Inspection on 11/10/06 for Elliot Avenue

This inspection was carried out on 11th October 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elliot Avenue 23/10/08

Elliot Avenue 23/08/07

Elliot Avenue 31/01/06

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Elliot Avenue 1 Elliot Avenue Bretton Peterborough PE3 9TG Lead Inspector Janie Buchanan Unannounced Inspection 11th October 2006 12:50 Elliot Avenue DS0000064274.V316315.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 Elliot Avenue DS0000064274.V316315.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. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elliot Avenue Address 1 Elliot Avenue Bretton Peterborough PE3 9TG 01733 331731 01733 331762 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) www.communitycaresolutions.com Community Care Solutions Limited Zoe Allcock Care Home 6 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the age range of service users will be 16 - 25 years only Date of last inspection 31st January 2006 Brief Description of the Service: Elliot Avenue was opened in May 2005 and is run by Community Care Solutions. The company operates residential homes specialising in the provision of care to adults with learning disabilities and associated challenging behaviours. The company has other homes in the Bedford, Peterborough, Rushden and Biggleswade areas. Elliot Avenue offers accommodation and support to 6 young people between the ages of 16 and 25 years. The current basic fees for the home are £1750 per week. The home is situated in a quiet cul-de-sac in South Bretton and there is access to local shops and transport. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s key inspection for the year 2006/7. Three service users, two members of staff and the manager were interviewed. A brief tour of the home was undertaken and a range of documents and policies were viewed. Five completed questionnaires sent to service users, requesting feedback about the home, were also received. What the service does well: What has improved since the last inspection? What they could do better: The home should reduce its reliance on agency staff so that service users receive a good continuity of care from workers who know them well. Although staff do receive training specific to the needs of the young people they look after, the percentage of staff holding NVQ awards falls below the percentage recommended by the minimum standards. The home should also closely monitor its use of surveillance equipment to ensure that it is absolutely necessary and does not infringe on service users’ privacy. Written records should be maintained of all concerns and complaints, (however seemingly trivial), made by service users at the home. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 6 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. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 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 Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. All young people have their needs thoroughly assessed to ensure that they can be met at the home. Admission procedures allow young people to ‘test drive’ the home before deciding whether or not is for them. EVIDENCE: There is a Statement of Purpose and Service User Guide that give good information about the home and the services it offers. The Service User Guide is in a simple format, with pictures, to help service users understand it. Admissions are not made to the home until a full assessment has taken place, and information from a range of health and social care professionals is sought. Staff at the home also spend time at the service user’s current placement to ensure they fully understand their needs before they are admitted. Prospective residents and their families always have the opportunity to visit and all service users spoken to confirmed that they had visited the home several times before moving in. Each service user is given a written contract that clearly tells them about the service they will receive. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good. Care plans clearly set out the needs of young people and how they will be met by staff at the home. Service users are involved in decision about their lives. EVIDENCE: Each service user has a care plan that has been agreed with him or her. The plans viewed covered a range of areas including communication, personal care, medication, social life, activities, finances, choice and freedom, and family. The plans had been reviewed regularly and the information they contained was detailed. They also provided good guidance for staff about specific interventions to be used with service users. The plans also included comprehensive risk assessments for a range of activities. Service users who completed the questionnaire stated that they make decisions about what they do each day and those spoken reported that that staff, on the whole, respected their decisions. Minutes of meetings held regularly with service users showed that they were consulted about daily life in the home and also prospective people coming to live at the home. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 10 Information about the young people is held securely in a locked filing cabinet and the home’s computer is password protected. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,14,17 Quality in this outcome area is good. service users have opportunities to learn and use practical life skills. Young people have access to a range of recreational activities. EVIDENCE: Five young people are currently undertaking independence courses at a local college and one service user is doing an NVQ in hairdressing. service users enjoy their courses and one told the inspector that she had learned how to cook a ‘fry up’ at college that day. Independent living skills are promoted within the home and service users take responsibility for their own room, domestic chores and cooking. One service user told the inspector that he was delighted with his new video/DVD rental card that a member of staff had helped him apply for. The home offers a number of leisure activities for service users to enjoy such as swimming, roller blading, picnics and going to the gym. Five young people are part of a weekly drama group that recently put on a performance at a local hall. Staff support service users to maintain links with their families and friends and the inspector overheard one service user’s request to invite her boyfriend over at the week-end being agreed by staff. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 12 Young people reported that food at the home was ‘good’ or ‘OK’. On the day of inspection young people were helping cook a chicken curry for their evening meal. All foodstuffs viewed in the home’s fridge had been stored safely. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. Young people’s health and emotional needs are met at the home. EVIDENCE: All service users are registered with a local GP and dentist and have access to a psychologist or psychiatric nurse when needed. The manager stated that all service users were in good health and required little medical attention. Service users interviewed confirmed this. All staff receive thorough training in non aggressive physical intervention. The inspector spoke with one service user who had been subject to a number of these interventions. This service user reported that she had never been hurt during them, and that staff intervened appropriately to protect her and others. All incidents of these interventions had been clearly recorded. Each service users has a key worker that enables staff to establish a special relationship and work closely on a one to one basis. All staff have received training in administering medication and medical records viewed by the inspector were in good order. Boots the Chemist provide further advice and training. