Inspection on 27/06/05 for Park Avenue 4

This inspection was carried out on 27th June 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Park Avenue 4 01/05/07

Park Avenue 4 01/08/06

Park Avenue 4 25/10/05

Park Avenue 4 25/10/04

Park Avenue 4 21/06/04

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 4 PARK AVENUE Wood Green London N22 7EX Lead Inspector Georgia Chimbani Announced 27 June 2005 @ 12.15 pm 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 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 Stationary 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. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 4 Park Avenue Address Wood Green, London, N22 7EX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8888 5055 020 8888 5055 Ms Marcia Clarke of Hoffman Foundation for Autism Ms Sharon Diana Martin PC - Care Home 6 beds Category(ies) of LD - Learning Disability registration, with number of places 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25 October 2004 Brief Description of the Service: 4 Park Avenue is a registered care home owned by the Hoffman Foundation for Autism, a voluntary organisation that provides services to meet the needs of people with learning difficulties who may also have autistic spectrum disorders. The home is a large converted house with six bedrooms on the first and second floors and the main communal areas on the ground floor. The premises are not suited to meet the needs of service users with significant mobility disabilities. 4 Park Avenue is walking distance to Wood Green shopping centre and a range of public transport links. Hoffman Foundation for autism also provides a separate day service provision in the adjoining premises. The stated aim of the home is to provide high quality residential service for up to six people with learning disabilities and characteristics that may fall within the autistic spectrum. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was 3 hours and 15 minutes in duration. Present was the registered manager Ms Sharon Martin and other members of staff. As part of the inspection process, the inspector was able to interview 1 service user and 3 members of staff. Interviews were attempted with several service users however discussion was limited due to their limited verbal communication skills and in some cases their reluctance to engage with the inspector. Despite this the inspector is of the opinion that service users are happy, comfortable, safe and well cared for. Part of the purpose of this inspection was to assess compliance with matters identified at previous inspections. 7 requirements were issued following the last inspection. Of these 6 are met and 1 relating to care planning documentation is restated. A further 5 are issued bringing the total number of requirements following this inspection to 6. Requirements issued covered issues such as review and dating of care planning documents, storage of medication, staff training, maintenance of the garden and elimination of offensive odours. What the service does well: The home makes a concerted effort to ensure compliance with requirements issued by the CSCI. Park Avenue is a comfortable and well run home that provides a good standard of care for service users with a range of complex needs. Service users looked happy and well cared for and this was confirmed through interviews with a service user and some staff. All staff at the home have been employed there for over 3 years. Even the bank staff have been working at the home for many years. The low staff turnover helps to give service users a sense of stability and reassurance as their routines are not constantly disrupted by new staff. The living and working environment is very comfortable with a good rapport between service users, management and staff. The manager at the home has been in post since the home first opened five years ago and it is the inspector’s opinion that the home has benefited from her management. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 6 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. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 standard(s) 2 The home is aware of the importance of service user pre-admission information as this ensures that their needs are fully assessed and can be effectively met. EVIDENCE: The home is registered for 6 service users all of whom have lived at the home for at least 2 years. The most recent service user moved into the home in 2003. Due to the length of time service users had been living in the home, the inspector did not request information on service user’s pre-admission assessments. However a discussion with the manager satisfied the inspector that she was aware of the need to obtain pre-admission information before a service user was admitted to the home. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 standard(s) 6, 7 and 9 The home effectiveness of care planning documents is undermined by lack of appropriate dates as this can cause confusion regarding service users’ current needs. Service user’s wishes and decisions regarding their care must be consistently sough to encourage them to be more involved in all aspects relating to their life at the home EVIDENCE: Two service user files were examined. Both files contained care plans that contained evidence of six monthly reviews. Both files also contained “guidelines” that had detailed care plan and risk assessment information on a particular area of need or concern such as toileting and working with a particular service user at night. The manager informed that the guidelines were the day-to-day care planning documents used by staff however these were not dated. In the absence of dates it was difficult to determine how up to date the information was and the length of time between reviews. This was required at the previous inspection and is restated. The inspector noted that both files contained a person centred plan [PCP] that the manager advised was part of the placing authorities requirements. This contained useful information about the service user’s needs and wishes obtained through close consultation 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 10 with them however not all PCPs were fully completed. The manager advised that this was a process that took place through a series of several meetings over a process of several weeks. In the absence of sufficient information showing service users’ wishes and decisions relating to all aspects of their care, a requirement is made regarding this. The registered person must ensure that service user’s wishes and decisions regarding their care are sought and recorded. Due to the limited levels of verbal communication and the reluctance of some service users, the inspector was only able to have a detailed discussion with one service user. They told the inspector very confidently that they were happy and well looked after at the home. Through observation the inspector noted that staff appeared to have a very rapport with service users and seemed to be very knowledgeable about their individual needs. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 standard(s) 14, 15, 16 and 17 Service user dietary needs and tastes are well catered for by the home and menu options are presented in a pictorial format that encourages service users to make informed choices on what they would like to eat. The home supports service users to engage in a variety of activities in the home and in the community and to maintain a regular network of friends and family. EVIDENCE: There was detailed documentary evidence indicating the range of activities that service users were involved in. The inspector was shown a daily shift plan that shows the names of all the staff on duty and the work or activities that they would be doing with an individual service users. If the activity does not take place staff must record the reasons why. The information in the daily shift plan is linked to the information contained in the service user’s weekly activities programme. The manager advised that this is tailored to individual tastes and reviewed when there are changes. Activities recorded include art, eating out, shopping, pub visits, cinema and trips in the home’s van. At the commencement of the inspection there were no service users at home however as the day progressed they arrived form various activities such as shopping trips and daycentres. