Inspection on 30/08/06 for Haslewood Avenue (1)

This inspection was carried out on 30th August 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Haslewood Avenue (1) 22/08/07

Haslewood Avenue (1) 19/10/05

Haslewood Avenue (1) 27/04/05

Haslewood Avenue (1) 21/12/04

Haslewood Avenue (1) 10/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Haslewood Avenue (1) 1 Haslewood Avenue Hoddesdon Hertfordshire EN11 8HT Lead Inspector Angela Dalton Unannounced Inspection 30th August 2006 11:55 Haslewood Avenue (1) DS0000019407.V306466.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 Haslewood Avenue (1) DS0000019407.V306466.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. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haslewood Avenue (1) Address 1 Haslewood Avenue Hoddesdon Hertfordshire EN11 8HT 01992 479 171 01992 479 171 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) Hightown Praetorian & Churches Housing Association Nichola Jane Larner Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Physical disability (8) of places Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate people with a physical disability (only when associated with a mental handicap). 19th October 2005 Date of last inspection Brief Description of the Service: Haslewood Avenue is a purpose designed bungalow in the centre of Hoddesdon built in 1995 to accommodate 8 adults with learning disabilities who had formally lived together in a long stay hospital. It is an attractive, compact building, surrounded by a small garden that provides eight single bedrooms, two assisted bathrooms, three wheelchair accessible WCs, a laundry, lounge, kitchen and dining room and an office and storage areas. The home has a very homely appearance and feel. The facilities of the local town are easily accessible by foot from the home, as are the local transport services. The home, which is run by Hightown Praetorian Housing Association, a voluntary organisation, provides full care services in an integrated and safe environment for its residents who all have learning and physical disabilities and who may present a moderate degree of challenging behaviour. The Statement of Purpose is available and each individual has a copy of the Service Users’ guide. Weekly fees range from £1061.69 to £1088.18. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection consisted of an unannounced site visit between 11.55am and 4.10pm on 30th August 2006. One Inspector visited the home and spent time with service users and staff. Most service users were at home and were involved in household activities or going out with staff. Day activities are usually provided by the Guidepost Trust but staff are currently on leave and the home’s staff were ensuring service users were continuing to access leisure opportunities. Care was observed to be delivered to a high standard and it was evident staff know service users well and this assists in the anticipation of their needs. Staff were observed to be kind and gentle with service users and this contributed to the calm and friendly atmosphere. The two bathrooms need improvements to fully meet service users’ needs as the layout and equipment requires review. This has been identified at previous inspections. The withdrawal of specialist support in the community has delayed progress and the home manager is exploring other ways to deal with this issue. What the service does well: What has improved since the last inspection? Some of the requirements made at the previous inspection in October 2005 have been met. Areas of the home have been redecorated and repairs to the hallways have been carried out. A flooring programme to service users’ bedrooms has commenced. In order for all bedrooms to receive new flooring service users are going on holiday in the coming months to ensure that this process does not intrude upon their routine. Anti suffocation pillows have been purchased for a service user who needed them and a risk assessment completed on the ‘rise and fall’ bed. The home currently has no Controlled Drugs on site and the manager is determining whether a cupboard and register is required for this purpose. All repairs that were required in the kitchen have been completed and the bathroom call bell is in working order. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 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. Haslewood Avenue (1) DS0000019407.V306466.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 Haslewood Avenue (1) DS0000019407.V306466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users’ needs and wishes are identified prior to admission. Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. EVIDENCE: No new service users have been admitted since the previous inspection in October 2005. All service users are assessed prior to moving to Haslewood Avenue to ensure that needs can be met. The home currently has a vacancy and an assessment has been completed for a potential service user. Senior staff complete an assessment and liaise with other professionals and family members were possible. The assessment provides a baseline for the development of the care plan. Haslewood Avenue (1) DS0000019407.V306466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Care plans reflect individual requirements and illustrate how they are met. Staff encourage service users to express choices and take risks which are recorded. Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans provide a wealth of information about each service user and identify how needs are monitored, managed and met. Documentation is being streamlined to ensure that the amount of information held in current files is relevant and not overwhelming. Staff know service users well and clearly meet their needs. Care plans reflect the principles of Person Centred Planning which ensures that the focus of care is the individual. Information is sometimes spread throughout the care plan and the aim is to collate information once staff vacancies are filled. The senior support worker is currently auditing care plans to ensure all relevant information is in place. Each service user has a keyworker who ensures that they are kept up to date with any changes in their care plan. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 10 Comprehensive risk assessments are in place and they provide guidance, which ensures staff can safely manage risks. They also detail what action is required should a risk occur. Haslewood Avenue (1) DS0000019407.V306466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Service users have a presence within the local community. Mealtimes are focused upon the needs of service users. Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Daycare activities are provided by the Guidepost Trust, which ensures that service, users have a clear division between home life and daycare. Home staff are responsible for providing cover during holiday periods (Guidepost Trust are not providing staff support for two weeks due to holidays) which was the case during the inspection. Service users are sometimes without daycare activities if Guidepost Trust staff are off sick or have holidays and the home is unable to cover. Social Services are aware of the issues and the home manager is hoping to resolve difficulties. Guidepost trust have recently introduced a ‘same sex’ support worker policy – this works well but if a service user is not the same sex as a Guidepost Trust staff member they have to return home to attend to any personal care needs. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 12 The manager is investigating how this challenge can be minimised as it reduces service users day care opportunities and may result in service users travelling in discomfort, as their needs cannot be quickly met. As the home is close to the town centre the service users have excellent access to the local community facilities and the home also has its own transport. All service users have had an annual holiday and another is planned later in the year to enable flooring to be fitted. Individual likes and dislikes are recorded within the care plan, as are family details to enable significant events, such as birthdays, to be celebrated. Mealtimes are a social occasion and the evening meal is an opportunity for service users and staff to eat together and discuss the events of the day. Haslewood Avenue (1) DS0000019407.V306466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Staff ensure service users’ individual requirements are met. Improvements would ensure a safe medication system is in place. Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff were observed to deliver care sensitively and gently. Several staff have worked within the home for a long time and have a good understanding of individual needs. Each service user has a care plan which reflects how needs are met. Specialist health services previously provided have been withdrawn and service users no longer receive physiotherapy or dietetic support. Service users now have to access support via a GP referral and do not receive regular input which assisted in maintaining good health. Storage temperatures are not recorded which does not ensure a consistent safe storage temperature is maintained. Controlled drugs are not currently used and the manager is assessing the introduction of a separate cupboard and drugs register. Staff would benefit from further medication training to build upon the regular training they receive, which is over one day. Local colleges provide diploma courses on the safe handling of medication. Haslewood Avenue (1) DS0000019407.V306466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users are actively encouraged to make their views known. Service users are protected from abuse. Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user has an identified keyworker. One to one time with service users occurs several times a day and views from service users’ are actively sought. For service users who cannot verbally express their views staff monitor reactions to situations and record service users reactions. Regular service user meeting occur. No complaints have been received since the previous inspection. The number of compliments the home receives far outweigh any concerns that are raised. Staff have a good awareness of the Adult Protection policy and the Whistleblowing procedure which ensures service users are protected from abuse. Service user finances were checked and found to be in good order. Haslewood Avenue (1) DS0000019407.V306466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The layout of bathrooms and facilities do not fully meet the needs of service users. Infection control could be better observed within the home. Quality in this outcome area is poor; this judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has two bathrooms: one with an assisted bath, the other with an assisted bath and shower. The assisted bath fails to meet the needs of service users and has proved unreliable. This has understandably made staff and service users nervous about its safety. The gap between the bath and wall is too small for staff to fit in and the fixing for the showerhead is too far from the bath to be of use. The second bathroom also provides challenges: it is cramped and offers little room to manoeuvre hoists and wheelchairs. The sink has recently been moved to the corner of the room but this is not accessible to wheelchair users. The wall it was taken from remains undecorated with holes in. The concertina waist height shower door is not substantial enough as service users use it for support and it is breaking. The grab rail encroaches upon the shower space and this impedes service user independence and staff’s ability to assist. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 16 A toilet seat was missing but this was replaced the day after inspection. It had been missing for a week after breaking. This is not the first replacement and the current toilet seats are clearly not suitable for the requirements of the service users. The rest of the home has benefited from a redecoration programme and it unfortunate that the ongoing issue of the bathrooms has not yet been addressed. The home is unable to access a specialist occupational therapist to advise but input must be sought to ensure any changes meet the complex needs of service users. The home is clean and the new bedroom flooring will address any odours. A requirement has been made to provide soft paper hand towels (preferably in dispensers) and to risk assess use of hand driers for service users versus hand towels and the appropriateness of a hand drier in the staff toilet. The manager will contact the Health Protection Unit to make further enquiries. Pump action soap and alcohol hand gel is widely available throughout the home. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 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 Competent and skilled staff ensure that service user needs are met. Accurate recruitment records are kept. Quality in this outcome area is good; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Training is ongoing and staff are encouraged to develop through the achievement of NVQ awards. A training matrix is in place to ensure staff skills are regularly updated. Training is reflected on the monthly rota and is diverse to ensure that service users’ needs are met. Staff confirmed they received a generous level of training. New staff are fully inducted and their competence is assured before they work unsupervised. Recruitment records were checked and found to be in good order. Haslewood Avenue (1) DS0000019407.V306466.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Evidence was not available that the home is run in the best interests of service users. Lighting is inadequate and not in good working order. Quality in this outcome area is adequate; this judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager operates an ‘open door’ policy and works shifts on occasion. This ensures a good insight into service users’ needs whilst balancing the management requirements of the home. Evidence of a quality assurance process was not available during the inspection and a requirement has been made. Ongoing problems with lighting and emergency lighting are ongoing and this must be addressed to ensure the safety of service users and staff. A hallway light continually emits a low level of light and when it is switched on a loud buzzing can be heard. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 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 1 25 X 26 X 27 X 28 X 29 X 30 2 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 X 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 2 X 3 X 2 X X 2 X Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 20 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. 2. Standard YA20 YA24 Regulation 13(2) 23(2)(b) Requirement Medication must be stored at the correct temperature. Works to refurbish the ground floor bathroom are required. This is an outstanding requirement from the two previous inspections. Enforcement Action may be taken if it remains unmet. Both bathrooms must be suitable to the needs of service users; fixtures must be safe and accessible, decoration must be kept in good order. Paper hand towels must be available (preferably in dispensers). Risk assessments for use of hand driers must be conducted, as this is not the ideal way to ensure good infection control. Evidence that a quality assurance system is in place must be submitted to the Commission. Emergency and communal lighting must be in good working order. Timescale for action 15/09/06 30/11/06 3. YA24 23(2) 30/11/06 4. YA30 13(3) 30/11/06 5. YA39 24 30/11/06 6. YA42 13(4) 15/09/06 Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 21 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 YA20 Good Practice Recommendations Staff would benefit from further medication training. Haslewood Avenue (1) DS0000019407.V306466.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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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