Inspection on 31/01/06 for Elliot Avenue

This inspection was carried out on 31st January 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 no outstanding requirements from the previous inspection report, but made 3 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 11/10/06

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 Announced Inspection 31st January 2006 09:00 Elliot Avenue DS0000064274.V270514.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 Elliot Avenue DS0000064274.V270514.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. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 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) Community Care Solutions Limited 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.V270514.R01.S.doc Version 5.1 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 Not applicable 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. It is situated in a quiet cul-de-sac in South Bretton and there is access to local shops and transport. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on the 31 January 2006 and was the home’s first inspection since becoming registered with the Commission for Social Care Inspection. It was announced. The inspection findings are based on interviews with two service users, one service user’s stepmother, one member of staff and the home’s manager. Chris Perks, an area manager with Community Care Solutions also contributed to the inspection. A brief tour of the home was undertaken and a range of documents viewed. The inspector also received 3 completed comment cards that had been filled out by each service user. At time of inspection three service users were being accommodated. Three requirements and three recommendations have been made in light of this inspection. What the service does well: What has improved since the last inspection? What they could do better: New service users should only be admitted to the home on the basis of a full and detailed pre-admission assessment so that they know their needs can be adequately met at the home. 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. Training for staff needs to improve so that they have adequate skills and knowledge to look after service users: in particular staff should undertake the NVQ Level 3 Caring for Children and Young People. Recruitment practices need to be more robust and no one should be allowed to start work until two detailed references have been obtained. All policies and procedures should show evidence of regular review. The garden area should be developed to provide a more interesting and stimulating environment for service users. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 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. Elliot Avenue DS0000064274.V270514.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 Elliot Avenue DS0000064274.V270514.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): 1,2,4,5 The home’s admission procedures are satisfactory, although more could be done to ensure that staff have detailed and thorough information about service users’ needs before they are admitted. EVIDENCE: The home has a statement of purpose and service user guide that contain good information about the home and the services it offers. Service users are only admitted after being assessed by the manager or the area manager. The inspector viewed a sample of pre-admission assessments and noted that the information contained in one, however, was a little Spartan in detail and did not give a thorough enough picture of the prospective this service user’s complex needs. Prospective service users do have the opportunity to visit the home and two of the three current service users visited before moving in. Each service user is given a written contract that sets out the terms and conditions of their stay. Elliot Avenue DS0000064274.V270514.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): 6,9,10 Individual plans of care reflect the needs, aspirations and goals of service users. Staff enable service users to take responsible risks. EVIDENCE: The inspector viewed all three service users’ plans of care. These were satisfactory and contained comprehensive and up to date information about each service user. Service users’ needs in relation to their accommodation, finances, personal care, communication, medication, and behaviour management techniques were clearly recorded. The plans had been reviewed regularly and service users had signed them. Action is taken to minimize identified risks and hazards and the inspector viewed a number of comprehensive risk assessments in place for a number of service user activities. Information about service users is held securely in a locked filing cabinet and the home’s computer is password protected. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 10 Elliot Avenue DS0000064274.V270514.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): 11,12,14,15 Service users are given opportunities to practice independent living skills and take part in range of leisure activities. Appropriate contact between service users and their families is encouraged to help them maintain relationships. EVIDENCE: Staff help service users engage in meaningful and appropriate activities. One service user told the inspector that on a Monday she swims; on a Tuesday she has a ‘home day’ where she undertakes a range of domestic chores; Wednesday she bowls; Thursday she goes to the gym and Friday she has a drama class. At weekends she likes to ‘chill out’. Another service user attends a ‘Life Skills’ course at a local college where he learns cooking, shopping and undertakes work experience placement. On the day of inspection itself this service user was at college, and the other two service users were getting ready to go to the seaside for the day. Service users have opportunities to learn independent living skills: staff are currently encouraging one service user to go out on his bike unaccompanied, and provide the other two service users with basic literacy and numeracy coaching. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 12 Staff support service users to maintain family links and friendships and one relative was very appreciative of the regular contact that she has with the home’s manager concerning the care of her son. One service user told the inspector that she was really looking forward to going home to her mother’s for her forthcoming birthday. Elliot Avenue DS0000064274.V270514.