Inspection on 05/04/05 for Park Avenue

This inspection was carried out on 5th April 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 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 24/02/09

Park Avenue 09/10/06

Park Avenue 06/09/05

Park Avenue 26/10/04

Park Avenue 11/06/04

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

CARE HOME ADULTS 18-65 Park Avenue 74 Alexandra Road Farnborough Hampshire GU14 6DD Lead Inspector Isolina Reilly Unannounced 5 April 2005, 1 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. Park Avenue Version 1.10 Page 3 SERVICE INFORMATION Name of service Park Avenue Address 74 Alexandra Road, Farnborouih, Hampshire, GU14 6DD 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) 01252 547882 Mr Lawrence Alexander & Mrs Diane Alexander Mr Lawrence Alexander CRH 12 Category(ies) of MD (mental disorder), 12 places registration, with number of places Park Avenue Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Service users are not to be admitted under the age of 18 years. Date of last inspection 26 October 2004 Brief Description of the Service: Park Avenue provides care for up to twelve male and female younger adults with mental health disabilities and associated behavioural support needs between the ages of 18 to 65 years. Mr and Mrs Alexander own the home and Mr Lawrence Alexander is the registered manager and is supported by a deputy manager. Mr And Mrs Alexander own the ‘Park Group’ of services that consist of Park View, Park Way and Park Avenue homes and an ‘outreach service’. The home is located in Farnborough with easy access to local shops and other amenities. The home is on a main bus route. The building is a three-storey domestic detached house built in the late 1990’s, comprising of twelve single bedrooms one with en-suite. One of the single rooms provides an independent flat facility on the second floor. The home’s communal space comprises of one lounge and separate dining room, a conservatory area and a further conservatory next door at Park Way provides a smoking area. There is a mature garden laid mainly to lawn and parking is available at the rear of the premises. Park Avenue Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. On the day of the inspection, the opportunity was taken to look around the home, view records and talk to service users and staff. Most of the service users were seen during the inspection and several were spoken with. Several staff were also spoken with. There were several residents from Park Way Outreach Service who visit the home who talked to the inspector about the home. What the service does well: What has improved since the last inspection? The decoration and furnishings are being gradually improved and many areas within the home are now looking better. Park Avenue Version 1.10 Page 6 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. Park Avenue Version 1.10 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 Park Avenue Version 1.10 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 and 5 The home’s procedures are very good for admitting service users on the basis of a full assessment. This makes the experience for individuals welcoming, informative and understandable. EVIDENCE: The deputy manager explained to the inspector that the home’s statement of purpose and service user guide is in the process of being reviewed and up dated. Three service users explained that they visited the home at various times and enjoyed the meals they had before they choose to come and live at the home. They all said that this made it easier for them to settle in and everyone made them very welcome. They also remembered having an interview with the manager so he could find out what help they would need and their likes and dislikes. One service user found being shown around the local area and being talked through the home’s rules was very helpful. All the service users spoken with said that the staff patiently explained the contract and cost of staying at the home before they signed it. The staff spoken with confirmed this. The inspector was able to look at three contracts and found them to be satisfactory and signed. The inspector was able to view the admission records of three service users Park Avenue Version 1.10 Page 9 and found that they contained the information needed to look after the individual. There were also copies of the health care professionals and social services records outlining what the individual aspirations and how the home should look after them. Park Avenue Version 1.10 Page 10 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 staff have a good understanding of service users’ support needs, aspirations and promotion of independence that is backed up by a good system for recording information that involves the service user fully. EVIDENCE: The inspector was able to go through three service users records with them present. The service users were all familiar with the records and their signatures were seen throughout the records. The individual records were clear and the service users confirmed that they are regularly assessed by their Key Worker to see how they progressing. Two of the service users explained that they are encouraged to think of doing new things like attending college, day centres and look for jobs. On reading the care plan with the service user they confirmed that they reflected their main issues, desires and wishes. The records seen also held records of risk assessments and service users abilities. The staff spoken with confirmed that they had had training on how to write care plans and risk assessment putting the service user first. So that the Park Avenue Version 1.10 Page 11 service users can be helped to make their wishes, desires and ambitions become a reality in a safe and enjoyable way. One service user explained that there is limit of one drink a day because of a previous problem with drinking and drugs. The staff spoken with confirmed that limitations are sometimes necessary to ensure the service user’s safety or that of others. However, the limitations are discussed and recorded with the service user and at the care reviews that are attended by the service user, family health and social services representatives. The inspector observed that staff and service users interacting well to each other and the service users stated that they feel respected. Park Avenue Version 1.10 Page 12 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) 12, 13, 15, 16 and 17 The home has a supportive and service user led ethos that develops and maintains daily living skills