Inspection on 24/02/09 for Park Avenue

This inspection was carried out on 24th February 2009.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Park Avenue 09/10/06

Park Avenue 06/09/05

Park Avenue 05/04/05

Park Avenue 26/10/04

Park Avenue 11/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Park Avenue 74 Alexandra Road Farnborough Hampshire GU14 6DD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter McNeillie     Date: 2 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Park Avenue 74 Alexandra Road Farnborough Hampshire GU14 6DD 01252547882 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): parkgroup.churchcircle@btopenworld.com Mr Lawrence Alexander,Mrs Diane Alexander Name of registered manager (if applicable) Sarah Mary Guilfoyle Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 12 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category; Mental disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Park Avenue is privately owned and managed care home registered to provide care, support and accomodation for up to twelve clients with mental health disabilities and associated behavioural support needs between the ages of 18 to 65 years. The home is part of The Park Group that operates other residential homes and an outreach service mainly in the Farnborough area. Care Homes for Adults (18-65 years) Page 4 of 29 care home 12 Over 65 0 12 Brief description of the care home The home is located in the North Hampshire town of Farnborough with easy access to local shops,community ammenities amenities, public transport (both train and bus) and the M27 motorway as well as towns of Aldershot and Guilford. The building is a three-storey domestic detached house built in the late 1990s, comprising of twelve single bedrooms one with en-suite. One of the single rooms provides an independent flat facility on the second floor. The homes communal space comprises of one lounge and separate dining room and a conservatory. There is a mature garden laid mainly to lawn and parking is available at the rear of the premises. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: As the persons being accomodated in this service prefer to be known as clients we will use this term in respect of our findings throughout this report. This report was written after taking into consideration a number of sources of evidence and information including a site visit to the premises,and sampling clients and staff training and recruitment records. We talked with clients, staff and management and received a response by the manager to a pre inspection Annual Quality Assurance Assessment. (AQAA). and responses by staff and clients to a CSCI pre inspection satisfaction survey. Care Homes for Adults (18-65 years) Page 6 of 29 During this inspection which took place on 06/03/09 between the hours of 10.00 am and 1.15 pm we were assisted in the absence of the Ranager by the senior member of staff on duty and the Registered Manager of the next door sister home. The Manager was spoken to by telephone following our visit. The results and findings contained in this report will determine the frequency and type of future inspections. The fees at the time of our visit ranged from four hundred and eight pounds to eight hundred and sixty four pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a system of assessing and identifying clients needs which ensures clients safety and that their assessed needs can be met. Evidence: There have been no admissions since the last inspection at which it was found that clients were only admitted in accordance with pre admission policy and procedure. This requires a detailed written assessment of need and risk being carried out by a member of the homes management team in consultation with the prospective client which should take into consideration the clients care, nutritional and communication needs, wishes, choices,aspirations as well as any present or potential risks. As part of the admission process management also liaise with external health and social care professionals regarding any care needs, risks, equipment and aids, that Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: need to be considered and included when developing a plan of care. Potential clients also visit the home to satisfy themselves the service can meet their needs and meet other clients whose views are also canvassed about any new admission. Records also confirmed ongoing assessments of need and risk for all residents are carried out on a regular basis and care plans (Section 7-11 of this report refers) updated to reflect any changes. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear and consistent care planning system in place, which ensures clients needs are met within a risk management policy that involves clients in decisions that affect them. Evidence: After talking with the staff and clients we formed the view that staff saw themselves more as supporters and enablers not carers and were there to assist residents in achieving their personal goals, aspirations and independence within a risk taking framework. A view with which the residents and staff agreed. Our views were reached following our observations and after reading four clients care/support plans chosen at random. All plans contained details on how assessed needs were to be met , how any risks were to be managed and confirmation that clients were consulted when the plan was formulated. In some cases clients wrote the plan themselves. