Inspection on 07/09/05 for Royal Avenue Residential Home

This inspection was carried out on 7th September 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 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

Royal Avenue Residential Home 12/11/08

Royal Avenue Residential Home 28/02/07

Royal Avenue Residential Home 29/06/05

Royal Avenue Residential Home 13/01/05

Royal Avenue Residential Home 09/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Royal Avenue 77, 81 - 83 Royal Avenue Lowestoft Suffolk NR32 4HJ Lead Inspector John Goodship Announced 07 September 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. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Royal Avenue Residential Home 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 Care Home 16 Category(ies) of LD Learning Disability (16) registration, with number LD (E) Learning Disability (1) of places Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 29/06/05 Brief Description of the Service: The service at Royal Avenue offers accommodation and personal care to 16 younger adults with a learning disability, including one person over 65 years old. The residents 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. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second inspection in the current inspection year. It was announced. The manager and the deputy were present throughout. The inspection lasted from 10.00am until 4.00pm. Several residents were in the house in the morning and other ones returned at lunchtime. One relative was in the house and spoke to the inspector. They were very happy with the care received by their relative. The inspector spoke to all the residents who were having lunch. Their comments are included in the body of the report. 4 comment cards were received from relatives. All were complementary. One said how happy and independent their relative had become since moving to the home. Staff were always welcoming, and kept relatives fully informed. All the national minimum standards have now been inspected, and they were all met. What the service does well: What has improved since the last inspection? What they could do better: There are no requirements or recommendations from this inspection. The manager and staff however are always trying new ways to raise the expectations and independence of residents. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 6 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. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.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 Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.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. Documents gave all the required information to allow an informed choice to a prospective resident. EVIDENCE: The home had completed the service users’ guide in pictorial format. It included information about residents’ meetings and satisfaction surveys. No new residents had been admitted in the previous 12 months. However the process for prospective residents to choose and try out the home, and for the existing residents to get to know the newcomer, were in place. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.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) 6,7,8,9,10. 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: Care plans held comprehensive information, which was up-to-date. They showed evidence of regular reviews, and topics had been rewritten when necessary. 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. Some residents spoke about changes to their life and day services which they had asked for, and said how pleased they were with the changes. There were regular residents’ meetings and satisfaction surveys. The home had been supporting one resident who was the subject of a disagreement between their parent and the funding authority on the location of Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 10 their care. The home was ensuring, as best they could, that this resident was protected from anxiety, and that their rights were recognised. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.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) 11,12,13,14,15,16,17. 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. 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. At the time of the inspection, the home was providing temporary day care to a client of Social Care Services, until more permanent arrangements could be made. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 12 The inspector joined the residents for lunch which was a friendly and talkative time. The menu had two choices for main course. Residents had good appetites, and most ate up everything on their plates. They enjoyed talking to the inspector about their morning, and about the other activities they had done, or were planning. Residents described, and showed photos of, their recent holidays to the large caravan belonging to the owner. They also talked about the day trips to see shows in London and elsewhere. Some residents attended courses at the local college. One resident initiated a change of their day centre because it was not meeting their needs. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 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) 18,19,20,21. Residents are appropriately supported in their daily lives and in the monitoring of their health needs. EVIDENCE: The food intake of one resident was being monitored as they were not eating properly. However no weight loss was apparent. The health of an older resident was of concern following a seizure. All appropriate action had been taken by the home, and the results of tests were awaited from the hospital. The home had information from residents or relatives on the preferred arrangements at the end of life. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 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) 22,23. Procedures are in place and understood by staff for the protection of residents. EVIDENCE: There had been no complaints over the previous 12 months. 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. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 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) 24,25,26,27,28,29,30. All these standards are met, providing residents with homely living with independence within a secure environment. EVIDENCE: A fire risk assessment was in place. Maintenance records were up-to-date and showed appropriate timescales for servicing. In no.81, a new kitchen had been fitted, with new flooring. It had also been redecorated. The kitchen in no 77 was planned to be re-fitted in October 2005. Fire door closers had been fitted to ensure doors which were normally kept open would close at the sound of the fire alarm. 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. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 16 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) 31,32,33,34,35,36. Residents have support from knowledgeable keyworkers, and 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. EVIDENCE: Discussions with staff confirmed that induction and foundation training had taken place. Other specialist training had also been done eg unisafe, care objectives, epilepsy, autism. 4 staff were qualified to NVQ Level 2 or above. 3 staff were scheduled to start their course in the autumn. Inspection of the files of the most recently appointed staff showed that all recruitment procedures for the protection of the residents had been followed. Supervision sessions for staff had re-started. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 17 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) 37,38,39,40,41,42,43. The interaction of residents and staff confirm 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. With the introduction of the policy on Access to Files/Confidentiality, the home had now completed all the policies and procedures required by the national minimum standards. Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 18 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 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Royal Avenue Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 19 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. 1. Standard Regulation NONE 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. 1. Refer to Standard NONE Good Practice Recommendations Royal Avenue I54 -I04 S24482 Royal Avenue V239357 050907 Stage 04.doc Version 1.40 Page 20 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. 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