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 12 Discussions with staff revealed that all of the service users have regular contact with their families. This was confirmed through examination of the visitor’s book and staff daily records. Service users are encouraged to be involved in household tasks such as preparing meals and cleaning and tidying the house. The home uses communication boards where pictures are used to show the activities that service users will be involved in on a daily basis. The inspector observed a service user who had just returned from a shopping trip confidently preparing lunch with support from a member of staff. The home has a 4-week set menu [with picture aids] with options for individual service users to take it in turns to make meal choices for everyone. Service users who do not like the meal selected still have the option to make their own choices. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 standard(s) 20 The home has stringent medication practises and safeguards however internal and external medication must be stored separately to minimise the potential risk to service users. EVIDENCE: There are no service users self-administering medication at present. The manager advised that medication training is required for all staff working in the home and all staff have received this training. A weekly supply of medication is picked up from the pharmacy by staff that then check and sign to ensure that the medication collected is correct. There is also a weekly check carried out by a member of staff to ensure that medication practises are being followed. Records of medication returned to the pharmacy were seen and the member of staff returning the medication and the pharmacist had signed these. Temperatures are maintained of the area where medication is stored. The inspector noted that internal and external medications are currently stored in the same box. These must be stored separately to avoid the risk of cross contamination in the event of leakages. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 standard(s) 22 and 23 Regular service user forums ensure that service users have a formal channel through which their concerns can be expressed and resolved. Lack of staff training in adult protection leaves service users vulnerable to harm and abuse. EVIDENCE: Following the last inspection the home has received one complaint. The inspector viewed the complaints record and noted that the complaint had been appropriately recorded and following investigation had been substantiated. The manager explained that the home holds user forum meetings every 3 months and at the Hoffman Foundation for autism head office every 6 months. These meetings encourage service user participation and provide a forum where issues of concern can be discussed and addressed. The inspector held a group discussion with three members of staff. They confirmed that they had not received adult protection training. When asked what they would do if they observed or received allegations of abuse they all agreed they would speak to the manager of the home. The registered person must ensure that all staff working in the home receive training in adult protection. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 standard(s) 24, 26, 27, 28 and 30 EVIDENCE: At the previous inspection a requirement was made for repairs to be made to broken furniture and fittings in a named service user’s room. The inspector inspected this bedroom and observed that it was sparsely furnished with a bed, desk, chair, a television and radio. The manager explained that the room was sparsely furnished in accordance with the service user’s wishes, as they would destroy any furniture or fittings that they did not like. This was recorded on the service user’s care plan. While touring the rest of the home the manager pointed out areas identified at the last inspection that had been addressed such as replacement of tiles in the top bathroom and glass on a kitchen door. The inspector noted that a chair in a named service users room on the top was stained and required cleaning or replacement. The home has a large garden at the rear but maintenance work such as trimming the hedges and racking of leaves is required to make it more pleasant and welcoming. While the home is comfortable and safe it is very sparsely decorated. The manager explained that this was because a service user would get agitated and destroy decorations such as pictures and when this occurred other service users were placed at risk 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 16 of injury. Despite the obvious constraints of decorating communal areas, service users are able to decorate their rooms according to their tastes. A service user was keen to show the inspector their room. They stated it was very comfortable and decorated in their favourite colour. They explained that they hoped to have it repainted soon in a different shade of their favourite colour. The offensive odour detected in a service user’s room at the last inspection had been eliminated however a smell was detected in another service user’s room on the top floor. The manager advised that this was due to the service user using the washbasin in their room inappropriately. The manager was confident that if the washbasin were removed it would encourage the service user to use the toilet facilities. A requirement is made requiring the registered person to ensure that offensive odours in a named service user’s room are eliminated. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Standard 35 was not assessed on this occasion. This will be assessed at the next inspection, as it is a key standard to be inspected at least once during a 12-month period. EVIDENCE: Not applicable 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 Through regular checks and detailed record keeping the home has shown its commitment to safeguarding the health and safety of service users. EVIDENCE: At the previous inspection the registered person was required to ensure that the provider organisation conducts monthly unannounced visits to the home. Reports of these visits must be kept in the home and a copy sent to the CSCI. The inspector confirmed that reports of these monthly visits were being sent to the CSCI. There was no evidence of fire doors wedged open in the home and a door that was in the past regularly wedged open had been fitted with a magnetic door holder linked to the fire alarm. The manager advised that all staff have received training in health and safety, first aid and food hygiene. Each week a different member of staff is assigned the responsibility of completing a health and safety check list. This ensures that all health and safety checks are completed and up to date. Records confirming these checks were seen by the inspector. 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 3 3 3 x 2 Standard No 11 12 13 14 15 4 PARK AVENUE x x x 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x Version 1.20 Page 20 G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 21 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. Standard 6 and 9 Regulation 15(2)(b) Requirement The registered person must ensure that all service user plans including guidelines for supporting service users are reviewed at least six monthly and are dated. [previous timescale of 7/1/05 not met] The registered person must ensure that service user’s wishes and decisions regarding their care are sought and recorded. The registered person must ensure that internal and external medication is stored separately. The registered person must ensure that all staff working in the home receive training in adult protection. The registered person must ensure that the chair in a named service users room is cleaned or relaced and maintenance work is carried out in the garden. The registered person must ensure that the offensive odour detected in a named service users room is eliminated. Timescale for action 27/8/05 2. 7 12(2) 27/9/05 3. 4. 20 23 13(2) 13(6) 27/8/05 27/9/05 5. 24 23(2)(d) (o) 27/9/05 6. 30 16(2)(k) 27/9/05 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 22 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 Good Practice Recommendations 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 23 Commission for Social Care Inspection North London 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 4 PARK AVENUE G59 S10748 Park Avenue V221515 27.06.05 Stage 4.doc Version 1.20 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!