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: All of the spoken spoken with confirmed they were aware of and had contributed to their own care plan (A copy of which they were offered and had received if requested) are capable of looking after themselves with regard to day to day personal care. It was clear to us that clients were masters of their own destiny and were totally responsible for the success of the placement. Clients right, and the opportunity to take risks is seen as fundamental and essential in their path to independence. Clients were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. Should any risk assessment indicate any type of restriction be called for this would not be implemented without the full consent of the client. To demonstrate their commitment to issues of diversity, in their AQAA completed by the manager we were told the home Practise person centred care where the individual is the central focus and any areas of diversity which impact upon them are addressed The community has a range of different religious places of worship or an appropriate member of the religion would be welcomed into the home We pride ourselves on having a mixed workforce from various backgrounds Policies and procedures are continually adopted and adapted within the care home Pre- admission documentation addresses dietary needs to ensure the home complies with any religious or personal beliefs. Ageist attitudes within the home or professionals entering the home would not be tolerated by either staff working within the home or professionals entering the home Care of dying policies and procedures properly take into account both the wishes of the patient and any religious observations of his/her religion Continue to work with all employees and take on board their comments regarding their workplace Continue Annual review of policies and procedures Maintain our Equal Opportunities monitoring system which compares our ethnic composition with local demographic area. We are maintaining our protocol of changing working practices to meet the equality and diversity needs of new patients as identified during the pre-admission assessment We continue to promote mental health in a positive light We have compiled a list of leaders/places of various faiths; local minority groups which relate to equality and diversity issues; and other access agencies within the area. Care Homes for Adults (18-65 years) Page 13 of 29 Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social activities family, contacts and the provision of varied and nutritious meals were well managed and reflected clients interests and choices. Evidence: Any decision taken that affects individuals always seeks to empower the individual by taking into consideration their choices, wishes, aspirations and need for independence. The above was reflected in the manner in which the home is run and day to day life conducted. This is in line with the staffs perception of themselves as enablers first and carers second. Clients spoken with told us during our visit and in a CSCI pre inspection survey, they liked living in the home, were treated with respect, could do what they chose and were Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: encouraged to gain their independence. comments such as The staff are great,could not be better,The best I have ever been in were typical the comments we received from clients. A visiting social care professional told us they were Totally satisfied with the service their clients received and Had never had any problems in their dealing with the home or its management. We were informed all clients had been offered the services of an independent advocate but all had declined. Monthly Residents meetings where any matters that affect living in or the running of the home are discussed including choosing the daily menus for which clients participate in food shopping and cooking. All clients spoken with said they were satisfied with the food the manner in which it was served and the flexibility of meal times that took into consideration their day to day arrangements and appointments. Clients are encouraged to chooses and arrange their own social activities with help, support and encouragement from staff in particular to access the local community. Family and friends who can also be entertained in the house by individual clients as long as it does not interfere with the others living in the home. During our visit we observed clients coming and going out in one case shopping by themselves for clothes and a gift for a friend. The range of activities currently being undertaken include, painting, board games, art, craft, baking, cooking, music, shopping, pubs and going to various clubs, dining out cinema etc. at the time of our visit at least one client was involved in voluntary work in a sister home. To assist clients even more we were told staff are in the process of compiling a local directort of facilities in the area. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of clients are met. Evidence: For most of the time clients are independent with regard to their personal health care needs and only require prompting with regard to personal hygiene. Should assistance is required staff and management informed the inspector this would be delivered in private, this was confirmed by residents who told us they could take care of themselves. Clients informed us were able to see the doctor of their choice or any other health and social care professional when they needed to. The records viewed indicated that apart from care managers, doctors, district nurses, community psychiatric nurses, the community mental health care team and the mental health home treatment team other specialists would be consulted as required. Records were kept of appointments with GPs, dentist, optician, chiropodist and any Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: other external health and social care professional and included details of any advice and treatment given. A policy and procedure is in place to enable clients who wish and are able to be responsible for their own medication following a risk assessment. Currently no clients are self-medicating. Cients spoken with informed us this was their choice. All drugs, which are dispensed by a pharmacist, are securely stored, administered, disposed of and recorded in accordance with an in house medication policy and procedure by trained staff. The pharmacist also visits the home to give advice and carry out regular audits to ensure all drugs and medicines are being stored, administered and recorded safely. Records of administration and disposal of unwanted drugs and medicines viewed were complete and accurate. