Inspection on 28/11/06 for Old Park Avenue 123

This inspection was carried out on 28th November 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

Old Park Avenue 123 13/11/08

Old Park Avenue 123 13/02/06

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 Key Unannounced Inspection 28 November 09:00 Old Park Avenue 123 DS0000010607.V308950.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 Old Park Avenue 123 DS0000010607.V308950.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. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 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 (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th February 2006 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. Fees for the home are £400 - £600. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 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. Both service users were at home during the inspection and the inspector spoke to them. The inspection comprised a tour of the home and inspection of service user’ and general home records. Comment cards were received from both service users. What the service does well: What has improved since the last inspection? What they could do better: An out of date wheelchair needs replacing. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Old Park Avenue 123 DS0000010607.V308950.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 Old Park Avenue 123 DS0000010607.V308950.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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective service users can be confident that their needs will be appropriately assessed and that they would be given the opportunity for a trial visit to see if the home matches their expectations. EVIDENCE: There have been no new admissions to the home since the last inspection but the home has good admission policies and procedures in place. The current service users have lived there for several years and the placing authority regularly and thoroughly reviews their care. One long term service user died of a terminal illness earlier this year. Mr. and Mrs. Carr were her main support people when she was in hospital and were with her continuously up until the time of her death. Old Park Avenue 123 DS0000010607.V308950.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 and 9 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users’ individual needs and wishes are respected and met, which enables them to live independent and fulfilling lives. EVIDENCE: The care plans for the two current service users were inspected. They are very well structured and have been regularly reviewed. Mr. and Mrs. Carr work with the service users to set new goals regularly and support them to meet these goals. One goal, to support a service user self medicate, was discussed and fully planned with the service user, but was not actioned because the service user sadly died. The daily notes for the service users are of a very high standard and reflect their needs and actions taken to meet these needs. These notes are comprehensive and of a standard that larger and better resourced homes could model. Service users spoken to were very positive about the care and support they receive and said they were able to exercise their choices and take control of their own lives. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 10 Old Park Avenue 123 DS0000010607.V308950.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): 12,13,14,15,16 and 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users have ongoing opportunities to lead active lives at home and in the community, as they choose. They are support to maintain their relationships and networks and are provided with excellent meals. EVIDENCE: The inspector spoke to the two service users about their daily lives. Their schedules are documented in care plans. One service user also sung a Christmas carol to demonstrate his love of music and to convey Christmas wishes. One service user goes out into daily and travels to different part of the country to visit friends and family regularly. He is a voracious reader and a film buff: he makes extensive use of local libraries and goes to the movies regularly. He said he was looking forward to seeing the new James Bond film. The home subscribes to a DVD/video library that delivers films. The other service user generally accompanies Mr and Mrs Carr during the day out and about in the community, including to visits to local and West End Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 12 attractions. She also pursues home based activities, which presently includes making Christmas cards and other Christmas items. Mrs. Carr said that the service user enjoyed gardening and the home intends to support her to participate in a garden centre activity project in the locality. Menus were inspected. The food is fresh, nutritious home cooking and both service said that they enjoyed the food very much and also had choices and input into what is offered. Old Park Avenue 123 DS0000010607.V308950.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, 21 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home ensures that the service users’ healthcare, physical and emotional needs are met, to support their wellbeing and quality of life. This includes providing support for service users who are dying. EVIDENCE: One service user receives personal care from Mrs. Carr and she was clear that this arrangement worked well for her. Care plans contained evidence that the home is providing excellent support for the service users’ health needs in a proactive manner. Specialists are involved regularly, as and when required. This was particularly the case for the service user who died earlier this year. Another service user has asthma and Mrs. Carr described how they work to maintain her wellness and prevent asthma attacks. Mrs. Carr said that they have discussed options for male and female health checks with the service users. One service user chose not to have a check-up but the other service user is booked for a check-up. Adaptations were made to the home to support a service user who had a fall and broke a leg and risk assessments were completed appropriately. This service user suffers from osteoporosis and requires a wheelchair when going Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 14 out. This wheelchair is old and no longer adequate for the service user’s needs and a requirement is given to replace it. One service user, whom the home had supported through a serious illness, died since the last inspection. Mr. and Mrs. Carr provided kind and dedicated support to her through the dying process, both at home and in the hospital. Medication policies and procedures are appropriate and adhered to. Medications are securely stored and MAR sheets are kept accurately. A risk assessment completed for one service user to self medicate was not needed because the service user died. The home has a close and supportive relationship with the local pharmacy. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are well protected by the home’s adult protection policies and procedures and by their complaints policy. Mr. and Mrs. Carr have a good knowledge of adult protection and are currently supporting a service user through an adult protection procedure. EVIDENCE: The complaints policy and procedure is appropriate and the service users are aware of what to do if they wish to use it. Mr. and Mrs. Carr are trained in adult protection and have a good understanding of how to support the service users in this area. One service user is currently being supported by the home while an adult protection process is underway. Mr. and Mrs. Carr were able to describe in some detail how they understand and implement adult protection procedures and act as service user’ advocates. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 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 and 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The service users live a homely environment that is kept to a very good standard. EVIDENCE: The home is comfortable domestic residence. It is spacious and well maintained throughout, with two large lounges and a homely kitchen. The service users have their own attractive rooms, which overlook the large garden. One service user showed the inspector his room, which is highly personalised. He now has TV/DVD/video machine that he is very pleased with. The service users’ rooms and the hallway have been repainted. The home is kept very clean and tidy. The laundry facilities are in the garage, accessible from the garden. Old Park Avenue 123 DS0000010607.V308950.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 and 35 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is well run to meet the service users’ needs. Mr. and Mrs. Carr are well resourced and able to focus on these needs. They would still benefit from having a back-up respite option when they need a break. EVIDENCE: Mr. and Mrs. Carr run the home by themselves. To date, options for respite care for the service users remain limited and the home does not have adequate cover for holidays. No new relief staff have been recruited to provide cover if required. An adult protection issue is under investigation coordinated by Enfield Council’s Social Services Department, who are acting to protect the rights and interests of one service user. Staff training is currently up to date and appropriate to the scale of the home. Old Park Avenue 123 DS0000010607.V308950.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 and 42 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. This well run home protects the service users’ health and safety. Service users are fully involved in issues affecting their own lives and have mechanisms for feeding back their views and wishes. EVIDENCE: The management of the home is well matched to its scale and to the service users’ needs. The home is run primarily for the service users’ benefit and they are consulted informally and formally to ascertain their wishes and views. The home has excellent record keeping and systems for safely supporting the service users with their finances. Electrical and gas safety certificates for the home were up to date and no issues were identified for improvement. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 19 Fire safety is well maintained: fire drills are held regularly and the service users participate in these. A fire blanket and up to date fire extinguisher are kept in the kitchen. Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 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 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 3 3 3 X 3 3 3 3 x Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 21 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 YA19 Regulation 13(4) Requirement The Registered Person must ensure that a new wheelchair is obtained for a service user who needs it. Timescale for action 28/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Old Park Avenue 123 DS0000010607.V308950.R01.S.doc Version 5.2 Page 22 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.V308950.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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