Inspection on 13/02/06 for Old Park Avenue 123

This inspection was carried out on 13th February 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Old Park Avenue 123 13/11/08

Old Park Avenue 123 28/11/06

Old Park Avenue 123 15/07/05

Old Park Avenue 123 03/02/05

Old Park Avenue 123 23/06/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Old Park Avenue 123 123 Old Park Avenue Enfield Middlesex EN2 6PP Lead Inspector Margaret Flaws Unannounced Inspection 13 February 2006 10:00 Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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 Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Old Park Avenue 123 Address 123 Old Park Avenue Enfield Middlesex EN2 6PP 020 8342 1636 020 8342 1636 eileen.carr@lineone.net 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) Mr Patrick Carr Mrs Eileen Carr Mr Patrick Carr Care Home 3 Category(ies) of Learning disability (0), Mental disorder, registration, with number excluding learning disability or dementia (0) of places Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th July 2005 Brief Description of the Service: Mrs and Mrs Carr offer a service to three service users within their family home. Two of the service users have a learning disability and one has mental health issues. The home was first registered in 1997. Mr and Mrs Carr first began caring for people as adult foster carers and then moved into residential care. They decided not to register with the Adult Placement Scheme as originally they would not accept services with more than two service users. Mr and Mrs Carr provide all the care and Mrs Carrs mother offers support when they want to go away. The home is a large semi-detached house located near to Enfield Town. The shops and public transport are all near the home. The service is very comfortable and homely. Two of the service users have their bedrooms in a loft extension on the second floor and they have the shared use of a bathroom. The third service user who has higher care needs has her bedroom on the first floor. Two of the service users are able to go out independently and during the week one takes part in organising a day service for a voluntary organisation and the other participates in a supported employment scheme and a day service. The third service user has a programme of activities organised by the home and this includes local walks, accessing local community facilities and enjoying hobbies in the home. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day and was undertaken by Inspector Margaret Flaws, as part of the routine schedule of inspections for the home. Mr. and Mrs. Carr were available throughout the inspection. Two service users were at home and one service user was in hospital. The inspector was able to speak to both service users and to Mr and Mrs Carr at length. A tour of the building and grounds, an inspection of service user, general home records and policies and procedures formed the basis of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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 Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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 Prospective service users can be confident that their needs would be appropriately assessed and that they would be given the opportunity for a trial visit to see if the home matched their expectations. EVIDENCE: There have been no new admissions to the home since the previous inspection. The current service users have lived there for several years. The processes for new admissions are in place should they be required. The service users have had their care reviewed by their placing authorities. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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, 8 and 9 Service users’ individual needs and wishes are respected and met, which enables them to live independent lives. EVIDENCE: The care plans for all three service users were inspected. They are well structured and had been regularly reviewed. New goals are regularly negotiated with the service users and set, with a clear rehabilitative function. Mr. and Mrs. Carr described how they worked with the service users to enable them to ‘stretch’ the range of challenges and opportunities in their daily lives. One example that Mrs. Carr discussed on this occasion was their aim of supporting one service user to self medicate, dealt with here under Standard 20. Interviews with the service users confirmed that each individual’s choices are respected and are central to the philosophy of the home. Service users exercise choice and control over their visitors, daily activities and routines, their personal spaces and lifestyle. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 10 Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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, 14, 15, 16 and 17 Service users have the ongoing opportunities to lead active lives at home and in the community. They are well supported to maintain their family relationships and social networks and are provided with healthy, wholesome meals. EVIDENCE: The inspector spoke to two service users about their daily lives. They have a daily schedule clearly documented in their care plans. One service user, who loves music, sung songs from well known musicals for us. Mrs. Carr described how the service users lead active lives in their local community and how they supported the service users with individual activity plans when the local day centre closed for several months. One service user described his life in detail. He said he regularly visits local shops, a pub, and cafes. He also enjoys travelling around London and Southern England on public transport. The other service user spoke about her voluntary work as at the local day centre, which she said she enjoys very much, participation in keep fit classes and library visits. Both said how much they valued the high quality care and support that Mr. and Mrs. Carr provide for them. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 12 Lunch was prepared during the inspection and appeared very healthy and tasty. Menus indicated a good balance of home cooked meals, with options available. The service users said they were very happy with the food. