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Inspection on 29/06/05 for Royal Avenue Residential Home

Also see our care home review for Royal Avenue Residential Home for more information

This inspection was carried out on 29th June 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a friendly and caring support from staff, which is shown by the excellent rapport between them. Residents` needs are kept under regular review, with good support from Social Care Services staff. Residents are supported to express their views about the home and to determine what they do each day.

What has improved since the last inspection?

Policies and procedures required by the National Minimum Standards have been written.

What the care home could do better:

The timetable for the supervision of staff should be updated and kept to. Proposed changes in the management structure should help to keep paperwork up-to-date. The manager would like to do more staff training, as part of the continuing development of the skills of the home staff. The production of a service user guide in an appropriate format must be completed.

CARE HOME ADULTS 18-65 Royal Avenue Residential Home 77, 71 - 83 Royal Avenue Lowestoft Suffolk NR32 4HJ Lead Inspector John Goodship Unannounced 29 June 2005 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. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Royal Avenue Address 77, 81-83 Royal Avenue Lowestoft Suffolk NR32 4HJ 01502 572057 01502 531405 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) Mrs Patricia Barnard Mrs Patricia Barnard Learning Disability 16 Category(ies) of LD Learning Disability registration, with number of places I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13/01/05 Brief Description of the Service: The service at Royal Avenue offers accommodation and personal care to 16 young adults with a learning disability, including one person over 65 years old.The service users live together in three large terraced houses in a pleasant residential area of North Lowestoft. Two of the houses, Numbers 81 and 83 adjoin and the other, Number 77, is next but one on the same side of the street. There was rear access to all the houses via a small service road. Each had a small, secure garden where service users could enjoy the open air. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the first in the current inspection year. The previous inspection took place in January 2005. The inspection covered the latter part of the afternoon when residents away at day centres returned home. The manager was present for most of the time. 16 residents were living in the home. Only one of the standards inspected was not fully met, the development of a user-friendly service user guide. What the service does well: What has improved since the last inspection? What they could do better: I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 6 The timetable for the supervision of staff should be updated and kept to. Proposed changes in the management structure should help to keep paperwork up-to-date. The manager would like to do more staff training, as part of the continuing development of the skills of the home staff. The production of a service user guide in an appropriate format must be completed. 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. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 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 I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 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) 1,2,3,4 Residents had been properly assessed before admission and had had plenty of opportunities to test out the home. The work to assemble a service users guide in an appropriate format is underway but needs to be completed. EVIDENCE: The most recent admissions were the 4 people who transferred from another home last July. The procedure was described in previous reports and met the relevant standards. The home had an up-to-date statement of purpose, but was still working on a user-friendly service users guide, in a format suitable for the communication needs of the residents. This had been a requirements from the last 2 inspection reports and is repeated here. However, from discussion and observation of the residents, most of whom had lived in the home for several years, they were familiar with and understood the home’s facilities and their rights and obligations. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 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) 6,7,8,9. Residents are involved in the regular assessments and reviews of their care needs. They play a full part in all daily affairs and activities of the home. EVIDENCE: 2 residents had recently been involved in the review of their care plans, and they discussed the outcomes with the manager. They were aware of funding issues, and changes in day activity arrangements. Most residents were able to express their wishes about what they wanted to do. Others had their wishes interpreted by staff, who had a good understanding of the residents’ means of expressing themselves. One resident was being assessed by Social Care Services for a possible move. A person-centred plan would be drawn up. The manager was concerned at how the resident’s wishes could be known as they had no communication. This would be discussed at the review meetings. The home had a policy on the sharing of confidential information with other agencies. The manager was concerned that bank accounts for the latest admissions could not be opened because of the banks’ ID requirements. All of these residents I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 10 currently banked with the County Council. The manager was advised that this was the best place in the absence of a bank. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 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) 11,12,13,15,17. Residents have many opportunities to take part in daytime, evening and weekend activities. They are supported by staff if they wish. They are supported in developing personal relationships. They are able to make decisions about what they do, and how they contribute to the life of the home. EVIDENCE: Residents described their day time activities. Many went to a variety of day centres during the week, and talked about what went on, usually over tea. Several residents liked to go shopping with staff. They also went to the bank. One resident was able enough to go for walks on their own. Residents made friends through the clubs and day centres. Staff were supporting one resident after a relationship had ended. 5 residents were on holiday at the home’s caravan at Skegness with 2 staff. Meals were decided on a daily basis with the residents, some of whom helped in their preparation with staff support. Tea was a jolly and chatty time with sandwiches and home-made cakes. Residents are expected to look after their own rooms, to keep them clean, and as tidy as they prefer. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 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 standard(s) 18,19. Residents are appropriately supported in their daily lives and in the monitoring of their health needs. EVIDENCE: Evidence at this and previous inspections showed that the home provided support to residents who needed help with mobility or personal care. Residents could get up when they liked, unless they had to attend day services. The manager described the health concerns around one resident. Referral to the GP had resulted in an early appointment at a specialist hospital. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 13 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) 23. Procedures are in place and understood by staff for the protection of residents. EVIDENCE: The home’s procedure for the protection of vulnerable adults had been updated, and the home had the latest County policy folder. Training on this procedure was given during the induction period and signed as covered. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 14 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) 24,30 The 2 standards are met, providing residents with homely living with some independence in a secure environment. EVIDENCE: The home is divided into 2 separate houses, although residents of both use number 81 for some day activities. The houses were well maintained, and the home had its own handyman. Residents are encouraged to contribute to keeping their own rooms, and the communal rooms clean and tidy according to their abilities. Each house had a small secure garden for residents. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 15 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) 31,33,34,35,36 Residents have support from knowledgeable keyworkers, from a staff team who support each other. Residents are protected by the required recruitment procedures for their safety. Any changes in their needs are assessed for additional staff support. Staff are properly inducted and supervised, although the latter timetable has slipped. EVIDENCE: The appropriate number of staff were on duty during the visit, including the owner/manager and the deputy. The most recently appointed member of staff had been recruited following proper procedures. This person had been properly inducted and was finding the work very fulfilling as they got to know the residents. Extra funding had been agreed with Social Care Services for 3 months, to support a resident with a special behavioural difficulty. There was a clear policy on the responsibilities of keyworkers, which had been developed with them to ensure they understood their role. The policy on staff supervision was in accordance with the standard. However, the sessions were not up-to-date on the 2 monthly cycle. The manager would be putting the timetable back on track. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 16 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) 37,38,40,41. The interaction of residents and staff reveal the ethos of the home, with a family feel to the place. Policies and procedures protect residents and assure their records are confidential and up-to-date. EVIDENCE: The home is run as far as possible to create a family environment, with the residents as part of that family. The owner/manager has many years experience of supporting residents with learning disabilities, and the home feels welcoming, with friendly and supportive staff. All policies and procedures required by the National Minimum Standards have now been completed. Records are kept securely and are up-to-date. I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 4 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 3 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 3 x 3 3 x x I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 18 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 5(1) Regulation YA1 Requirement The Registered Person must provide for each service user a Service User’s Guide in an appropriate format that the person will understand. Information must include those matters detailed at performance indicator 1.2 in the National Minimum Standards. This is a repeat requirement, the timescale for which was 30th November 2004. Timescale for action 30/09/05 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 Good Practice Recommendations I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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 I54 - I04 S24482 Royal Avenue V235845 050629 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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