including social and leisure activities. The service users are fully involved in the provision of nutritious variable meals of their own choose that develop individual skills, confidence and is part of the empowering and rehabilitation aims of the home. EVIDENCE: The service users spoken with explained that they each have a weekly programme of activities that the staff support them to plan. This plan was seen in the records. The plans seen had activities such as visits to the gym, going out for walks attending local social clubs, food and clothes shopping, going to creative response clubs and activity centres. One service user enjoys writing poetry and has written a cookery book. All the service users felt that the routine within the home is dictated by their own schedules and likes. They explained that the staff are very flexible about the daily routine. Park Avenue Version 1.10 Page 13 One service user stated that she was looking forward to going out with a friend. Another service user says that she enjoys going out with her mother who come to the home. In the records it was noted that a service user was going away to stay with a friend for three days. The individual confirmed that she had arranged the trip and was looking forward to going away. The staff spoken with confirmed that the service users are encourages and supported to make new friends and join in the local events. The service users spoken with explained that they decide and plan their own meals, go shopping weekly for food and cook their own meals. One service user explained what she was cooking her evening meal from raw ingredient and was proud of her culinary skills. The staff confirmed that all service users within the home choose and plan their own meals with the support of the staff if this is necessary. Records of food prepared by service users are kept on their individual file. The records showed that the food was varied and nutritious. The staff explained that some service users require more prompting than others but most will need some prompting to ensure that balanced and healthy meals are eaten. The home pays for the food bought by the service users and they get a weekly budget to shop with. The staff monitor the shopping receipts closely. Park Avenue Version 1.10 Page 14 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) 18 and 19 The personal support, health and emotional care in the home is offered in such a way as to promote service user independence, privacy and dignity. EVIDENCE: The staff spoken with confirmed that several service user need to be reminded and prompted to get out of bed in the morning and to shower or bath regularly. This was seen in the records sampled. Two of the service users spoken with stated that they look after themselves and do not need staff to help them to wash and dress, although one service user said that sometimes when she is not well the staff will let her know when she needs a bath. The service users spoken with confirmed that they are able to call their doctor at any time or if very unwell will ask staff to call them. One service user explained a recent medical problem experience where she had to go to hospital to have treatment. All the service users spoken with had recently attended either opticians and/or dental appointments. The home is situated on a main bus route and the service users spoken with confirmed that they also have the use of the home’s car and staff will drive them. The records seen had information on individual medical visits and other appointment letters. Park Avenue Version 1.10 Page 15 Park Avenue Version 1.10 Page 16 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 The staff have an excellent knowledge and understanding of Adult Protection issues that protects service users from abuse. The home has very open and positive approach listening to service users views and improving. EVIDENCE: All the service users were very clear how and to who to complain to if they are not happy. They all stated that the staff are very good and always listen to individuals concerns. The home also holds regular ‘house meetings’ were the service users get together to discuss issues within the home. The inspector saw a poster on how to complain up at each notice board within the home. This poster included the address for the Commission and that all complaints will be dealt with promptly within 28 days. The home’s complaint records were not seen on this visit. However, the staff spoken with confirmed that the complaints log is kept up to date. The staff had a very positive attitude towards complaints and stated that they see them as a way of improving things and an opportunity to look at the way things are done with a view to improving them. The staff confirmed that they receive training in Abuse of vulnerable adults. There has been no allegation of abuse at this home. The staff suggested that they wish to look at calling their training ‘Protection of Vulnerable Adults rather than Abuse to use the same terminology as the Hampshire County Council policy and procedure that was found in the home’s office. Park Avenue Version 1.10 Page 17 The inspector was able to read the home’s policy and procedure on the ‘Protection for Vulnerable Adults’ and found that it informative and follows the Hampshire County Council one. Park Avenue Version 1.10 Page 18 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 and 30 The home presents as a clean, homely, comfortable and suitable environment for the service users. The standard of the décor within the home is very good with evidence of improvements through maintenance and future planning. EVIDENCE: The service users stated that the home is looking nice and fresh from the recent painting. The staff confirmed that the lounge, upstairs and bedroom two have been redecorated. They like the home and all were very happy with their rooms. Three of the service users stated that they help with the cleaning of the home and have certain tasks they do weekly like vacuuming and polishing. They feel the home is always clean and mostly tidy. The inspector was able to look around the home and viewed most of the bedrooms. There was one room that had a slight unpleasant odour. The staff member that was showing the inspector around explained that they are working on improving the individual’s personal hygiene and this is an on-going issue. The home is planning to refurbish the kitchen this year. Park Avenue Version 1.10 Page 19 The Environmental Health Officer last visited the home in June 2004 and the home had been awarded a four star rated certificate that was