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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 and 20 The home ensures that service users health care needs are met, ensuring their wellbeing and quality of life. A risk assessment must be completed if one service user is to be supported to self-medicate. EVIDENCE: Only one service user requires assistance with personal care, which is delivered appropriately by Mrs Carr. All care plans were inspected and were up to date. Health care plans contained evidence of regular appointments with specialist services. Individual health care logs are up to date and maintained. The inspector discussed the need for regular men’s and women’s health checks for service users and they agreed to address this appropriately with the service users. A recommendation is made to cover this. One service user was in hospital at the time of the inspection because of a fall in home. The inspector discussed the situation with Mr. and Mrs. Carr and how they would manage any prospective adaptations necessary when the service user returns home, most likely in a leg cast, which may limit her mobility. All the service users’ bedrooms are located upstairs. A requirement is made that the CSCI be informed of what steps will to be taken to support this service user on returning home. The inspector spoke to a service user who said she had received excellent care and support in the home while dealing with a serious illness. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 14 Medication policies are appropriate and there was evidence that procedures are followed. Medicines are stored in a locked container inside a locked filing cabinet and administration recorded on MAR sheets. Mrs. Carr discussed plans for one service user whom she felt would gain independence from selfmedicating. She said that steps towards self-medication will not be taken without the full involvement of the service user, the CPN and doctor and with the development of risk assessments. A requirement is made that risks be fully assessed and documented. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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 and 23 Service users are protected by the home’s adult protection policies and procedures and by the complaints policy. Mr. and Mrs. Carr have a good knowledge of adult protection. EVIDENCE: The complaints policy and procedure is appropriate and the service user spoken to was aware of the process. No complaints have been received. Mr. and Mrs. Carr are trained in adult protection and have a copy of Enfield Council’s Adult Protection Policy and Procedures. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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, 26, 28, 29 and 30 The overall quality of the environment is good and meets the standard. Service users are provided with a homely and attractive place to live. There may need to be some specialist adaptations made to support a service user who has had a leg injury. EVIDENCE: The home is a comfortable domestic residence. It is spacious and well maintained throughout, with a two large lounges and a kitchen. The service users maintain control over their own rooms. The exterior garden is a welcoming summer living space. The inspector spoke to two service users and visited two bedrooms, which were very personalised and homely. The home is clean and tidy. The laundry facilities are in the garage, accessible from the garden. As referred to under Standard Eighteen, there may need to be some adaptations made to meet the needs of a service user with a broken leg. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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): 31, 32, 34 and 35 Mr and Mrs Carr have the appropriate skills to meet service users’ needs, ensuring that service users know they are cared for by appropriately trained staff. EVIDENCE: Mr. and Mrs. Carr run the home by themselves for most of the year. They are currently exploring options for relief cover or respite in the future. Previously, family members, who were correctly recruited and inducted, have been employed in the past but are no longer available. The home has now received all certificates for the staff who attended fire safety training. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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 and 42 The service protects the service users’ health and safety through maintaining a safe environment and working practices. EVIDENCE: The home is well run by Mr. and Mrs. Carr. Mrs. Carr has now received her Registered Manager’s Award. The home has a simple annual questionnaire for consultation with the service users. The most recent results were examined and were extremely positive. Mr. and Mrs. Carr are trained in fire safety. Small domestic fire extinguishers were identified on the last inspection as being close to their expiry dates. They have been replaced and a fire blanket bought for the kitchen. The gas cooker has had its annual service and gas safety inspection and found to be in good condition and was certificated. The last documented fire drill was successfully held in January 2006. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 2 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 X X 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Old Park Avenue 123 Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000010607.V270000.R01.S.doc Version 5.0 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 YA29 Regulation 14 (2) Requirement The Registered Person must ensure that specialist advice is taken to meet the needs of a service user who has a broken leg and that the CSCI is informed of subsequent steps taken. The Registered Person must ensure that a risk assessment is produced for a service user who may self-medicate. Timescale for action 15/03/06 2. YA18 13 (4) 01/04/06 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 18 Good Practice Recommendations The Registered Person should discuss male and female healthcare checks with the service users and action these as appropriate. Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Old Park Avenue 123 DS0000010607.V270000.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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