure that action was taken to prevent prolonged use without appropriate review. Residents who found it difficult to swallow large tablets were routinely prescribed soluble or liquid medication. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 standard(s) 22, 23 People who use this service can expect that their views will be taken into account and that staff understand how to protect them from abuse. EVIDENCE: There is a complaints policy in place however the service has not received a complaint since the last inspection. The staff spoken to cannot remember a complaint being made. All the residents spoken with were able to identify what they would do if there were something they were unhappy about. Some residents identified their key worker as the person to approach. Although staff training on Protection of Vulnerable Adults needs updating staff were able to discuss appropriate action they would take if they had concerns for a resident. They were aware of the possibility of a problem occurring outside the home as well as in the home and cited an incident which had taken place at one of the day centres and been dealt with under the correct procedure. One resident told the inspector that they had been unhappy at a previous home and badly treated. They said they liked this home; the staff were all ‘nice’. Financial records for three residents were seen. The records were thorough and clearly documented. Personal money was kept in individual locked cash tins and tallied with the record balances. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 standard(s) 24, 25, 26, 28, 29, 30 People who use this service can expect to have access to a safe, clean homely environment with personalised bedrooms and specialist equipment, if needed, to maximise their independence and choice of lifestyle. EVIDENCE: The communal areas of the home were spacious and consisted of a lounge, dining room, large kitchen and sunroom. All the rooms were clean, tidy and furnished with appropriate furniture and attractive pictures on the walls. All the bedrooms seen were very individual with different colours, curtains and bed linen chosen by the resident. Two residents showed off their own television and music centre in their rooms. Each room had a selection of family photographs on display and some had posters and newspaper cuttings or drawings up as well. One resident with a serious sight deficit explained about using the furniture in the room to orientate themselves. Two residents had electronic recliner chairs, which they used to rest their legs. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 17 One resident who is wheelchair dependent has a bedroom on the ground floor and an en-suite bathroom with a specialist bath. They also have an adjustable bed with a specialised mattress to give comfort and prevent pressure area damage. Working surfaces in the room are at wheelchair level to facilitate drawing and writing. The laundry was well equipped and cleaning agents were stored in locked cupboards. Hand washing facilities were easily accessible. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 35, 36 People who use this service can expect staff to be competent and part of a team which is supported and supervised by the manager, however they cannot be assured that the training staff receive to meet individual needs will be up to date. EVIDENCE: A number of staff have several years working experience in the field of learning disabilities. The manager is working towards National Vocational Qualification (NVQ) Level 4 Management and a number of support workers have NVQ Level 2 in care with one person attaining NVQ Level 3 in care. Staff spoken with said they felt supported by the management and had supervision on a regular basis. Records were seen to support this. Staff felt able to raise issues of concern with the manager as they occurred, not wait until supervision took place. They mentioned some concern about sickness among newer staff but said that the rotas were always filled and no pressure was applied to do extra shifts. They felt the team was strong and committed to the work in the home. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 19 The staff, on the day of inspection, were unable to provide training records but training certificates were seen. The majority of these were not recent and indicated that training updates were required. Staff spoken with said they were due updates but were unaware of any dates already set. Mandatory training for Manual Handling and Protection of Vulnerable Adults must be undertaken urgently. Staff who administer medication should have updates on their training and there was not evidence that this was the case. Personal staff files were not available for inspection as the manager was off duty, so verification that appropriate checks had been made on new staff was not possible on the day of inspection. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 40, 41, 42 People who use this service can expect that their health and safety will be protected but they cannot be assured that policies and procedures in the home will safeguard their interests. EVIDENCE: Since the last inspection the service has complied with requirements to fix selfclosing fire mechanisms to all internal doors and safety restrictions to all upper windows. The manager said that smoke detectors have been checked by the fire inspector and are appropriate for the building. Some risk assessments relating to fire procedures, in particular for a wheelchair dependent resident, were not available to the inspector on the day of inspection. A copy of this assessment must be sent to CSCI for verification. There was evidence in the kitchen that checks were made and recorded on the refrigerator temperatures and they were within safe levels for food storage. Foods in the refrigerator was covered and labelled with content and date. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 21 The freezers were well stocked and temperatures were being recorded. Although the temperatures were within safe limits the freezers both looked in need of de-frosting. Staff were unable to supply the policies and procedures folder on the day of inspection. One folder that was offered was a Suffolk Social Care folder, which dated from 1994 and was clearly not relevant to a Mencap home. Policies and procedures should be available for staff and resident reference and accessible at all times. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cumberland Avenue Residential Home Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x x 1 1 3 x I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 23 Yes 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 35 Regulation 18 (c ) Requirement Timescale for action 31/10/05 2. 3. 40 42 Mandatory training for Manual Handling and Protection of Vulnerable Adults must be undertaken by all staff. 17 (3) (b) Policies and procedures files must be available for inspection at all times. 23 (4) (c ) A risk assessment in respect of a (iii) wheelchair dependent resident and the action required during a fire must be sent to CSCI. immediate immediate 4. 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 35 Good Practice Recommendations All staff should have an individual training profile and records of training undertaken should be collated and up to date. Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 5th Floor, St Vincent House 1 Cutler Street Ipswich Suffolk, IP1 1UQ 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. Extracts may not be used or reproduced without the express permission of CSCI Cumberland Avenue Residential Home I54-I04 S24369 Cumberland Avenue V239270 050714 Stage 4.doc Version 1.40 Page 25 - 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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