displayed at main entrance of the home. During the tour of the home the inspector noticed that all the communal hand sinks have liquid soap for washing hands and disposable paper towels. The staff spoken with include a new member of staff confirmed that they have had recent training in ‘infection control’. They also have had training in the safe use of chemicals for cleaning and the importance of hand washing. Park Avenue Version 1.10 Page 20 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) 33, 34 and 35 The staff morale is high resulting in an enthusiastic workforce that is skilled, knowledgeable and works positively with service users to improve their whole quality of life. The home has an excellent ethos towards developing staff as individuals and this is reflected in the service users feeling safe and comfortable at the home. There is a need to ensure the homes recruitment procedures are fully implemented and ensure that the level staff on duty does not put the service users at risk. EVIDENCE: On the last inspection, the staffing levels and shift patterns were discussed to ensure that sufficient staff are on duty at the most busy times of the day. The duty rota was seen on this visit for the months of April and May 2005. The rotas showed that there were times when only one member of staff is working. However, the staff spoken with said that this is often for a few hours only. The service users who assisted the inspector on this visit said that there was always enough staff to look after them and that they felt safe. The introduction of a risk assessment process to ensure that the number of staff on duty is sufficient to ensure the safety of staff and support for service users to meet their aspirations in safety was recommended. The staff felt this Park Avenue Version 1.10 Page 21 was a good idea and the deputy manager stated this would be discussed at the management meeting and system will be implemented. The staff felt that the recruitment process within the home is thorough. The service users also confirmed that they are asked their opinion on new staff coming to look around and have put together interview questions for the manager to ask at interviews. The inspector was able to seen three different staff records and found that they were detailed and that most of the checks had been taken to ensure staff are fit to work at the home. However, it was noted that one of the staff had recently started working without references so the home was unable to check that this staff member is fit to work at the home. Another staff member is an overseas student and the deputy manager was aware of the restricted hours of working for this person as set out by the Home Office. A new member of staff stated that he has found his induction very useful; as this is the first time he has worked in care. The induction was very intense and practical and is part way through the Care Skill’s Council induction training. The home’s training records show that the home has training done by staff and management with specialist skills and also various external training courses. The staff confirmed that they undertake training regularly and that most of them have achieved a care qualification since working for Park Group. The home has a positive supportive ethos to staff training and carer development. The training records seen showed that courses that are aimed at ensuring safe practices and environment increase knowledge and skills of staff regarding mental health illness, general principles of care and supervision and management skills. Park Avenue Version 1.10 Page 22 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) 37 and 42 Service users benefit from a positive and inclusive ethos within the home. There is a clear leadership with a supportive management approach. The home is well run ensuring the safety of service users. EVIDENCE: The service uses spoken with all expressed their liking for the managers finding them approachable and always available when you want them. One service user describe the managers as ‘compassionate but to the point.’ The staff said that the management were open, positive and inclusive. All the staff felt very supported. One service user confirmed that the gas boiler repairman had recently been around and that equipment is repaired and maintain around the home. The inspector was able to seen the maintenance certificates for the home’s electrical and gas systems and appliances demonstrating that the home is maintained. Park Avenue Version 1.10 Page 23 The home has a system of testing the fire alarm weekly. All the service users state that the staff do set off the alarm to ensure that it is working. They also said that sometimes the alarm goes off and everyone has to go outside, although there is no fire. The staff explained that the evacuation undertaken by the home include the service users. The inspector was able to view records that confirmed that the home has tested the fire alarm, undertaken visual checks of fire extinguishers, emergency lighting and smoke alarms. There were also recent maintenance certificates for all fire safety equipment within the home. The inspector was able to see the home’s file and risk assessments for the safe storage and use of chemicals that may be hazardous to health. The service users stated that they felt save at the home. 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 Standard No 24 Version 1.10 Score 3 Page 24 Park Avenue INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score 25 26 27 28 29 30 STAFFING x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 2 4 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x 3 Park Avenue Version 1.10 Page 25 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 33 Regulation 18(1)(a) Requirement The home must have sufficient staff on duty at all times to the needs of service users. The home must ensure that all new staff are fit before commencing work. The home msut ensure that a minimum of two stisfactory refernces are recived prior to staff commencing work. Timescale for action 01/05/05 2. 34 19(1) (a)(c) Schedule 2(5) 01/05/05 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 33 Good Practice Recommendations The home should risk assess and establish staffing level requirements prior to each shift to ensure that the correct level of staff is available on each shift. Park Avenue Version 1.10 Page 26 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Park Avenue Version 1.10 Page 27 - 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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