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): 19,20 Service users’ health and emotional needs are closely monitored and their welfare is safeguarded by the home’s policies and procedures for administering medicines. EVIDENCE: Service users’ health care needs were clearly recorded in the care plans viewed by the inspector and all service users are registered with a local GP and dental practice. Two of the service users have regular contact with psychiatric services and one service user has recently been checked over by the specialist ‘looked after children’s’ nurse. The inspector read a recent letter from a psychiatric nurse praising the home’s staff for their ‘dedication and commitment’ in dealing with a service user’s particularly challenging behaviour. The inspector checked the home’s medication storage and administering records and these were satisfactory, as were the home’s policies and procedures (dated March 2003) in relation to medication. All staff complete a medication workbook to ensure their competency at administering medication. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 14 There is a designated key worker system in place to ensure consistency and continuity of support for service users. Staff receive good training in physical intervention and all incidents of its use are clearly recorded. Elliot Avenue DS0000064274.V270514.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 Complaints are taken seriously and responded to appropriately. EVIDENCE: Details of how to complain are contained in the service user’s guide and are also explained to service users at their six monthly reviews. Both service users interviewed were aware that they could complain, and records inspected confirmed that formal complaints were dealt with appropriately. One service user’s relative told the inspector that concerns she had about her step son’s nutritional needs had been addressed by the manager. All staff receive training in protecting vulnerable adults and the manager is to undertake an advanced practitioner course in May 2006. Elliot Avenue DS0000064274.V270514.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): 24,25,27,28,30 The environment of the home provides service users with an attractive and homely place to live. 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 4 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. However, the garden looks a little neglected and shabby and much more could be done to make it an interesting and stimulating area for service users. Both service users spoken to told the inspector that they liked the home, although one stated that she didn’t like the fire place or sofa in the main lounge. The inspector noted that in one service user’s bedroom there was a couple of holes in the wall and these should be repaired. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 17 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): 32,34,35,36 Staffing levels are satisfactory and there are sufficient staff on duty to meet service users’ needs. However, staff training needs to better reflect the needs of service users, and recruitment procedures need to be tightened to ensure that service users are protected. EVIDENCE: There are 3 members of staff on each morning and four members on each evening. At night, one ‘sleep in’, and one ‘waking’ member of staff are on duty to support service users. Scrutiny of the duty rota showed these staffing levels to be maintained. Service users stated that they receive individual support when they needed it. However, the home only has a pool of eight permanent staff and relies heavily on agency workers to cover shifts. On the day of inspection itself two of the three staff on duty were from an agency. All new staff receive a good induction training, as well as training in managing challenging behaviour, medication, and protecting vulnerable adults. However, none of the current staff group have an NVQ level 2 in care, or an NVQ level 3 in Caring for Children and Young People, as recommended by the national minimum standards. This qualification is of particular importance as the home is registered to accommodate 16 and 17 year olds. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 18 The inspector viewed the personnel files for three members of staff. All staff had undergone appropriate CRB and POVA checks, and two written references had been obtained for them. However, one reference only stated the dates the person had worked for his previous employer, and gave no information about his suitability to work with vulnerable adults. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 19 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): 38,40,42 The management approach of the home creates an open and positive atmosphere for service users and staff. Health and safety practices in the home ensure that service users are protected EVIDENCE: The manager is in the process of applying for registration with the Commission for Social Care 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. She was well prepared for the inspection and talked knowledgably about the service. The member of staff interviewed by the inspector reported that she felt supported and valued as a worker, and described the manager’s approach as ‘relaxed but always professional’. 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. A number of records in relation to health and safety (fire, gas, Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 20 liability insurance, temperature readings) were viewed by the inspector and found to be in good order. The inspector viewed no major health and safety hazards in the home. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 21 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 2 3 x 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 x 14 3 15 3 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x 3 3 x 2 x 3 X Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 22 Not applicable 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. 2. Standard YA2 YA32 Regulation 14 (1) 18 (1) Requirement New service users must only be admitted on the basis of a full and detailed assessment. 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. Two detailed references should be obtained for prospective employees. Timescale for action 31/01/06 01/08/06 3 YA34 7,9,19 (Sch 2) 31/01/06 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 Refer to Standard YA28 YA32 YA40 Good Practice Recommendations The garden should be developed to provide an interesting and stimulating area for service users. The home’s reliance on agency staff should be reduced The home’s policies and procedures should be regularly monitored, reviewed and amended. Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Elliot Avenue DS0000064274.V270514.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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