Inspection on 09/10/06 for Park Avenue

This inspection was carried out on 9th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 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 09/07/2008.

CARE HOME ADULTS 18-65 Park Avenue 74 Alexandra Road Farnborough Hampshire GU14 6DD Lead Inspector Tracey Box Unannounced Inspection 9th October 2006 09:30 Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Avenue Address 74 Alexandra Road Farnborough Hampshire GU14 6DD 01252 547882 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Lawrence Alexander Mrs Diane Alexander Sarah Mary Guilfoyle Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 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 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, 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. The manager confirmed the fees for the home range between £388.60-£528.00 per week. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The opportunity was taken to look around the home, view records, procedures and talk with two of the three service users who live at the home, who said they were happy at the home. The inspector also had the opportunity to observe the interaction between service users and staff. The staff on duty during this visit felt they were supported to do their job. The commission has received information from the home prior to this visit. This has provided additional evidence that the home is meeting the key standards. The CSCI sent out three relative/visitor questionnaires, however none were returned. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefited from having their needs and aspirations assessed on a regular basis. EVIDENCE: Evidence from service users’ files showed that they had all had care management assessments prior to moving into the home. In addition, the home undertook further assessments of service users’ needs on a regular basis. Assessments were comprehensive and addressed a full range of need areas, including psychological and mental health needs, communication and employment/educational needs. Individual Care Plans on file clearly related to the issues identified through the assessment process. Individuals needs and aspirations are discussed at their annual reviews, records showed these occurred and involved social services and the service users families if they wished. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users know their assessed and changing needs are reflected in their individual plans. Service users are fully supported to make decisions in all areas of their lives. Risk assessments are in place and ensure service users are able to take risks as part of an independent lifestyle. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 9 EVIDENCE: One service user spoken with was clear that he was able to make his own decisions about his life and lifestyle and that these were supported by staff as well as being encouraged to participate in activities by herself, such as preparing and cooking lunch and administering own medication. Staff spoken with were able to demonstrate an understanding of the need to support service users to make their own decisions, this is also covered during new staff induction. Records made at service users annual reviews confirmed service users are fully supported to undertake activities that they have identified. Service users had keys to their rooms. Individual bedrooms were decorated to each service users taste, one service user said ‘I like my bedroom, I chose the colours. The Statement of Purpose and Service User Guide were clear about the rules in the home and each service user had a copy. These also contained information on who service users could talk to if they were unhappy about any aspect of the home. Both documents were produced in an easily accessible format for service users who had some difficulty reading. Risk assessments were on file for each service user to cover areas where potential risk had been identified, all of which had been reviewed every three months. The risk assessments seen were clearly written and staff said they were easy to follow. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. The home actively promotes appropriate personal, family and sexual relationships. Service users’ rights are protected and they enjoy a healthy and nutritious diet. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 11 EVIDENCE: A service user described the home as ‘nice place to live with great staff’. 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. Records showed a variety of activities take place, including shopping, visits to the local pub, clubs and a gym. Service users attend a day centre which provides the opportunity for socialising with peers, employment projects, as well as attending the local college to complete English and maths courses. The home has one vehicle, which service users use to attend their activities. During the evenings the majority of service users like to go to the cinema, pubs, go swimming or generally relax watching television. The manager said the home arrange disco’s, manicure sessions, poetry evenings The manager said the local area provides good public transport. Staff are aware of the importance of supporting service users to follow their religious beliefs, and of listening to opinions without forming judgements. The home arrange different culture evenings, where service users experience food and music from different countries. Service users are fully involved in planning, preparing and cooking their meals, staff provide support in considering the need for balanced and healthy meals. Records of meals eaten showed that the food was healthy and varied. Each service user buys their own food on a weekly basis and alternatives are taken into consideration during planning the weekly shop. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from having personal support in the way they prefer. Comprehensive procedures ensure service user’s physical and emotional health needs are met. Service users are protected by appropriately trained staff, who follow the homes policies and procedures for dealing with medicines. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 13 EVIDENCE: The service user spoken with was able to confirm that he had been consulted about how he preferred to receive personal care and this had been recorded on his care plan. The care plan was clearly written and specific enough to explain to each member of staff the exact support they needed to give and how it needed to be given. Staff spoken with were clear about each person’s care plan and individual preferences. Care plans include records of visits to healthcare professionals, social workers and a community psychiatric nurse. National Health Service (NHS) direct posters were displayed showing details of how to contact the service. The manager explained service users are finding it difficult to get an appointment with a NHS dentist in the area, due to the public demand. The staff spoken with confirmed that currently there is one service users who self-administer their own medication. The staff spoken with confirmed that service users who self-administer are regularly risk assessed and monitored to ensure that they are safe to do so and understand the importance of the medication they are taking. This was reflected in the records sampled. The staff were observed and discussed with the inspector good medication administration practices that are reflected in the homes policy and procedures that were briefly sampled. The medication receipt, administration and disposal records were seen by the inspector and found to be satisfactory. Records showed all staff have received medication training. The manager showed the inspector the home’s medication storage cupboard that was clean with medication stored correctly in date and in sufficient quantities. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 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 the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for protecting service users and responding to concerns are satisfactory. EVIDENCE: One service users was clear of who they would talk to if they had to complain, he also said that the staff are very good and always listen to him. The home’s complaint records were seen and found to have no entries, the manager said this was because they have not received any complaints. The staff spoken with confirmed that the complaints log is up to date. The staff confirmed that they receive training in Abuse of vulnerable adults. There has been no allegation of abuse at this home. The home has a copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure that is available in the home’s office. The inspector looked at the financial records of three service users who said they preferred the home to hold the majority of their cash. The cash held equated to the amount recorded for each individual. The amount of cash held in the home for each service user is also checked by staff after each staff shift change over. Money is stored in a cash tin which is locked in a cabinet in the staff office. Service users have their own bank accounts or post office accounts, and staff support service users to access their money. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 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 the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally the home presents as clean, hygienic and comfortable providing a safe, homely environment for service users to live in. EVIDENCE: The home appeared clean, no offensive odours were detected. However the carpet on the stairs had stains on it, the manager said she has arranged for a cleaning company to clean on a regular basis but the stains remain. One service user said they chose the colours for their bedroom, one vacant bedroom will not be decorated until a prospective service user chooses the colours. Two shower /toilets have been refurbished, one bathroom is due to be refurbished with a new suite. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 16 Staff said they have completed infection control training, and were aware of the home’s policies and procedures of hygiene issues. The inspector saw records of staff training, the manager said recently a cleaning rota was introduced for service users to participate with, one service user cleaned the kitchen after cooking her lunch. The home’s radiators and pipe work are safe ensuring that all potential hot surfaces are kept to low temperature. The garden appeared well maintained and is accessible to service users. The manager explained service users are encouraged to furnish the room with personal belongings, furniture and pictures to make it feel like home. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users individual and joint needs are met by appropriately trained staff who are well supported and supervised. Service users are protected by the homes practices regarding the recruitment and selection of staff. EVIDENCE: Records of staff training reflect the training staff have received. The home has a suitable recruitment and selection procedure in place and the records of three staff demonstrated that this was followed appropriately. All staff had had necessary checks prior to beginning work in the home. Staff confirmed they receive regular structured supervision, however their manager is approachable at all times should they need to see him. The service users spoken with described the staff as ‘friendly, helpful’ and make us laugh. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 18 The team manager confirmed she feels there are sufficient staff on duty to meet individual service users. Since the last inspection the number of staff on duty during the weekend has improved. The staff duty rotas sampled also confirmed this. The staff spoken with confirmed that staffing levels at weekend in general had improved. The service users spoken with said that there was always enough staff to look after them and that they felt safe. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed efficiently and service users benefit from a well run home. Service users views are sought to ensure they are involved in the selfmonitoring, reviewing and development of the home. The health, safety and welfare of service users is fully promoted with staff being well trained and showing a sound knowledge within the areas of health and safety. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager confirmed she has completed her Registered Managers Award (RMA) and has been registered manager since January 2006. The manager is a qualified ‘train the trainer’ in Adult protection, medication risk management, infection control, manual handling and dementia, which enables her to provide training to the staff team. The staff confirmed there is clear management structure they feel supported by their manager and benefit from regular supervisions and staff meetings, the inspector saw records which show staff receive regular supervisions. The inspector sampled three staff files, which confirmed staff receive regular mandatory training, and specific training to meet individuals needs, such as adult protection and managing challenging behavour. The manager confirmed that the home’s induction programme has been assessed against the Skills for Care Council induction standards and staff have been working to the Learning Disability Award Framework (LDAF) standards. One member of staff told the inspector “I feel that the training I have done so far has given me the skills I need to support service users who live here, and the staff as I have completed team leading training.” The provider has developed a quality assurance system which the home use to gain views and opinions from the people who use the service, a questionnaire was sent to service users and their families/representatives in May’06, which identified some minor actions, which were identified in an action plan that the manager discussed at the manager’s monthly meeting to ensure the issues are actioned. The manager said the home have regular service users meetings. The inspector saw records of monthly regulation 26 visits. The staff complete regular weekly health and safety checks to ensure the safety of the building. Certificates were seen to show regular servicing of the boiler, electrical items and liability insurance. Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park Avenue DS0000012056.V315318.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 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. 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