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 14 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): 22,23 Quality in this outcome area is adequate although more should be done to capture information about service users’ concerns and complaints. EVIDENCE: Details of how to complain are contained in the service user’s guide and are also explained to young people at their six monthly reviews. However, it was of concern to note that there were no recorded complaints or concerns (or compliments) from service users at the home. This is unusual given that most of the service users are very able to express their concerns. Despite this, service users spoken to identified the manager or their social worker as someone they would talk to if they had concerns. The manager has recently undertaken the key practitioner course in adult protection and all staff receive training in this. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 15 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): 24,29, 30 Quality in this outcome area is good. Service users live in a comfortable and well-maintained environment. EVIDENCE: Elliot Avenue is a large and recently converted detached house with a goodsized garden. The home meets all the environmental requirements of the national minimum standards. All bedrooms exceed minimum size requirements and all of the bedrooms have either an ensuite bath or shower in addition to a toilet and wash hand basin. In addition to the six bedrooms, there is a large sitting room, dining room, study room, utility room, staff office/sleep in room and lots of cupboard storage. There are also two large garages. Quality of the furnishings and fittings is good and the environment adequately meets the needs of its service user group. The garden area has improved since the last inspection and there is now garden furniture and a basketball net for service users to use. One service user proudly showed the inspector a rose bush that she herself had planted and grown. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 16 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): 32,34,35,36 Quality in this outcome area is good. Service users are protected by the home’s recruitment procedures and benefit from staff who are well supported and supervised EVIDENCE: Staffing levels in the home are high and there are sufficient staff on duty to the needs of the service users. Although the use of agency staff has reduced since the last inspection, the home still does rely on these staff to cover shifts. On the day of inspection itself two members of agency staff were on duty. All new staff receive a good induction training, as well as training in managing challenging behaviour, medication, autism and protecting vulnerable adults. However only one member of 14 staff has completed and NVQ level 3 in caring for children and young people. This qualification is of particular importance as the home is registered to accommodate 16 and 17 year olds. All staff receive regular supervision and those interviewed reported that it was useful and in reviewing their care practices and identifying their training needs. The home has a thorough recruitment process and personnel files for two recently employed staff members were checked: each contained appropriate references and POVA and CRB checks. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 17 Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 18 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): 37,39,42 Quality in this outcome area is good. The management of the home is open and inclusive. The home regularly reviews aspects of its performance. EVIDENCE: The manager has gained registration with the CSCI since the last inspection. This is her first post as a manager of a residential establishment, however she has 5 year’s experience working with both adults and children with learning disabilities, as well as experience of running a family business. Both the staff and service users reported that they felt well supported by her. Feedback about the quality of the service provided at the home has been sought through the use of a questionnaire that was sent to all service users, their families, staff and health care professionals. The questionnaire covered a range of topics including the environment, food, activities and staff. The results of the questionnaires had been closely analysed. Overall the results were positive indicating that service users were happy living at the home. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 19 The home has comprehensive policies and procedures in place that reflect the requirements of the regulations and standards. However, these were all dated March 2003, and showed little evidence of having been reviewed or updated since then. This was raised at the last inspection. The home has recently installed two door alarms that let staff know when a service user has left their bedroom. These alarms are extremely loud and must disturb the other young people living in the house. The use of such surveillance devices must be kept under close scrutiny and removed immediately when they are no longer deemed necessary. The home must also detail in its statement of purpose the fact that they use such devices, and the grounds for their use. A number of records in relation to health and safety (fire, gas, motor insurance, water temperatures) were viewed and found to be in good order. Staff interviewed by the inspector confirmed that they had received training in fire safety, food hygiene, and first aid. Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 20 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 3 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 x 14 3 15 x 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 21 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 YA32 Regulation 18 (1) Requirement Staff must undertake training appropriate to the work they are to perform. 80 of care staff working with service users aged 16 and 17 should hold an NVQ level 3 in Caring for Children and Young People. Previous timescale of 01/08/2006 not met. Timescale for action 01/04/07 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. 3. 4. Refer to Standard YA22 YA32 YA40 YA42 Good Practice Recommendations Service users concerns and complaints should be recorded, as should any action taken to address them. The home’s reliance on agency staff should be reduced The home’s policies and procedures should show evidence of regular monitoring and updating. The use of surveillance equipment should be regularly monitored and reviewed. DS0000064274.V316315.R01.S.doc Version 5.2 Page 22 Elliot Avenue Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Elliot Avenue DS0000064274.V316315.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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