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse. Evidence: The complaints procedure, which is also included in the service users guide, the house meeting folder and is displayed included information on how to contact The Commission for Social Care Inspection (CSCI), was seen, as was the record of complaints. No complaints have been received by CSCI since the last inspection. All clients and members of staff spoken with of stated they felt confident in discussing any concerns, complaints with management either in house or external. Staff also felt they could raise any issue on behalf of any client and were confident any matters raised would be dealt with promptly and fairly. The homes corporate adult protection policy is works in tandem with the procedure produced by Hampshire County Council, which is based on National Guidelines and the document No Secrets and is designed to safeguard residents from abuse. Management and staff who were spoken with confirmed they had all received training in recognizing various types of abuse, this was confirmed by records viewed. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: All were able to demonstrate they knew the procedure to follow should they witness or suspect the abuse of any resident. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, well maintained, clean and suitably furnished home is provided for clients which meets their needs. Evidence: The home is situated in a pleasant residential area in Farnborough close to public transport (Bus and rail), shops and other community amenities. At the time of our visit the doors and woodwork in the entrance hall were being painted as part of a full programme of decoration involving thewhole house in accordance with a rolling maintenance and repair programme. Furniture was comfortable, homely and in a good state of repair, in keeping with the decor and met clients individual and collective needs. All of the clients who confirmed the home is always clean and smells fresh are accommodated in single rooms which they can personalise to suite their own tastes. All communal areas were accessible by clients including the garden which is shared with the next door sister home. Care Homes for Adults (18-65 years) Page 21 of 29 Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clients needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all clients. Evidence: In our view, with which clients agreed, was that at the time of the inspection staff numbers and the deployment of staff was sufficient to meet their needs. As reported earlier in this report clients care needs were for most of the time nil, and staff were available only for support and guidance. This clearly has an effect on the number and deployment of staff. The planned staffing level for the home is two staff at all times at all times during the day and evening and one staff awake in at night plus telephone back up for emergencies. We were also informed us staffing could would be raised if clients needs increased. As part of this inspection, we viewed four staff recruitment and training files selected at random. In the absence of the manager the confidential recruitment the registered manager of the neighbouring home accessed files for us. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: All files viewed included evidence that staff are employed in accordance with a robust equal opportunities recruitment, and selection procedure, which is designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment, records seen confirmed that all staff are subject to an in house induction and a training programme that include first aid, handling medication, food handling, moving and handling, safeguarding and infection control as well as other training required to equip them to do their job. Details of all staff training is held on a comprehensive matrix that also includes dates for training to be updated. Following completion of their induction programme All staff are expected to undertake a National Vocational Qualification N .V. Q.) Course. Information provided indicated that 25 of staff has been trained to at least NVQ level 3 with a further 62.5 either on a course or due to start a level three course. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought through their representatives. Evidence: From the evidence see, and comments by staff and clients we were satisfied that the service is well managed by The Registered Manager who has a number of years managing services for persons with a mental health support needs and is qualified to National Vocational Qualification level in care and management at level four. The registered manager also has an organisational lead for training at which staff and other senior staff described her as Brilliant. Comments made by clients confirmed they can speak to the manager and all care staff at any time and they are always willing to listen and give them time. This view that was also echoed by the staff who described the manager as available and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: approachable. Staff also that confirmed that there is a clearly defined management structure operates an open door policy, and encourages them to share any concerns or ideas they have for the betterment of the service. It was also evident from our observations that the manager has enthused the highly motivated staff team who were all fully aware of there responsibilities, worked within clear lines of accountability and guidelines and recognized and promoted the ability of the individual clients not the disability. As part of the homes quality monitoring system, clients, clients representatives and health and social care professionals staff and social care professionals are invited to participate in satisfaction surveys the results of which are seen as key in highlighting areas that may require improvement or attention and the future development of this service. A health and safety policy was in place as were records of health and safety checks, the servicing of equipment, staff training in the techniques of moving and handling, first aid, health and safety, infection control, the procedures to follow in the event of fire (including evacuation) and accidents. We were informed that the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all hot pipes and where radiators were covered to protect clients from burning. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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