Inspection on 31/01/06 for Flaxman Avenue (77) - City of York Council

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Flaxman Avenue (77) - City of... 19/10/09

Flaxman Avenue (77) - City of... 11/09/07

Flaxman Avenue (77) - City of... 20/09/06

Flaxman Avenue (77) - City of... 12/05/05

Flaxman Avenue (77) - City of... 02/03/05

Flaxman Avenue (77) - City of... 02/09/04

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

CARE HOME ADULTS 18-65 Flaxman Avenue (77) - City of York Council 77 Flaxman Avenue Tang Hall York North Yorkshire YO10 3TW Lead Inspector Terry Downey Unannounced Inspection 31st January 2006 2 pm Flaxman Avenue (77) - City of York Council DS0000034930.V278503.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 Flaxman Avenue (77) - City of York Council DS0000034930.V278503.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. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Flaxman Avenue (77) - City of York Council Address 77 Flaxman Avenue Tang Hall York North Yorkshire YO10 3TW 01904 426428 01904 426428 carole.aherne@york.gov.uk 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) City of York Council Mrs Carole Ann Aherne Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th May 2005 Brief Description of the Service: Flaxman Avenue is registered to provide residential, personal, and social care on a respite basis for up to 6 adults with learning disabilities. The home is a single storey purpose built property owned by the City of York Council. All of the bedrooms are of single occupancy, three have en-suite bathrooms and three have en-suite toilets. There is currently a six person day service being run from the lounge at the front of the home. This is staffed separately from the care service and finishes at 3.30pm. so does not interfere with the respite care provision in the home. The home is located on the outskirts of York City centre with good access to the City’s services and amenities. There is a large car park to the front of the home and an enclosed garden at the back of the property. The responsible individual is Mr Daryoush Haj- Hajafi and the registered manager is Mrs Carole Aherne. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the inspection process on 31st January 2006. The manager Mrs Aherne was available to assist with the inspection and it was also possible to speak to five members of staff and 7 service users, the responsible individual for the scheme, and a visiting care manager. The inspection was timed for late afternoon so the inspector could see the service users at tea time and also to witness the impact of the day service. Time was spent talking to the service users, two of whom used both the day service and the respite service. The inspection also involved, discussions with staff and managers, a tour of the premises, and a check on some of the records kept by the home. The inspection showed that the home was well organised and managed, that the staff were aware of their duties, and the service users were well cared for. What the service does well: What has improved since the last inspection? Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 6 All the staff have had up to date medication training. The staff records are now kept in the home. Service users care plans are more detailed and up to date. Auditory monitoring has been reviewed and all approved by the relevant parents / carers. A new system is being considered. The transitions work has developed and the communication between the children’s services and the home is constantly improving. The service has a history of providing quality care which is not easy to maintain. It was clear that the manager and the staff team are constantly looking at ways to improve the service they provide to give a better quality of care to the service users. 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. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.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 Flaxman Avenue (77) - City of York Council DS0000034930.V278503.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 Proper assessments ensure that individuals’ needs can be met by well trained staff. EVIDENCE: All the service users have assessments involving carers, and other professionals, prior to coming into the home and they have an opportunity to visit and look around before being admitted. The home was able to demonstrate this following a recent admission to the service. Two members of staff have taken on the responsibility for the transitions age group and ensure that the necessary information from all the children’s services is available to the home prior to a visit. They ensure that the information from care managers is available and up to date and this was witnessed during the inspection. They also maintain good links with families and carers during the transition process. This ensures that all the information is available and the transition from one service to another is less stressful. The home has an emergency bed which is allocated on a rota basis and service users and their families are aware that their stay may have to be cancelled at short notice if an emergency arises. All residents and carers have the information they need before they come into the home. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.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): 6,7,9,10. The residents health and personal care needs are met and they are encouraged and supported to make choices about their daily lives. This helps them to have control over their lives in the home. EVIDENCE: Comprehensive assessments and care plans identify their personal and social care needs which are updated regularly between the resident and the key worker. Risk assessments are included in the care plans so that both staff and service users are aware of the support required. The staff have regular care plan meetings at which residents changing needs are discussed. This ensures that staff are kept up to date and that a consistent approach can be achieved. There were examples of the service users making decisions in the home and these included, choice of daily activity programmes, leisure activities, and menu planning. The residents were pleased to discuss these and they were aware that some required support and others could be more independent in different activities. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 10 The information in the home is kept securely. The service users were aware that records were confidential and could only be shown to others with their permission. This gave them confidence in the manager and staff team that any problems they share with them will be treated with respect. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.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): 12,13,15,16,17 The service users enjoy a wide range of activities both inside and out of the home and use the local services and amenities very well. EVIDENCE: Each service user has an individual programme aimed at making their stay both enjoyable and beneficial in terms of developing their skills. The staff are constantly looking for new activities which will interest the service users and provide further stimulation and development. All the service users use the local facilities in York e.g. theatre, pubs, and clubs and the staff rota ensures that staff are available to support them. The evening meal was served during the inspection and staff and service users enjoyed a well prepared meal and social gathering. The service users said they really enjoyed the meals and the clean plates witnessed bore testimony to this. Some service users also help in the kitchen as part of their programmed activities. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 12 The day service was open at the beginning of the inspection so it was possible to witness how it operated. The indications were that if it had any effect on the respite service at all it was a positive one. Staff explained that after some early teething problems it now has little impact on the service they provide. The service users spoken to, two of whom used both services, felt it was good having it there but it did not affect the respite service. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.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. The residents physical and emotional health needs are met. EVIDENCE: The care plans were comprehensive documents agreed with the service users and carers and in conversation both residents and staff found them very useful for providing the appropriate levels of care. . The home operates a key worker system and they meet with their service user to make any changes and ensure the information is up to date. Both staff and residents spoken to felt that the system worked very well and was a good way of meeting their needs. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Residents are protected from abuse neglect and self harm. EVIDENCE: The home has a detailed complaints procedure, in suitable formats, but the service users spoken to had not used it but felt safe knowing that it was there. They also said they could talk to the manager and staff and knew that they would take them seriously. Some complaints had been made since the last inspection and these were well investigated and recorded. It was clear that the home takes complaints seriously and uses them to improve the service. The vulnerable adults procedure is available in the home and training of staff has been recorded. Staff were aware of the procedure and as with the complaints procedure above would take all reports seriously and deal with it properly. Residents said they felt safe in the knowledge that everyone knew about it. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. The home was clean, and well decorated and furnished and provided a comfortable place to live. EVIDENCE: Flaxman Avenue is decorated and furnished with the needs of service users in mind. It has comfortable lounges, a dining room, and large kitchen. Bathrooms have the equipment required to deal with lifting and assist both staff and service users. Service users are encouraged to provide their own personal items in their rooms which makes it their own private space. The home was clean and hygienic and free from offensive odours. There is an infection control policy to alert staff and ensure good hygiene practices. The home has a planned maintenance programme to ensure that it is kept safe and comfortable. The service users said it was a very nice place to stay. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. The staff are well trained and well supported by the manager and this ensures that residents feel supported and staff are aware of their duties. A robust recruitment procedure offers protection for the residents in the home. EVIDENCE: The home has a settled staff team. They work at times suitable for the service users who all felt supported by them. Despite some recent changes, the staff felt that there were enough staff on each duty to meet the needs of the service users. The staff considered that they work well as a team and are supportive of one another and examples of this were witnessed during the inspection. A key worker system operates in the home. Service users felt that this was helpful to have someone to work closely with. Staff also felt that it helped the service users especially with communicating their care needs. The staff are well trained and all statutory training was up to date. This provides protection for the residents. All staff receive supervision at least 6 times per year and this ensures that they are aware of the ethos of the home feel supported by the management. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 17 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): 37,38,39,42. There is clear leadership and guidance from the manager which ensures consistent quality care for the service users. This also means that their health, safety and welfare is promoted at all times. EVIDENCE: The manager believes that the service users should be involved in the running of the home so keeps them informed and asks for their opinions. The service users said this gives them trust in the manager and staff. The service users have meetings to agree programmes and activities and are encouraged and supported by the staff to take part. They also eat together and this provides a relaxed informal atmosphere where all service users can contribute. This was witnessed during the inspection and demonstrated the level of control the residents have over their lives. Health and safety records were well maintained and staff were aware of their responsibilities. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 18 There is clearly a lot of information between the home and the service users and carers which the home uses to improve and develop the service. This needs to be formalised into a quality assurance system where feedback is actively sought from all stakeholders, measures the success of the service and results in an annual plan reflecting the views of the survey. The results of the survey should then be published and made available to stakeholders, service users and the Commission. Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 19 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 1 3 3 3 3 Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 20 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA39 Regulation 24 Requirement A formal quality assurance system must be introduced and a copy of the report submitted to the Commission. Timescale for action 30/05/06 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. Refer to Standard YA6 Good Practice Recommendations Individual service user plans should be developed in the format seen during inspection for all people resident at the home and should include individual task specific detail and individual preference. Where other professionals make recommendation for care plans this should be written into the homes individual plan of care. The use of auditory monitoring systems for service users should be reviewed and recorded in individual service user plans to account for issues of invasion of privacy, consent and to evidence the least intrusive method to maintain safety is being used. 2. YA16 Flaxman Avenue (77) - City of York Council DS0000034930.V278503.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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